1. Developing a sustainable system for managing and reducing medical waste Stephanie Ng, RN University Health Services | UT Austin

2. Objectives  Examine the importance of reducing the environmental impact of student health centers  Define methods for assessing waste patterns  Discuss how to develop, implement, and evaluate a waste reduction and recycling plan  Field questions

4. Promote Healthy Values  “Do no harm”

5. Environmental Benefit  Hospitals and medical facilities are some of the largest waste producers in the country

7. Fiscal Benefit  Cheaper to make products using recycled materials  Save on landfill and incinerator costs

8. Health and Sustainability  Human health and environmental health are linked

10. Types of Waste  Solid waste  Regulated medical waste  Hazardous waste  Pharmaceutical waste  Universal waste  Recyclables  Construction and Demolition Debris  Composting

11. Reduce Biohazard Waste  Biggest cost for us  Other consequences:  Incineration  Can set an example for labs across campus and future medical school

12. Increase Recycling  Surprising amount of supplies and equipment can be recycled!

13. Reduce solid waste  UHS produces ~91 lbs of waste/day  That’s ~455 lbs/week

14. Products in Use  Most commonly used materials and supplies

16. Financial Resources  Green Fee Grant

17. Establish Realistic Goals Current StatisticsGoals% difference Solid Waste 68.9%60%-12.9% Recycling 15%30%+100% Hazardous Material 16%10%-37.5%

18. Metrics  Weigh waste (Penn State)  Survey staff

19. Support from Organizational Leadership  An absolute MUST!

20. Phased Culture Shift  Need to get staff on board  Implement in small, achievable steps  Incentives

21. How to Get Started  Who are the departments you will collaborate with?  Material management department  Facilities, EH&S, and custodial staff  Who are your vendors?  Who is your recycling vendor? What can they recycle? Do you need to find specialized vendors?

22. How to Get Started  What is the current process your health center uses to take out solid, recycling, and biohazard waste?  How much is going into your 3 streams?  What are other departments on campus doing?  Which of your staff are on board?

23. The Plan  Educate, educate, educate  Place single stream recycling bins in break rooms and nurses’ stations

25. The Plan  Educate  Place single stream recycling bins in break rooms and nurses’ stations  Place recycling bins in every exam room  Place a graphic in every exam room

28. The Plan  Educate  Place single stream recycling bins in break rooms and nurses’ stations  Place recycling bins in every exam room  Place a graphic in every exam room  Initiate pilot trials of nitrile glove recycling in WH, UC, and lab

30. The Plan  Educate  Place single stream recycling bins in break rooms and nurses’ stations  Place recycling bins in every exam room  Place a graphic in every exam room  Initiate pilot trials of nitrile glove recycling in WH, UC, and lab  Experiment with smaller biohazard bins

32. Implementation  Pilot Trial #1  In Urgent Care & Women’s Health for 2 weeks  Outfit every exam room with a recycling bin and graphic  Determine how easy or difficult it is for clinical staff to divert waste into correct receptacle by surveying staff  Staff education

33. Implementation  Pilot Trial #2  Roll out in General Medicine, Sports Medicine, & Lab for 2 weeks

34. Implementation  Pilot Trial #3: Nitrile glove recycling in Urgent Care, Women’s Health, & Lab

35. Evaluation  Weigh waste  Analyze any statistical differences from Fall 2013 data  Surveyed staff

36. Evaluation Fall 2013 StatsGoalsSpring 2014 Stats Solid Waste 65.4%60%58.4% Recycling 14.3%30%33.8% Hazardous Material 20.3%10%7.8%

37. Some Thoughts for the Future  Are exam table paper and pillows necessary?

38. Some Thoughts for the Future  Composting

42. Acknowledgments BIG thank you to the following people!  Kathy Mosteller  Ben Lara & the materials management team  Karen Blaney & the Office of Sustainability  Sally Moore, Fidel Garcia, Patricia Maurizi Schiff, & the custodial team  Nena Anderson, Joe Bussey, & the EH&S team  Darlene Mitchell & the SSB Building Management team  All of UHS’ nurse managers

43. Resources  Healthier Hospitals Initiative (2012). Healthier Hospitals Initiative. Retrieved from http://healthierhospitals.org/  Practice Greenhealth. (2013). Practice Greenhealth. Retrieved from https://practicegreenhealth.org/  Rich, C.R., Singleton, J.K., Wadhwa, S.S. (2013). Sustainability for Healthcare Management: A leadership imperative. New York, NY: Routledge.

44. Other Examples  Pennsylvania State University  University of North Texas (UNT)  Medical University of South Carolina (MUSC)  UT Southwestern

45. Questions