Business Waste Reduction

Waste Reduction Activities for Hospitals

Waste prevention means eliminating waste before it is created. It's a proven cost-effective approach that helps both your bottom line and the environment. Combined with a comprehensive recycling effort, hospitals can significantly reduce their waste. All activities on this fact sheet have been implemented by some hospital in the United States or have been provided by a medical professional.

Waste, Here Today and Tomorrow

Californians generate 45 million tons of waste each year. That's equivalent to eight pounds per person per day! Meanwhile, landfills are filling up as it becomes more costly.

To address this problem, in 1990 the California legislature mandated that local jurisdictions reduce their solid waste generation by 25 percent in 1995 and 50 percent in the year 2000. All of us, at home and work, have a responsibility to conserve resources for future generations.

Fortunately, many waste prevention practices save money.Waste reduction, the combination of waste prevention and recycling efforts, makes good business sense.

Waste reduction begins by understanding what is purchased, how goods are used, and what is discarded, and then is put to use by finding ways to eliminate, reduce, reuse, and recycle materials.

Contrary to popular belief, nonhazardous medical waste makes up nearly 3/4 of the waste generated in a hospital and should not be overlooked.

A good strategy is to target the largest components of the waste stream and do the easy waste reduction steps first. Below is a chart showing the solid waste composition in hospitals in the city of Los Angeles. Although waste varies, in most hospitals the largest components of the waste stream are paper (especially cardboard, mixed paper, newspapers, and high-grade paper), plastics (especially film plastic), food waste, and disposable linens (a combination of paper and other materials). Yard trimmings may be a much higher percent of your waste stream if your hospital has a large landscaped area. See Appendix A for a more detailed listing of these materials.

Along with preventing waste and recycling, it is important to purchase products made from recycled materials. This makes recycling successful by stimulating demand for recycled materials.

And finally, consider rewarding employees for their successful waste reduction ideas. Some hospitals reward employees with cash bonuses and recognition.

Below are ideas to help you identify waste reduction opportunities at your hospital. By setting up a solid waste management program you can turn ideas into action. (See Sources of Information for guide books on how to set up your own solid waste management program.)

Percent Solid Waste Composition (By Weight) In Hospitals*

*Based on composition of waste in nine Los Angeles City hospitals (1990)

Custodial Services

1. Renegotiate contracts with haulers of "red bag" or regulated medical waste to provide clean and reusable containers.

2. Eliminate plastic trash bag liners in administrative areas.

3. Buy most cleaning substances in 55-gallon drums that are refilled by the supplier.
4. Use concentrated cleaning solutions that staff mix as needed.
5. Use washable mop heads instead of disposable ones.

Purchasing

1. Buy in bulk whenever possible; it saves packaging.

2. Select or ask vendors to follow packaging preference criteria:

• No packaging or minimal packaging.
• Consumable, returnable, refillable, reusable packaging.
• Recyclable packaging/recycled material in packaging.

3. Improve ordering practices so perishable products don't become outdated and unusable.
4. Cut down on multiple subscriptions of medical publications by asking staff to share journals and magazines.
5. Reuse packaging.

Patient-Care Supplies

1. Determine if cloth towels can be used and later sold for rags.
2. Replace paper towels with air dryers.

3. Use cloth diapers.

4. Use worn diapers as cleaning rags.
5. Provide decubitus-care mattresses instead of foam "egg-carton" mattresses.

6. Eliminate duplicate admission kits.

7. Replace disposable admissions kits (water pitchers, glasses, and bed pans) with reusables in patient rooms.

8. Use washable linens, bed pads, underpads, gowns, and emesis basins.

9. Purchase reusable pillows.
10. Convert blankets, mattress pads, and quilts into potholders (done by volunteers).
11. Set up system where nursing staff evaluate personal care items such as aspirin packets, tissues, shampoo, baby wipes and diapers for reuse (following infection control guidelines) instead of automatically disposing them

Medical/Surgical Supplies

1. Eliminate unused items from custom surgical packs (once a pack is opened, unused items are discarded).

2. Consider switching from disposable to reusable medical instruments (e.g., stainless steel trays, laparoscopic instruments).
3. Contact the manufacturer when one item in a surgical tray is causing the whole pack to outdate early (e.g., tetracaine in a spinal tray).
4. Evaluate changing to a nontoxic x-ray developer.
5. Purchase washable surgical and isolation gowns and sterilization trays.

6. Mend gown ties so they last longer.
7. Convert surgical drapes into biopsy cloths.
8. Sanitize and reuse plastic fracture pans.
9. Sanitize and reuse graduated measuring containers.
10. Donate clean, unused operating room (OR) supplies for reuse overseas.

Cafeterias

1. Use washable plates, eating utensils, glasses and cups for cafeteria and patient service.

2. Sell reusable mugs with no-spill lids, then offer discounts to anyone using their own mug.
3. Start up a"think before you use" campaign to decrease use of disposable items: napkins, condiments, etc.
4. Switch to a bulk milk dispenser for patients instead of individual milk cartons.
5. Compost kitchen and food waste.

Offices

1. Assess need for photocopies and print only what is needed.

2. Customize the distribution of reports (e.g., daily census).

1. Increase double-sided copying in central copy areas.
2. Keep records on microfiche or double-side copies for paper documents.
3. Consolidate multiple forms and reduce extra copies.
4. Use fax machines that take plain paper so faxes do not need to be copied again.
5. Keep report and memo writing to a minimum and limit distribution.
6. Reuse paper only used on one side.
7. Purchase recycled paper and print stationery, business cards, etc. on recycled paper.
8. For more resources of reducing office paper, see our Business Waste Reduction page.

Landscaping

1. Use mulching mowers and leave grass clippings on the lawn so they can decompose naturally (grasscycling).

2. Landscape using plants that grow slowly or have enough space so they do not need to be constantly trimmed.

Hospital-Wide Reuse

Set up a reuse area where employees and local schools can pick up used, yet still useful, items such as old binders, folders, paper clips, cassette tapes, plastic containers, etc. For information on how you can participate in a statewide materials exchange network, contact the California Materials Exchange (CalMAX) at (916) 341-6611. CALMAX issues a free quarterly catalog that list materials wanted and available.

Recycle Waste That Can't Be Prevented

1. Set up a collection system, arrange to have items picked up for recycling, and educate staff. These are items that are recycled in other hospitals:

• Corrugated cardboard*
• White office paper
• Newspapers
• Mixed paper*
• Beverage containers (aluminum cans, glass bottles)
• Steel cans (used by food service)
• Plastics (work with suppliers so goods are made from or packaged with same plastic resin so they are easier to recycle)

* Stan Strickland from Kaiser Permanente Northern California Region analyzed their recycling options and found that for starting up their recycling program it as best to focus on paper and cardboard. The savings in avoided disposal costs for these bulky items makes this a cost-effective approach.

2. If you must use disposables, select ones that can be recycled.

Appendix A: Type and Amount of Waste Generated At Hospitals

For more information contact:
Ellen Hae at Recycling By Nature, (408) 626-1917 or Jan Satt at the City of L.A. (213) 237-1444.
*Only refers to nonhazardous solid waste

Sources of Information

Copies of most of these items are available from the California Waste Prevention INFO Exchange, (916) 341-6363.

• City of Los Angeles, Source Reduction and Recycling Element, Vol. 2, Solid Waste Generation Study, April 1993, pages 197-204.
• DiPietro, Robbe Charles, "Michigan Hospital Creates 'Recyclecare' Program," BioCycle, May 1991, pages 52-53. This article describes a program at Butterworth Hospital, Grand Rapids, Michigan, a 526-bed hospital with 3,300 employees. Contact at hospital: Daniel Stickles, Environmental Director.
• Indiana Hospital Association, The New Three Rs: A Solid Waste Management and Recycling Guide for Indiana Hospitals, 1 American Square, P. O. Box 82063, Indianapolis 46282. (317) 633-4870.
• NFORM, Inc., Making Less Garbage: A Planning Guide for Communities, 381 Park Ave. So., New York, NY 10016-8806, (212) 689-4040, pages 62-67.
• Harding Lawson Associates and Legacy Health System, A Model Waste Prevention Program, Legacy Health System, May 1994, Contact: David Allaway, Harding Lawson Associates 227 SW Pine St, 3rd floor, Portland, OR 97204, (503) 227-1326.
• Kaiser Permanente Northwest Region, Green Team Update (mulching mowers), July 1992. Contact: Pat Grant (503) 786-5542.
• Michigan Departments of Commerce and Natural Resources, Office of Waste Reduction Services, P. O. Box 30004, Lansing, MI 48909, (517) 335-1178. Case study: McPherson Hospital, Howell Michigan, 136-bed community hospital.
• New York City Department of Sanitation, A Comprehensive Solid Waste Management Plan for New York City and Final Generic Environmental Impact Statement, August 1992, pages 7-14, 7-15. Contact: Dexter Dugan at New York City Health and Hospitals Corporation (a city agency), (212)391-7402.
• Nenonen, Liisa, et. al., Simple O. R. Ways to Save the Earth, a 2-page list of ideas to reduce waste in the operating room. Contact: Liisa Nenonen, The RACORSE Network, 407 Vernon St., #305, Oakland, CA 94610, (510)832-2868.
• Slater, Pam. "Local Surgery Units Cutting Waste," Sacramento Bee, 12/6/93.

Guide Books Available

• American Hospital Association, An Ounce of Prevention: Waste Reduction Strategies for Health Care Facilities. Cost: $29.95 (member), $50 (nonmember); order number 057-007. To order call (800) AHA-2626. For more information contact American Society for Healthcare Environmental Services, (312) 280-4458 (recommended by several recycling coordinators, includes waste prevention).
• Minnesota Hospital Association, Waste Not Book. Contact MHA Public Affairs, (800) 462-5393 to order. A guide for hospitals on how to reduce and reuse. 75 pages. Cost: $25.

For More Help

• Preferred Packaging Procurement Guidelines, 1994. To order this or other CIWMB Business Waste Reduction Publications, call (916) 341-6334  or the CIWMB publications clearinghouse: (800) CA-WASTE (California only).
• For information on how to prevent waste, call the Waste Prevention Information Exchange, (916) 341-6363.
• CIWMB Buy Recycled Program (916) 341-6481.

Publication #500-94-042

To order this publication, or for more Business Waste Reduction Assistance, please contact us! If you have questions, information, ideas, educational materials, etc., please share it with us so we can share it with others!

Last updated: November 01, 2007