The Growing Focus on Waste Segregation & Sustainable within the Healthcare Industry Caring for patients, the environment, and the bottom line.

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1 The Growing Focus on Waste Segregation & Sustainable within the Healthcare Industry Caring for patients, the environment, and the bottom line. Stefani Kirchhoff, M.S., Sustainability Manager WM Healthcare Solutions, Inc. THINK GREEN.

2 What We ll Cover Today About Waste Management The Situation Waste Generation by Healthcare Institutions Sustainability in Action - A Solution to Lowering Environmental Costs Performance Monitoring and Best Practices to Reduce and Redirect Waste

3 About Waste Management Dedicated healthcare industry experts nationwide Tailored integrated environmental solutions for healthcare facilities Reliable environmental services State-of-the-art treatment facilities Manage complex types of healthcare wastes A Waste Management company, North America s largest environmental services company Waste Management s Integrated Environmental Solutions for healthcare are endorsed by the American Hospital Association

4 The Situation

5 State of the Industry Recession Reform, initiatives starting Sept. 23 Continued Regulatory Scrutiny Focus on the environment

6 The Recession s Impact Lingers

7 Healthcare Reform: Key Provisions Provides coverage to 32 million uninsured people by Changes insurance rules to protect consumers. Builds on existing employer- and government-sponsored insurance programs. Tests ways to tie payment of hospitals and physicians to quality improvement. 7

8 Continued Regulatory Scrutiny Typical RCRA Violations: Labeling HW manifests Improper management of chemical (incl. mercury) waste Mercury Amalgams Fluorescent lamps Thermometers HW employee training Typical OSHA Viloations: Bloodborne pathogens (exposure control plans, universal precautions) Hazard communication (hazcom plans) Managing New Regulations: Haz pharmaceutical waste regulations 8 8

9 Adapting to the Situation As concerns over profitability take center stage, the facilities that will flourish are the ones that contain costs without compromising quality. But how do you achieve this? Increase cost savings; Safeguard your facility, employees and patients; Improve operational performance; and Meet environmental goals.

10 Understand and Manage your Waste Streams

11 Typical Healthcare Waste Streams Solid Waste Composition 10-15% Medical Waste Sharps Regulated Medical Waste <5% Hazardous Waste Mercury/Chemicals E-Waste (vary) Universal waste (vary) Haz & Non-Haz Pharmaceuticals 80% Solid Waste Confidential Documents C & D Recyclables (plastic, glass, metal, etc.) 11

12 Healthcare Waste Complex Wastes with Environmental Impact Category Types Description Infectious Waste (RMW) Hazardous Chemicals (RCRA) Red bag Sharps Universal Waste Disposable infectious waste, Human tissue, bio material Injectibles, needles, scalpels, labware (e.g. pipettes) E-waste, fluorescent bulbs, batteries, electronics, paints Path/chemo Reagents and chemo-therapy Pharma Off-spec/old pharma products (Not controlled substances) Specialty Waste Materials Other Mercury & Radiological waste Solid Waste Materials C & D Solid waste Construction and Demolition waste Noninfectious garbage and trash Recyclable Materials Recyclables HIPAA Paper, plastics, metals & glass other re-useable items Confidential patient documents

13 Common Hospital Recyclable Waste Generation By Area Sources Of Waste Fiber Plastic Metal Glass Shipping and Receiving Nutrition Services Laboratory Area Patient Care Areas Administrative Areas OCC,WP,CP, NP OCC, Boxboard OCC, WP, CPO, CP, Mags NP, Mags, WP, CP, CPO, OCC, WP, CP, CPO, NP, Mags, OCC #4 LLDPE Stretch Wrap, #6 PS - Pkg Peanuts #1 PET, #2 HDPE, #6 PS #2 HDPE, #5 PP, #6 PS - Pkg Peanuts Al/Met Cans Al/Met Cans #2 HDPE, #5 PP Al/Met Cans #1 PET Al/Met Cans Glass: Clear and Colored Glass: Clear and Colored Chemical (Haz & Non-Haz) Grease, Aerosol Cans Wood Pallets Organic Food Waste Others Donations (medical equipment, furnishing, etc.) Donations (medical equipment, furnishing, etc.), Batteries ewaste, Donations (furnishings, desks, chairs, etc.), Ink/Toner Cartridges Radiology, Invasive #2 HDPE, #5 PP, WP, CP, OCC Cardiology, CT Scan Film, Clear Glass Silver Recovery Ink/Toner Cartridges Surgical Services OCC, CP, WP, #1 PET, #2 HDPE, Mags #5 PP, #6 PS Clear Glass Ink/Toner Cartridges Pharmacy OCC, WP, #2 HDPE Plastic, Al/Met Cans Ink/Toner Cartridges Dialysis #2 HDPE, #3 PVC, WP, CP, NP, #6 PS, #4 LLDPE Mercury Wastes Mags, OCC, Box Glass: Clear Batteries (Alkaline And Other Types), Stretch Wrap, #4 Al/Met Cans from Monitoring Board, Books, and Colored Toner Cartridges, Outdated Supplies, LDPE Bags, #5 PP Technology Mixed paper Bottles Physicians Offices WP, NP, Mags, CP #2 HDPE Al/Met Cans ewaste, Ink/Toner Cartridges Medical Records WP, CP, CPO, NP Al/Met Cans ewaste, Ink/Toner Cartridges Housekeeping/Environ Batteries (from bathroom dispensers & WP, OCC #2 HDPE Aerosol Cans mental Services faucets) Facilities Management (includes administrative area, plumbing, carpentry, electrical, etc.) WP, OCC #2 HDPE Al/Met Aerosol Cans Wood (yard waste) C&D Debris, Wood Pallets Hospital Wide Phone Directories Florescent Fixtures, ewaste, Donations (Furnishing, Desks, Mattresses, Carpets, Administrative materials, Dishware, etc.), Public Areas (Lobbies, Waiting Areas, Grounds) Mags, NP Al/Met Glass: Clear and Colored Donations (Furnishing, chairs, Carpets, etc.)

14 A Solution Takes Shape THINK GREEN.

15 Sustainability What is it? Financial measure People measurement Planet component What does it mean to you? Lower your costs for environmental services Safeguard your employees, community and reputation Adopt best practices that benefit your business and the environment Where do you start? 15

16 Integrated Solutions to Fit Many Sizes Whether you re a hospital, clinic or multi-specialty practice, an integrated model of services may suit your environmental and economic objectives. Training your employees to segregate waste correctly can help create savings.

17 Why an Integrated Solution? To help manage the challenges of clinical, regulatory, operational and environmental performance throughout your facility. Small to large quantity generators can benefit 17

18 Assess Areas for Improvement Opportunities Facilities (e.g. correct collection locations and containers) People (e.g. staff training and education) Process (e.g. appropriate waste segregation, compliance practices) Environmental impact (e.g. opportunities to reduce, reuse, recover)

19 Implement Viable Sustainable Options Consolidate waste handlers/vendors Right size your waste pick-ups Implement viable segregation program Cardboard/Paper Recycling Single Stream Recycling Donations Programs Mercury, amalgam, U-waste, E-waste Recycling Provide appropriate waste handling training for employees Consolidate/Streamline invoicing and manifesting

20 Performance Monitoring and Best Practices to Reduce and Redirect Waste THINK GREEN.

21 Maximizing Opportunities Have you reviewed your waste materials and found all of the opportunities? January 2010 August 1,

22 Continually Challenge Your Assumptions About Managing Waste Is your supply chain creating unnecessary waste? Where can you streamline operations and materials? Are your employees part of the solution? Are you trying to save money in the wrong places? 22

23 Reducing and Redirecting Waste is Key Diversion Avoidance Incinerate-ONLY $1.50/lb* Regulated Medical Waste $.25/lb* *Amounts shown are hypothetical, only. Municipal Solid Waste $.03/lb* Recycling ~$.00/lb*

24 The Results

25 Sustainability in Action Integrated Customer Resultss Improved aesthetics and continues to save money Instituted a centralized collection area for all waste Replaced old units with green units Reduced environmental impact Landscaping debris for composting Electronics waste Future: Medical plastics Good neighbors Donated reusable items from old buildings and storage to a worthy cause in their community. The City recognized the facility for its green efforts.

26 Improvements to Facilities Equipment and Product Placement Before After Clean up and reconfiguration required. Rejuvenation included addition of a recycling compactor. 26

27 Improvement to Environmental Impact More Materials are Recycled Before After Comingled waste and recycling material improperly dumped. Metal, wood, pallets and green waste now 100% recycled. 27

28 Improvement to Compliance and Participation Before After Identified compliance issues in regulated medical waste storage areas. Standardized and converted regulated medical waste bins. 28

29 Improvement to Collection Process Centralized Collection Area Before After Multiple non-regulated drop-off and collection areas Established a satellite collection area in a safer, monitored location. 29

30 Questions or Comments THINK GREEN.

Recycle whatever can be recycled according to the DHMC Recycling Program! See the intranet site or the last page of this document for details.

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