Are you looking for ways to better manage, maintain and streamline your waste management program? Waste streams within the healthcare industry can be misunderstood, underrepresented and sometimes even missed altogether. This presentation offers some tips and tricks for building a Sustainable, Compliant, Cost-Effective, Safe and Simple waste management program.

1. Streamlining Waste
Management
in Healthcare
Tips for Managing Your Waste
Streams More Effectively

2. Meet Your Moderator:
James Ciccone

3. During this Webinar
 All lines will be muted – please communicate via
the questions tab in your webinar panel.
 There will be live, interactive polling.
 There will be a Q&A session at the end of the
presentation – submit your question(s) anytime
throughout the webinar.
 Stick around for an exclusive offer at the end of
the webinar.

4. Meet Your Presenter
Steve Todisco,
HEM, CHMM, Six
Sigma Green Belt
Corporate Director of Healthcare
Triumvirate Environmental
Stodisco@triumvirate.com

5. Our Key Message
5 Keys to Healthcare SuCCeSS
Sustainability, Compliance
Cost Effective Behavior
Safety, Simplicity

6. Who Is This For?
Individuals looking for simpler solutions to unique issues
Those looking for a safer way to manage their programs
Employees looking to incorporate change to build cost-effective
solutions
Folks directly responsible for compliance
Healthcare institutions looking to increase sustainability

7. What Will You Learn?
• Focus on 3 RCRA Categories:
Hazardous Waste
Hazardous Pharmaceutical Waste
Universal Waste
• Using regulations to your advantage to
reduce costs & save time
• What does waste min actually mean for
departments?
• Work with teams upstream to manage
waste in a more cost-effective and
compliant manner
• Why the lifecycle of waste is valuable

8. Agenda
What is SuCCeSS in Healthcare?
Hazardous Waste, Pharmaceutical Waste and
Universal Waste
Cost and Time Savings Opportunities
The Lifecycle of Waste
Summary/Q&A

9. Poll Question
Which department’s
waste generation
challenges you the
most?

10. What is SuCCeSS in Healthcare
1) Sustainability
2) Compliance
3) Cost Effective Behavior
4) Safety
5) Simplicity

11. What is SuCCeSS in Healthcare
• Systematic and
comprehensive waste
reduction
Sustainability

12. What is SuCCeSS in Healthcare
• Sufficient knowledge
and engagement to
exceed regulatory
compliance
Compliance

13. What is SuCCeSS in Healthcare
• Expenditures in a metric
that healthcare
understands
Cost
Effective

14. What is SuCCeSS in Healthcare
• Health and well-being of
employees and patientsSafety

15. What is SuCCeSS in Healthcare
• Avoiding complex
components that don’t
function together
Simplicity

16. Why are these 5
areas so woven
together?

17. Su – C – CE – S - S
• Sustainability & Simplicity are primary targets of Cost Effective Behavior
• Cost Effective behavior requires Sustainability, due diligence, KPIs
• Compliance is a function of safety and education
• Safety elements push compliance
• Simplicity is how to make most things work

18. Agenda
What is SuCCeSS in Healthcare?
Hazardous Waste, Pharmaceutical Waste and
Universal Waste
Cost and Time Savings Opportunities
The Lifecycle of Waste
Summary/Q&A

19. Does your institution measure
waste generation by
department or the whole
institution?
Poll Question

20. The World of Solid Waste
RCRA Hazardous
Waste
Solid Waste
Universal Waste
RCRA
Pharmaceutical
Waste

21. RCRA Hazardous
Universal
Pharmaceutical
Waste

22. RCRA Hazardous
D00’s F00’s U00’s P00’s K00’s
Characteristic Waste (s) Listed Waste (s)

23. Light Bulbs Batteries Pesticides
Thermostats Mercury Devices CRT’s

24. Medications Regulated by the Same RCRA Rules that
Govern Traditional Hazardous Waste (Examples)
Warfarin Nicotine Melphalan
Mitomycin Barium Silver Nitrate
Thimerisol Vaccines Chloral Hydrate Physostigmine

25. Agenda
What is SuCCeSS in Healthcare?
Hazardous Waste, Pharmaceutical Waste and
Universal Waste
Cost and Time Savings Opportunities
The Lifecycle of Waste
Summary/Q&A

26. • Co-mingling opportunities
• Bulking opportunities
• Using less harmful non-RCRA chemicals
• Purchasing modifications
• Correct sizing of waste containers
 While in satellite accumulation
 While in central accumulation
• Right sizing your central accumulation area
• Pack in progress / maximizing waste out
• Shifting disposal costs to labor costs
• Chemical re-use programs
• Accurate characterizations
• Managing the time clock
• Managing upstream
Types of Opportunities

27. Co-mingle Similar Waste Streams
• Determine volumes of similar wastes
• Determine the disposal methods of similar wastes
• Determine the EPA waste codes of similar waste streams
• Consolidate or co-mingle similar waste streams into the appropriate size
container:
 Use the most appropriate size container for consolidation
 Do not mix wastes that will be treated in different manners
 Do not add acutely toxic wastes to co-mingled waste streams

28. Bulking
• Think like a liquid
• Think like a specific department
• Take over internal waste transportation
from individual labs
 Histology
 Microbiology
 Hematology
 Cytology
• Plan with your generator status
• Think recycling

29. Discuss Chemical Substitution
Opportunity for substitution?
• Is there a chemical that is less harmful to the environment and oneself?
• Chemical disposal is diverted to a less costly waste stream/disposal
option, e.g. sink disposal or solid trash
Examples of substitutions:
• Alcohol thermometers instead of mercury thermometers
• Sybr safe gel stain instead of ethidium bromide
Other considerations:
• Historic knowledge to recreate the research requires specific chemicals
• Timeframe of project may inhibit such a substitution
• Funding may not approve if there is a substitution

30. Modify Your Purchasing Habits
• Focus attention on your chemical inventories
• Review current purchasing volumes / frequencies
• Interdepartmental purchasing
• Reduce stock chemical storage
 Increase the space in your lab (clinical, non-clinical, research)
• Does census alter purchasing habits?
• Just-in-time delivery or frequency-based buying
In many estimations healthcare “wastes” between 15-30% of stock material

31. Right Sizing Collection Containers
• Begin with the end in mind
• Understand your limiting factors
• What container should you collect waste in?
• Satellite accumulation vs. Main or Central Accumulation
• Answer the “how much for how long” question
• How will you get it from point A to B?

33. What is Lab Pack as You Go?
• Works with your generator status, not against it:
 Based on your 90/180 day clock, date of oldest
container
 Uses it to your advantage
• Avoids large cleanouts & maintain compliance on a
routine basis:
 Less containers for inspection
 Less regulatory concern
• Forces routine processes to happen
• Works hand in hand with trading disposal costs /
labor costs

34. Shifting Disposal Costs to Labor Costs
Disposal Labor

35. A Tougher Challenge
• Chemical re-use
 Embracing detailed chemical inventories
 Making them work for you
• More applicable research settings
• Focus on virgin / unused items
• Develop a marketplace
• Interdepartmental communication
• Re-use instead of waste
 Pay, use versus pay, use, pay to dispose, pay to store, pay to manage

36. Accurate Waste Characterizations
• Work to truly understand what is in your waste container
 No, it’s not just waste solvents or Xylene and Alcohol
• Accurate profiling can change disposal costs
• Accurate profiling increases opportunities for consolidating / bulking
• Pharmaceutical waste management
• Get upstream as far as you can
• MSDS’s & SDS’s only get you so far
 Generator knowledge

37. • Learning not to ship everything
• Work with your oldest dates
• Daily tracking for when items “become due”
• Example – Acids and Bases
 Not usually an opportunity to “bulk”
 Usually items to “lab pack”
 How many are generated over time?
Managing the
Clock

38. Swim Upstream
• Perform a Tracer
• One Step at a Time
• Waste Generating Process
• Chemical Storage
• Ordering
• Need
• Root Cause

39. Agenda
What is SuCCeSS in Healthcare?
Hazardous Waste, Pharmaceutical Waste and
Universal Waste
Cost and Time Savings Opportunities
The Lifecycle of Waste
Summary/Q&A

40. The Lifecycle of the Waste Generation Process
Purchasing
Waste
Process
Generation
Satellite
Accumulation
Main / Central
Accumulation
Off-Site
Disposal
• Why do you buy what you buy?
• How is the waste generated?
• How is it stored?
• Can it be better managed in the MAA?
• How does it leave your site?

41. Know How the Waste is Generated
• Determine if the waste container is the appropriate size for the process
• Determine if the waste bottle is made from one process
• Use your understanding of waste code applicability/definitions to make
hazardous waste determinations
• For machine generated waste, are there multiple lines going into the same waste
container? Can any of those be separated?
• Understand the timeline of the process/research

42. Educate Generators on Proper Waste
Collection Techniques
• Are the chemicals compatible in the
waste container? Do they present a
new hazard?
• Can some of the chemicals be
disposed of using different treatment
techniques for cost savings?
• Understanding local wastewater
discharge regulations

43. Agenda
What is SuCCeSS in Healthcare?
Hazardous Waste, Pharmaceutical Waste and
Universal Waste
Cost and Time Savings Opportunities
The Lifecycle of Waste
Summary/Q&A

44. Summary
Todays Focus
Healthcare – Hazardous, Universal and
Pharmaceutical
SuCCeSS
Sustainability, Compliance, Cost Effective
Behavior, Safety and Simplicity
Utilizing Regulations
Working Upstream / Understanding Lifecycles
What does Waste Min mean for the Individual?

45. Our Key Message
5 Keys to Healthcare SuCCeSS
Sustainability, Compliance
Cost Effective Behavior
Safety, Simplicity

46. Thank You For
Attending!
Request a Free Waste Assessment:
http://info.triumvirate.com/waste-assessment-web
Call Us!
1-888-834-9697
www.triumvirate.comSteve Todisco:
stodisco@triumvirate.com
Corporate Healthcare Director, HEM,
CHMM, Six Sigma Green Belt
Contact: