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Improving Environmental Improving Environmental Performance From A Performance From A Healthcare Perspective Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

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Minnesota Hospitals Minnesota hospitals are committed to being good stewards of the environment and understand the important correlation between public health and protecting the environment. Minnesota hospitals are committed to being good stewards of the environment and understand the important correlation between public health and protecting the environment. Hospitals are driven by the mission of caring for patients 24/7. Hospitals are driven by the mission of caring for patients 24/7. -Ann Gibson, Minnesota Hospital Association

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Page 1: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Improving Environmental Improving Environmental Performance From A Performance From A

Healthcare PerspectiveHealthcare Perspective

Steven A. WaderichNational Environmental Partnership

SummitAtlanta GA

May 10, 2006

Page 2: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Introduction Introduction Minnesota treasures its water, not only for consumption, but Minnesota treasures its water, not only for consumption, but

also for recreation. also for recreation. Healthcare produces enormous volumes of hazardous waste, Healthcare produces enormous volumes of hazardous waste,

which, if not handled properly, threaten our rivers, stream which, if not handled properly, threaten our rivers, stream and lakes.and lakes.

Reducing the amount of pharmaceutical & other waste from hospitals that goes to sewers and landfills diminishes the risk of surface water contamination.

Page 3: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Minnesota HospitalsMinnesota Hospitals Minnesota hospitals are committed to Minnesota hospitals are committed to

being good stewards of the being good stewards of the environment and understand the environment and understand the important correlation between public important correlation between public health and protecting the environment.health and protecting the environment.

Hospitals are driven by the mission of Hospitals are driven by the mission of caring for patients 24/7.caring for patients 24/7.

-Ann Gibson, Minnesota Hospital Association-Ann Gibson, Minnesota Hospital Association

Page 4: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Allina Hospitals and ClinicsAllina Hospitals and Clinics Allina consists of 11 hospitals and over 50 Allina consists of 11 hospitals and over 50

clinicsclinics Abbott Northwestern HospitalAbbott Northwestern Hospital

646 beds646 beds 38,170 Inpatient admissions38,170 Inpatient admissions 37,462 Emergency visits37,462 Emergency visits 192,890 Outpatient visits192,890 Outpatient visits 40 hospital based clinics40 hospital based clinics 5300 employees5300 employees

Page 5: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

The ChallengesThe Challenges Little expertise within the healthcare Little expertise within the healthcare

community in handling hazardous community in handling hazardous wastewaste

Decentralized management of waste Decentralized management of waste streamsstreams

Healthcare is highly regulatedHealthcare is highly regulated JCAHO JCAHO (Joint Commission Accreditation of (Joint Commission Accreditation of

Healthcare Organizations)Healthcare Organizations) OSHAOSHA MPCA/EPA/County MPCA/EPA/County DOTDOT DEADEA

Page 6: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Pharmaceutical Waste Data Pharmaceutical Waste Data 20052005

Total collected, 40,932 poundsTotal collected, 40,932 pounds Total Hazardous, 12,785 pounds (31%)Total Hazardous, 12,785 pounds (31%)

RCRA Haz, 4771 pounds, 12%RCRA Haz, 4771 pounds, 12% P-listed, 379 pounds, 1%P-listed, 379 pounds, 1% Dual Haz/infectious, 10%Dual Haz/infectious, 10% Controlled Substances, 1%Controlled Substances, 1%

MN lethal, 8%MN lethal, 8% Total Non-haz, 24,373 pounds (60%)Total Non-haz, 24,373 pounds (60%) Total trash, 3772 pounds (9%)Total trash, 3772 pounds (9%)

Page 7: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Pharmaceutical Waste Data 2005

9,512

3,275

28,145

40,932

23%

8%

69%

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

RCRA MN Haz Non-Haz 2005 Total

Tota

l in

Poun

ds

0%

10%

20%

30%

40%

50%

60%

70%

80%

% o

f Tot

al

Page 8: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Pharmaceutical Waste DataPharmaceutical Waste DataFirst Quarter 2006First Quarter 2006

Total collected, 22,410 pounds Total collected, 22,410 pounds Estimated Annual 89,640 poundsEstimated Annual 89,640 pounds

Total Hazardous, 5947 pounds (26%)Total Hazardous, 5947 pounds (26%) RCRA Haz, 4592 pounds, (20%)RCRA Haz, 4592 pounds, (20%)

P-listed, 119 poundsP-listed, 119 pounds Dual Haz/infectious, 2154 pounds (9%)Dual Haz/infectious, 2154 pounds (9%)

MN lethal, 1354 pounds (6%)MN lethal, 1354 pounds (6%) Total Non-haz, 12,925 pounds (58%)Total Non-haz, 12,925 pounds (58%) Total trash, 3600 pounds (16%)Total trash, 3600 pounds (16%)

Page 9: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Pharmaceutical Waste Data 1st Quarter 2006

4,592

16,525

22,471

1,354

20%

6%

74%

0

5,000

10,000

15,000

20,000

25,000

RCRA MN Haz Non-Haz 2006 1Q Total

Tota

l in

Poun

ds

0%

10%

20%

30%

40%

50%

60%

70%

80%

% o

f Tot

al

Page 10: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Waste Projection CostsWaste Projection Costs Based on current data we Based on current data we estimateestimate annual annual

waste disposal at Abbott Northwestern waste disposal at Abbott Northwestern Hospital to be:Hospital to be: $350,000 - $375,000$350,000 - $375,000

Includes Haz, Haz/Dual & Non-Haz pharm. disposalIncludes Haz, Haz/Dual & Non-Haz pharm. disposal Includes Lab waste disposalIncludes Lab waste disposal Includes containers & vendor chargesIncludes containers & vendor charges Includes outside vendor sorting feesIncludes outside vendor sorting fees

Does not include Does not include Additional staff time commitment (est. 2.3 FTE’s)Additional staff time commitment (est. 2.3 FTE’s) Training (est. $66/employee)Training (est. $66/employee) Off site clinicsOff site clinics Evaluation processesEvaluation processes

Page 11: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Positive OutcomesPositive OutcomesRecyclingRecycling

(Information provided by Lynn Montgomery, Allina Labs)(Information provided by Lynn Montgomery, Allina Labs)

ABBOTT NORTHWESTERN SITE ONLY January - December, 2005Amount Recycled Product $/Gal $Purchase $ Dispo/Gal $Disposal Cost Savings

679 GallonsAlcohol 7.04 4,780 2.80 $ 1,901 $ 6,681

610 Gallons Xylene 12.00 7,320 2.80 1,708 9,028

1519 Gallons Formalin 11.34 17,225 2.80 4,253 21,478

$37,187 Waste

Disposal fees$ 3,679 Savings $ 33,508

Page 12: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Recycling SuccessRecycling Success(Information provided by Lynn Montgomery, Allina Labs)(Information provided by Lynn Montgomery, Allina Labs)

Allina Metro Allina Metro HospitalsHospitals Recycled 5057 Recycled 5057

gallons of reagents gallons of reagents (92 drums)(92 drums)

AlcoholAlcohol XyleneXylene 10% formalin10% formalin

Reduction in Reduction in ReagentReagent PurchasesPurchases Disposal feesDisposal fees Freight and handlingFreight and handling Employee safetyEmployee safety

2005 Savings at four metro hospitals $ 62,988

Page 13: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Positive OutcomesPositive Outcomes MnTAP Intern Project 2005MnTAP Intern Project 2005

$8000 - $11,000/year$8000 - $11,000/year Lab chemical reductionLab chemical reduction

Eliminated 400 chemicals and processesEliminated 400 chemicals and processes Vile Crusher Project ($500/week, Vile Crusher Project ($500/week,

$26,000/year)$26,000/year) Successful Recycling program ($33,500/year)Successful Recycling program ($33,500/year)

Pharmaceuticals (proper management)Pharmaceuticals (proper management) Evaluated 4100 formulary drugsEvaluated 4100 formulary drugs Epi Irrigation process changesEpi Irrigation process changes

Page 14: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Positive OutcomesPositive OutcomesStandardizationStandardization

Allina Hospitals and ClinicsAllina Hospitals and Clinics Regulated & Hazardous Waste CommitteeRegulated & Hazardous Waste Committee Standardized Training materialStandardized Training material Standardized collection & handling processesStandardized collection & handling processes Data gatheringData gathering Waste streams and profilesWaste streams and profiles RFP & resource management initiativesRFP & resource management initiatives Drafted an Environmental PolicyDrafted an Environmental Policy

Page 15: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

Regulatory ConsensusRegulatory Consensus Most often regulators and the community that Most often regulators and the community that

they are regulating only meet in an they are regulating only meet in an enforcement arena.enforcement arena.

Minnesota hospitals appreciate the willingness Minnesota hospitals appreciate the willingness of the Solid Waste Coordinating Board and of the Solid Waste Coordinating Board and Minnesota Pollution Control Agency to come to Minnesota Pollution Control Agency to come to the table to discuss approaches for hospitals the table to discuss approaches for hospitals to achieve compliance with hazardous waste to achieve compliance with hazardous waste regulations while keeping in mind our regulations while keeping in mind our important mission of quality patient care.important mission of quality patient care.

Encouraged communication with local Encouraged communication with local regulatorsregulators

Page 16: Improving Environmental Performance From A Healthcare Perspective Steven A. Waderich National Environmental Partnership Summit Atlanta GA May 10, 2006

SummarySummaryHealthcare will do the right thing to ensure Healthcare will do the right thing to ensure

the proper disposal of pharmaceutical, lab the proper disposal of pharmaceutical, lab and other hazardous wastes to protect and other hazardous wastes to protect employees, our patients and the employees, our patients and the environment of the communities we serve.environment of the communities we serve.