1. Improving Health Care’s Environmental Performance: A Technical Assistance Perspective Catherine Zimmer, MnTAP National Environmental Partnership Summit Atlanta, GA May 10, 2006

2. Background MnTAP description Mission –Pollution Prevention (P2) focus Tools and Resources www.mntap.umn.edu

3. Partnerships Connections to regulatory staff Healthcare Environmental Awareness & Resource Reduction Team (HEARRT) –Ongoing since 1997 Hospitals for a Healthy Environment (H2E) –Statewide workshops in ’01 & ‘03

4. Strategies Talk up P2 Meet regulated community where they’re at –Might need compliance assistance –Waste gets closer look for P2

5. Opportunities Pharmaceuticals –Epinephrine Formalin –Potential regulation Mercury –Lab reagents –Pharmaceuticals –Other equipment

6. Tools Tech Diffusion Model –Formalin recycling –Mercury Elimination Formalin fact sheet Mercury Fact Sheets –Lab Reagents –Pharmaceuticals Intern program

7. Challenges –Data management ~140 hospitals in MN Multiple contacts in each Multiple waste streams –Data Collection From facilities –Get info prior to solution From regulators –Format differences –Perceptions Compliance questions Non-regulatory

8. Benefits Improved recognition of waste More interest in P2 Improved communications and relationships P2 information disseminated Better documentation

9. The Stars Line Up! Seven hospitals add formalin distillation –Savings ~$250,000 annually Mercury equipment elimination –~1000 pounds Dade Behring –Eliminates mercury from 6 out of 7 reagents Three facilities eliminate B5 fixative –Savings ~ $3000 Abbott Northwestern –Eliminates mercury from five reagents –Eliminated “acid bath”: $610 disposal savings Occupational health savings $300- 13,500.

10. P2 Results (cont.) Shriner’s Hospital –eliminated epinephrine waste 16 lb, ~$2000 disposal savings Stay VSQG Hutchinson Hospital –eliminated most mercury Falls Memorial Hospital –eliminated mercury reagent –242 lb, ~ $1000 disposal cost savings

11. H2E Results 147 Hospitals 24 H2E Partners 5 Mercury award winners 3 Partner for Change awards

12. HEARRT Results Prior to 2003 –Regular attendance ~20 –~5 facilities Subsequent –Attendance ~50 –~12 facilities –Hospital Association

13. Next Steps Maintaining relationships Regulatory integration –Multi-media, pollution prevention inspections Continued technical assistance –2006 Pharmacy intern projects

14. Summary Need both regulatory drivers and incentives Use variety of tactics and tools Healthcare responsive Regular Communication Persistance