Inova saves by cutting red-bag waste
Pizza boxes, flowers, wadded-up paper, latex-glove boxes—those were just some of the items regularly tossed into the red bags reserved for regulated medical waste at Inova Health System, headquartered in Falls Church, Va.
“You name it and it ended up in our red bags,” said Seema Wadhwa, Inova’s director of sustainability. “And it didn’t need to be there.”
In 2008, as part of a broader effort to improve sustainable practices, Inova’s senior leaders noticed the five-hospital system was generating far more regulated medical waste than was appropriate. Experts say regulated medical waste should account for 8% to 10% of a hospital’s total waste.
But those percentages were as high as 38% at some of Inova’s hospitals. That led Wadhwa and other system leaders to conclude that the system needed a far more aggressive waste-segregation and education strategy.
Though the definition of regulated medical waste varies slightly from state to state, it usually includes items that are contaminated with bodily fluids and have the potential to transmit infection, such as blood-soaked gowns, tubing and drains, gauze and suction canisters.
Because regulated medical waste has to be specially treated before it can go to a landfill—often by autoclaving—disposal costs are at least five to 10 times as much as for regular garbage, and the energy burden is far greater, Wadhwa said.
“Hospitals may not realize just how many dollars go right into the waste stream,” said Janet Howard, director of facility engagement for Practice Greenhealth, a Reston, Va.-based notfor-profit membership group that promotes sustainability in healthcare.
On average, hospitals generate 32 pounds of waste per bed per day, Howard said. “If you are putting diapers, containers and other things into those red bags, you are paying at least five times more and that really adds up over time.”
Before they launched a program to curb regulated medical waste, Wadhwa and her team conducted a systemwide audit, walking the halls to assess whether waste containers were in the right places, poring over bills and paperwork from Inova’s waste hauling vendors, and examining the contents of waste bags.
Understanding how much of your hospital system’s waste stream is regular garbage, how much is hazardous waste, such as mercury and formaldehyde, how much is recyclables and how much is regulated medical waste is a crucial first step, Howard said. “Talk to your haulers and ask for those numbers,” she said.
Wadhwa’s first targets were the operating rooms at 926-bed Inova Fairfax Hospital, Falls Church, which produced nearly 900 pounds of regulated medical waste each day. Her strategy included a staff education campaign touting the benefits of proper wastedisposal practices, lots of regular measurement and feedback, and much smaller waste containers to cut down on inappropriate use.
Those efforts, which later were implemented across the whole Inova system, have resulted in a reduction of several million pounds of regulated medical waste and savings of more than $300,000 to date.
The program wasn’t without its challenges, she said. Staffers were accustomed to disposing of waste in certain ways and some were wary of changes. For example, staff in the intensive-care unit expressed concern that the new, far smaller regulated medical waste containers wouldn’t be large enough for their needs. “We had to overcome those barriers of perceived inconvenience,” Wadhwa said.
Now, Inova’s regulated medical waste ranges from between 8% and 16% of its total waste.
Howard attributes much of the system’s success to Inova CEO Knox Singleton, who has championed environmentally conscious practices and even co-authored a book with Wadhwa for healthcare managers on sustainability.
“Sustainability has provided an opportunity for us to support our mission to improve the health of our community,” Singleton said. He also said the system’s efforts have helped to engage employees and cut costs.
“Any hospital can realize the benefit of taking a closer look at their waste stream,” Howard said. “What’s special about Inova is that Knox sees sustainability as a priority and invests in it.”