Beth Israel Medical Center’s Success in Regulated Medical Waste Reduction November 12, 2004 Janet...
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Beth Israel Medical Center’s Beth Israel Medical Center’s Success in Success in Regulated Medical Waste Reduction Regulated Medical Waste Reduction November 12, 2004 Janet Brown 212/941-2486 [email protected] www.h2e-online.org
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Transcript of Beth Israel Medical Center’s Success in Regulated Medical Waste Reduction November 12, 2004 Janet...
Beth Israel Medical Center’s Beth Israel Medical Center’s Success in Success in
Regulated Medical Waste ReductionRegulated Medical Waste Reduction
November 12, 2004Janet Brown212/941-2486
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Regulated Medical Waste – One part of a Regulated Medical Waste – One part of a Comprehensive Waste ProgramComprehensive Waste Program
<5%10-15%
85%
Hospital Waste(Trash) Regulated Medical Waste Hazardous Waste
Hospital Waste (Trash)
Includes 2%pathologicalwaste
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$-$200,000.00$400,000.00$600,000.00$800,000.00
$1,000,000.00$1,200,000.00$1,400,000.00$1,600,000.00$1,800,000.00
Dollars Spent on RMW
PETRIE SINGER PACC KHD Total
Campus Name
Before
After
Reduced Waste Fees Reduced Waste Fees
Waste Fees reduced by over $1,000,000Per year system-wide.
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Beth Israel Medical CenterBeth Israel Medical Center
Petrie Campus – 930 beds (1990’s) Singer Division – 230 beds Kings Highway Division – 212 beds Phillips Ambulatory Care Center –
200,000 outpatient visits per year St. Lukes Roosevelt – 400 each Long Island College Hospital – 500
beds
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Fear of Waste Fear of Waste → → MWTA MWTA → Garbage Nightmare!→ Garbage Nightmare!
April 1989 – 2,300 pounds RMW/Day
$27,000/month. July 1989 – 11,000 pounds RMW/Day
$130,000/month FTE’s – 15 to 26! (11 x $28K = $308K) 808 lbs. of boxes/day! (just the weight
of packaging alone)
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Petrie Campus – 930 bedsPetrie Campus – 930 beds 1,000 doctors, 1,000
nurses 6,000 employees Operating Budget of
$650,000,000 and challenged to cut $120,000,000 to $180,000,000. (20 – 25% over three years)
No space, no time, no money
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Successful ProgramsSuccessful Programs
Simplicity Economically Viable Communication/Education Support Shared Savings Buy-in from Leadership Dedicated Staff Person Employee Recognition
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RMW ReductionRMW Reduction
Reduce volume of RMW.
Switch to a reusable sharps container.
Switch to reusable shipping containers for RMW.
Address # of FTEs handling RMW.
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Step by Step to RMW ReductionStep by Step to RMW Reduction
Infection Control Committee – Policy Development
Gather baseline data – Project savings Reduce red bags BEFORE evaluating
onsite treatment technologies Review waste contracts – non-incineration
treatment of RMW. Consider on-site versus off-site. Review sharps contracts.
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What goes in a red bag anyway?*What goes in a red bag anyway?*
Blood, Products of Blood Anything caked, soaked or
dripping in blood Tissues from surgery and
autopsy Cultures and stocks of
infectious agents and discarded vaccines.
Suction canisters with any fluid. Hemovac and pleurovac drainage.
Operating room waste saturated with body fluids as defined by OSHA.
Waste from patients isolated with HIGHLY communicable diseases. (These are CDC Class IV definitions including Ebola, Lassa Fever, Marburg and Small Pox. NOT such conditions as AIDS< Hepatitis or TB.)
Sharps, including syringes and unused sharps.
IV Bags, tubing, foley bags Non bloody gloves Packaging, Urine-soaked waste, feces,
vomit Blood-tainted waste
(Note distinction between blood-soaked and blood-tainted. A little bit of blood on an item can go in the regular waste stream.)
YES! RED BAGNO! Put in Clear Bag
* Check your local regulations
Questions? Call Waste Manager
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Waste Segregation – ImplementationWaste Segregation – Implementation
Present PlanSurvey FacilityDevelop MaterialsPurchase equipment, supplies.Issue MemoContainer placementProperly Labeled, SignageProper placementTraining (never ends.)Monitoring and reportingContinue!
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Suction CanistersSuction Canisters
http://mntap.umn.edu/health/91-Canister.htm
40% of Operating Room Waste is from suction Canisters!
Potential for occupationalExposure in transport.
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ObstaclesObstacles Fear of Waste Lack of training Old habits No clear can
available Overfilled clear
lined can Ran out of clear
bags!
Housekeeper collecting clear bags into red bag.
Use closest can Change of Staff No time No can available Confusion of
Isolation rooms Confusion over
body fluids
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Reusable ProductsReusable Products
Supply Chain: Include waste fees when comparing disposable versus reusable products.
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Disposable vs. Reusable Sharps Disposable vs. Reusable Sharps ContainersContainers
Nurses were responsible for changing containers
Containers often overfilled. Containers often removed
without being closed properly.
Disposable filled containers were stored in the soiled utility rooms
Too many employees handling sharps containers.
Beth Israel incinerated approximately 2,700 disposable sharps containers per month at one site alone!
Vendor offered a full-service sharps management service.
One dedicated person for handling sharps.
Much fewer incidents of overfilled containers.
Nicer looking container Reduced needle sticks
associated with waste Elimination of 2,700
containers per month! Reduced liability Positive feedback from
staff.
Disposable Reusable
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10 Steps to Reducing RMW10 Steps to Reducing RMW
http://www.h2e-online.org/ pubs/tensteps/Rmw10steps.pdf
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For more information:For more information:
Janet Brown, Partner Coordinator Hospitals for a Healthy Environment 3 West 18th Street, 7th Floor
New York, NY 10011 Phone: 212/941-2486 Cell: 347/393-3809 Fax: 212/941-1422 Email: [email protected]
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Toll Free Hotline: Toll Free Hotline: 800-727-4179800-727-4179
E-mail: E-mail: [email protected]@h2e-online.orgwww.h2e-online.orgwww.h2e-online.org
Kelly Heekin, Communications [email protected]
202-234-9656 Emily Cronenwett, Program Assoc.
[email protected] 603-643-6710
Eydie Pines, Special Projects [email protected]
603-643-6710 Jolie Patterson-Rosst, Awards Coordinator
[email protected] 202-234-0091 ext. 10
Laura Brannen, [email protected]
603-643-6700 Chen Wen, Director
[email protected] 202-564-8849
Janet Brown, Partner [email protected]
212-941-2486, cell 347-393-3809
Sarah O’Brien, Champion Coor. [email protected]
(802) 479-0317 Cecilia DeLoach, State Partnership Programs
800-727-4179
H2E Program ContactsH2E Program Contacts
