1. CREATING AND RUNNING WASTE-MANAGEMENT & MATERIALS RECOVERY PROGRAMS IN COMPLEX ORGANIZATIONS WILLIAM BORGES CREATING AND RUNNING WASTE-MANAGEMENT & MATERIALS RECOVERY PROGRAMS IN COMPLEX ORGANIZATIONS WILLIAM BORGES © William Borges, All Rights Reserved, 2013

2. A BROAD DEFINITION OF WASTE AT PROGRESSIVE ORGANIZATIONS THAT USE CONTINUOUS-IMPROVEMENT MANAGEMENT SYSTEMS IN THE PAST, WASTES WERE SIMPLY THOSE THINGS WE THREW AWAY IN THE PAST, WASTES WERE SIMPLY THOSE THINGS WE THREW AWAY THINGS LIKE: SOLID, HAZARDOUS, AQUEOUS, GASEOUS MATERIALS – PLUS ENERGY – OF ALL KINDS THINGS LIKE: SOLID, HAZARDOUS, AQUEOUS, GASEOUS MATERIALS – PLUS ENERGY – OF ALL KINDS HOWEVER, THANKS TO CONTEMPORARY MANAGEMENT THINKING, THE COMPREHENSIVE DEFINITION OF WASTE IS: THIS INCLUDES THINGS LIKE: DELAYS, MISTAKES, DEFECTS, WORK-AROUNDS, REWORK, ACCIDENTS & NEGLIGENCE SUSTAINABILITY-FOCUSED WASTE- MANAGEMENT AND MATERIALS- RECOVERY ACTIVITIES CAN OFTEN BE INTEGRATED INTO ADMINISTRATION AND OPERATIONS PROCESSES WITHOUT A LOT OF FUSS “ANYTHING THAT DOES NOT ADD VALUE TO A PRODUCT OR SERVICE” © William Borges, All Rights Reserved, 2013

3. EXAMPLES OF WASTE-STREAM COMPONENTS AT HOSPITALS & OTHER HEALTHCARE DELIVERY FACILITIES EXAMPLES OF WASTE-STREAM COMPONENTS AT HOSPITALS & OTHER HEALTHCARE DELIVERY FACILITIES CONVENTIONAL SOLID WASTE HAZARDOUS WASTE INCLUDING LABORATORY & CLINICAL CHEMICALS, INFECTION-CONTROL AGENTS, CLEANING AGENTS & MAINTENANCE MATERIALS REGULATED MEDICAL WASTES INCLUDING INFECTIOUS, BIOHAZARD, “SHARPS”, “RED-BAG” WASTE, PHARMACEUTICAL WASTE &RADIOLOGICAL WASTE USED EQUIPMENT, INCLUDING IT AND MEDICAL DEVICES UNUSABLE SUPPLIES ENERGY WASTES FROM EQUIPMENT OPERATION, LIGHTING, STEAM PRODUCTION, HVAC SYSTEMS, WATER HEATING, FOOD SERVICE, PERISHABLES STORAGE, etc. FURNITURE FOOD WASTE LANDSCAPE CUTTINGS CONSTRUCTION & DEMOLITION DEBRIS IRRIGATION & STORMWATER RUNOFF GASEOUS DISCHARGES SANITARY & INDUSTRIAL AQUEOUS DISCHARGES LARGE VOLUMES OF USED LINENS & GARMENTS © William Borges, All Rights Reserved, 2013

4. TASK 1 – Secure a C-level executive mandate to create and operate an advanced waste- management program that supports specific organizational policies and strategic objectives TASK 2 – Define generalized lifecycles & quantified generation baselines by waste-stream component TASK 3 – Audit regulatory compliance for all current waste streams & related activities TASK 4 – Assess efficiency of current waste- management processes, facilities, equipment, labor and other resources in terms of meeting objectives with least cost, effort and risk TASK 5 – Set specific waste-stream-component reduction, reuse and recycling goals, plus unit and personal accountabilities for their achievement TASK 6 – For each waste stream component, design a PDCA-based work process that will achieve its reduction, reuse and recycling goals TASK 7 – Define and implement the structural and behavioral change-management process to introduce, actively manage and sustain each waste stream’s reduction, reuse and recycling work process TASK 8 – Periodically – i.e., no less than quarterly – review progress toward the stated reduction, reuse and recycling goals – as well as achievement of unit- and personal-level accountabilities – for each waste stream component TASK 9 – Celebrate successes and/or implement immediate and effective corrective actions WHATWHYHOWWHOWHENWHERECHECK WASTE-MANAGEMENT & MATERIALS-RECOVERY PROGRAM DESIGN TEMPLATE © William Borges, All Rights Reserved, 2013

5. CLOSING REMARKS & Q&A CLOSING REMARKS & Q&A © William Borges, All Rights Reserved, 2013 SYSTEMATIC PROGRAM MANAGEMENT COMPLIANCE INCREASED REVENUES EFFICIENCY COMPETITIVE ADVANTAGES THROUGH TRANSPARENCY