This presentation offers guidance to those hospitals that are rolling out a new pharmacy program as well best practices for maintaining and continuously improving current programs. Take a look and find out why annual program reviews are highly recommended.

1. Optimize Your
Pharmaceutical Waste Program
Get the latest strategies for revamping your
program.

2. 1. All lines are muted, use the chat panel for tech issues.
2. Q&A at the end. Type into the “questions” section of your
chat pane.
3. Unanswered questions will be answered via email after the
webinar.
4. Webinar recording and slides will be emailed to you later
today.
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3. Meet Your Presenter
Dennis Carroll, HEM
Healthcare Operations Manager
Triumvirate Environmental,Inc
dcarroll@triumvirate.com
4+ years at Triumvirate with a focus in
Healthcare
• Environmental Specialist for 2.5 years
• Operations Manager 2 years
• BS in Safety Studies at Keene State
College

4. Our Key Message
Understanding the importance of
reviewing and re-evaluating your
pharmacy program on an
annual basis.

5. Who Is This For?
Environmental
Health and
Safety
Environmental
Services
Facility
Management

6. When is the last time you had your
formulary characterized?

7. You Might Be
Thinking...

8. What Will You Learn?
Pre-Program Implementation
Ongoing Program Management
Importance of reviewing your program on
and annual basis
How to Successfully Manage a Sustainable
Rx Waste Program

9. Pre-Program Implementation
Pre-Program Implementation
Optimizing Your Rx Program
Case Studies
What’s New? Subpart P
Wrap Up/Q&A

10. Pre-Program
Implementation
• Formulary Characterization Process
• Generator Status
• Specific Waste Streams (How will you
Manage?)
• Roles & Responsibilities:
• Understanding all roles and
responsibilities within program, e.g.
Nursing, Pharmacy, EVS/Housekeeping
• Training Plan

11. Formulary Characterization
• Obtain an Up-to-Date Formulary
• (NDC #, Brand Name, Generic Name, Form) in
Excel
• Characterization
• What medications are regulated?
• Medication compatibility
• Waste stream creation
• Containers
• Labeling/signage
• End Waste Disposal requirements
• Waste profile

12. Generator Status
CESQG/SQGs
• P-Listed Waste- 2.2
Lbs./Month
• Massachusetts VSQG
(No P-Listed Waste)
CESQG*Less than 100 kg/month
• No accumulation limit up to 1,000 kg
SQG*Between 100-1,000 kg/month
• 180-day accumulation limit
LQG* Greater than 1,000 kg/month
• 90-day accumulation limit
• Most stringently regulated
Are You Properly Registered?

13. How Will You
Manage:
Non-Hazardous Waste?
Narcotic Waste?
NIOSH Listed Waste?
Bulk/Trace Chemotherapy Waste?

14. Roles & Responsibilities
Nursing
Pharmacy
EVS/Housekeeping
Must get all departments involved early to
gain insight and buy-in to the process.
TIP!

15. Initial Training
Department Specific!
• Based on Responsibilities (Nursing,
Pharmacy, EVS)
Formal or In-Service Trainings
Future New Hire/Orientation Training

16. Rollout Program!
Plan and execute!

17. Optimizing Your Rx Program
Pre-Program Implementation
Optimizing Your Rx Program
Case Studies
What’s New? Subpart P
Wrap Up/Q&A

18. Our Key Message
Understanding the importance of
reviewing and re-evaluating your
pharmacy program on an annual
basis.

19. Optimizing Your
Rx Program
• Assess how the program is operating
• Understand the importance of an annual
evaluation of the program.
• Ongoing SAA Inspections-Compliance
checks
• What are the benefits?
• Container Sampling as a method of
evaluation.
• Continued Training
• How to utilize your resources for
training purposes

20. How is the Program
Operating?
• Get Overall Collective Feedback:
• Surveying
• Direct feedback
• Inspection data
• What improvements can be made?
• Is the program sustainable?
• Are you staying within your regulated
limits?

21. Understanding the importance of an
annual evaluation of your Rx program.
Your hospital’s formulary could
be in a constant state of change!

22. Have hazardous medications been added or removed from the
formulary?
Does your formulary still align with your generator status and
program plan? P-Listed Waste?
• How is this being tracked?
Waste Disposal
• Know when the waste profile needs to be updated
The Formulary
Characterization Process

23. • Potential compliance issues
associated with not consistently
reviewing your formulary.
• Nurse confusion
• Compatibilities
• Unaccounted Waste codes
• Improper labeling
The Formulary
Characterization Process

24. Ongoing Rx SAA Inspections
How often are these areas
getting inspected for
compliance by trained
personnel:
• Weekly?
• Monthly?
• Never?

25. Ongoing Rx SAA
Inspections
Documented Inspections:
• Offers trending compliance data
• Reassures compliance
• Best management
Electronic Inspections:
• Data is easily attainable (possible
training opportunities)

26. Container Sampling
Breakdown containers to
check actual contents
Ask yourself: “Are all forms
of waste being properly
disposed of?”

27. 24%
54%
4%
4%
14%
Hazardous Pharmacetical Waste
Non Hazardous Waste
Universal Waste
Biological Waste
Municipal Waste
Container Sampling

28. Ongoing
Training Plan
Use the resources you
have at your disposal!

29. Case Studies
Pre-Program Implementation
Optimizing Your Rx Program
Case Studies
What’s New? Subpart P
Wrap Up/Q&A

30. Case Study: P-Listed Waste
• Understand your generator status requirements

31. Case Study: Program
Re-Assessment
Annually
Understanding the importance of
reviewing and re-evaluating your
pharmacy program on an annual
basis.

32. What’s New? Subpart P Highlights
Pre-Program Implementation
Optimizing Your Rx Program
Case Studies
What’s New? Subpart P
Wrap Up/Q&A

33. What’s New?
Register at: http://www.triumvirate.com/training/events

34. Wrap Up/Q&A
Pre-Program Implementation
Optimizing Your Rx Program
Case Studies
What’s New? Subpart P
Wrap Up/Q&A

35. Action Plan
Clearly identify all Roles & Responsibilities
Track Generator Status consistently
Get End User’s Involved
Review your program annually

36. QUESTIONS?

37. Contact Information
Dennis Carroll, HEM
Healthcare Operations Manager
Triumvirate Environmental, Inc
dcarroll@triumvirate.com
M:617.599.4464
O:617.715.8915

38. Thank You For Attending!
You will receive:
• A recording of this presentation
and copy of this presentation
• A link to a short survey
• A gift to help you get started with
your program optimization/rollout
Attend other events:
• www.triumvirate.com/training/even
ts