It is important to determine which materials are waste and what classification they fall into early (e.g. right after the waste is generated). Segregating the waste by type (e.g. pharmaceutical, pathological), can be useful in reducing the load on the treatment processes and reducing total cost of waste management.
The three-bin segregation system is an easy way to implement a collection system. The categories can be (1) sharps, (2) biomedical/infectious waste, and (3) general waste. A color scheme could be red for sharps, yellow for infectious waste, and black for general waste.
Containers and bags should not be filled to more than three quarters of their capacities. Keep containers covered so people don’t accidentally get into them or, worse, vermain. Vermain and other pests can carry disease, and you don’t want your facility to be identified as a source of infection.
How long should waste remain in storage? If you have a hazardous waste permit, it will state a maximum time for storage. Facilities managers generally want the time in the permit to be long, but they also typically want the length of time the waste stays in storage to be short. Having waste on site is more risky than shipping it with a qualified waste management company. Sometimes biohazardous waste must be refrigerated if it will be on site for long. Your permit will specify this.
In the storage areas, keep a supply of cleaning equipment and supplies, PPE, and extra waste bags. A sink with soap should be available. If possible, build berms or other measures to keep spills from spreading to the rest of the facility or the environment and to facilitate clean-up.
Keep waste containers on pallets as they await transport tor disposal. Choose an area that is accessible to the disposal company so as to reduce the risk of spills or container drops. Your disposal company probably wants a bar code on the containers. Work out with them whether you put the bar code on or whether they will. Scan the bar codes to enter the container to your inventory system and when it leaves your facility.
Reducing production of waste is - other things being equal - almost always a good idea. It saves money on treatment and disposal costs and it reduces liability risk.
Healthcare facilities can reduce their waste costs by choosing wisely in purchasing and by proper inventory management. It takes some thought, but supplies that produce a less hazardous waste product and using as much as possible (preferably all) or the material in a container benefits your overall waste management profile. Possible techniques:
Implement centralized purchasing and storage of hazardous chemicals. It makes overall storage costs lower and risk lower, too.
Checking of the expiry date of all products at the time of delivery, and refusing to accept short-dated items from a supplier.
Containment - keeping medical waste inside the facility and in designated areas inside the facility and from exiting to the environment and protecting facility workers and visitors from exposure.
Accounting - tracking waste items and batches through the facility and after it exits to the facility until it gets to final disposal.
Segregation - using defined waste categories and keeping waste physically separated from waste in other categories.
Small facilities are almost always better off paying a contractor to handle their medical waste - haul it off, treat it, and dispose of it.
An exception is if your waste is exotic or unusual - so unusual that treatment processes - which tend to be blunt - may not be effective.
The originator of the waste retains some legal liability for it. You can’t necessarily wash your hands of problems for harm your waste may cause by paying for someone else to take it away.
Economy of scale matters for treatment, storage, and packaging for disposal. A good rule of thumb is less than 500 lb/month is too small to merit any on-site treatment system. The break-even calculation must be done with reasonable estimates of waste generation rates and treatment costs.
The bigger your facility or organization, the more you need a waste minimization program. Without one, you are almost surely producing more waste than you need to. Facilities without a formal program are usually inefficient and can make great gains when they start. These gains show up all over: less waste means lower disposal costs, purchasing and inventory costs are often lower, operational efficiency often is improved, and there is less clutter in the facility.
Your employees might bristle at a waste minimization program Getting them on-board and participating is a people management challenge.
To develop and maintain a waste minimization program, you need accurate information on historical and expected generation rates by waste type as well as cost information on storage, treatment, and disposal.
A watchphrase among the recycling and green communities is 3R. This encourages people to think:
Reduce Reuse Recycle
when considering both workflow design and day-to-day operations.
Some evangelists have expanded to 6Rs, although there is no agreement about what all 6 Rs stand for. Some say:
Recognize Reconsider Repair Reduce Reuse Recycle
Another list is Refuse (to buy or take in what you do not need) Reduce Reuse Recycle Recover Rot (let waste go to landfill, the least desirable option)
Or Reduce Rethink Refuse Recycle Reuse Replace
Other Rs you can insert include replenish and respect.
These are buzzwords, yes, but buzzwords can be given meaning and help people remember the mission. However you cut it, these admonitions call upon the operating manager to examine processes leading to production and management of waste throughout the facility.
See our page on treatment of medical waste.
Answering questions from the public in the case of an accident.
Cleaning is important not just for healthcare facilities, but for any building that sees a lot of visitors. The main and most obvious aim is to remove dirt and cleaning is primarily mechanical dislodging of extraneous material. Soaps and detergent promote solubility but do not necessarily have antimicrobial activity. Basic cleaning in a janitorial sense is mostly mechanical.
Medical and healthcare facilities often choose to use disinfectant washes. Many building supply cleaners have disinfectants in them. No waste professional or infection control officer would claim a floor has been “disinfected” because it has been washed with those cleaners. Disinfected has a more technical formal meaning in waste management and medicine.
Too vigorous cleaning is often suspected as the cause of nosocomial infections in hospitals. But although long-term regular cleaning may promote nosocomial infections, the short-term benefits swamp any idea of stopping the cleaning. Guidance published by the CDC for hospitals in 2003 stated "most, if not all, housekeeping surfaces need tobe cleaned only with soap and water or a detergent/disinfectant, depending on the nature of the surface and the type and degree of contamination." The organization Health Care Without Harm is promoting greener cleaning and non-chemical methods. All other things being equal these are certainly desirable, but the infection control officers, industrial hygiene professionals, and waste managers must make the best decision for their facility, and there is no universal answer.
