Waste Reduction Strategies

Health Care

Also see: Health Care Case Studies in Oregon

Waste Prevention

Pharmacy

• Use the first-in, first-out system to rotate chemical stocks, pay attention to expiration dates.
• Buy drugs in container sizes that permit formulation of daily doses with the least quantity of excess product leftover.

X-ray

• Reduce photographic wastes from imaging equipment, like wastewater containing photographic chemicals and silver from film.
• Extend the life of fixing baths by adding ammonium thiosulfate (doubles the allowable concentration of silver buildup in the bath).
• Add acetic acid to fixing baths to keep the pH of the bath optimally low.
• Do not mix used X-ray fixer and developer: dedicate separate containers and treatment methods.
• Collect used X-ray fixer and store used in a closed plastic container labeled "Hazardous Waste - Used Fixer" with the date fixer was first added. Contact a recycling service when enough fixer has accumulated (usually 5-10 gallons).
• Install a silver recovery unit at the end of the X-ray processing unit.
• Evaluate changing to a non-toxic x-ray developer.

Custodial

• Renegotiate contracts with haulers of "red bag" or regulated medical waste to provide clean and reusable containers.
• Eliminate plastic trash bag liners in administrative areas.
• Buy most cleaning substances in 55-gallon drums that are refilled by supplier.
• Use concentrated cleaning solutions that staff mix as needed.
• Use washable mop heads instead of disposable ones.

Purchasing

• Select or ask vendors to follow packaging preference criteria of no packaging or minimal packaging; consumable, returnable, refillable, reusable packaging; and recyclable packaging/recycled material in packaging.
• Improve ordering practices so perishable products don't become outdated or unusable.
• Cut down on multiple subscriptions of medical publications by asking staff to share journals and magazines.

Supplies

• Determine if cloth towels can be used and later sold for rags.
• Use cloth diapers.
• Use worn diapers as cleaning rags.
• Provide decubitus-care mattresses instead of foam "egg-carton" mattresses.
• Eliminate duplicate admission kits.
• Replace disposable admission kits (water pitchers, glasses, and bed pans) with reusable in patients rooms.
• Use washable linens, bed pads, under-pads, gowns, and emesis basins.
• Purchase reusable pillows.
• Convert blankets, mattress pads, and quilts into pot holders (done by volunteers).
• Set up a 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.
• Eliminate unused items from custom surgical packs (once a pack is opened, unused items are discarded).
• Consider switching from disposable to reusable medical instruments.
• 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).
• Purchase washable surgical and isolation gowns and sterilization trays.
• Mend gown ties so they last longer.
• Convert surgical drapers into biopsy cloths.
• Sanitize and reuse plastic fracture pans.
• Sanitize and reuse graduated measuring containers.
• Donate clean, unused operating room supplies for reuse overseas.

Cafeterias

• Use washable plates, eating utensils, glasses and cups for cafeteria and patient service.
• Sell reusable mugs with no-spill lids, then offer discounts to anyone using their own mug.
• Start up a "think before you use" campaign to decrease use of disposable items: napkins, condiments, etc.
• Switch to a bulk milk dispenser for patients instead of individual milk cartons.
• Buy products in bulk and keep in stay fresh containers on display instead of selling individually wrapped products. (e.g., breakfast muffins, cereal, etc.).
• Purchase products that come in recyclable packaging such as tin, aluminum and glass.
• Place rubber mats around bus and dish washing stations to reduce china and glass breakage.
• See Food Service for more restaurant related tips.
• Also see General Tips for more Office Waste Reduction Tips.

Recycling

• To preserve confidentiality while recycling look into having shredded files and papers recycled.
• Investigate recycled content and recyclable products. The Legacy Health System in Portland, Oregon switched form paper/plastic blend disposable coffee cups to an all-plastic recyclable cup. See Oregon Success Stories.
• Assess the need for recycle bins near vending machines, in waiting rooms or in other commons areas to accommodate visitors.
• Request recyclable tote containers from suppliers, whenever possible, to reduce chemical drum waste and disposal costs.
• Set up recycling containers at the dish disposal/tray collection area so that materials are sorted for recycling rather than thrown away.

Composting

• Contact your waste hauler or city recycling coordinator about collection service for kitchen and food waste that can be composted.
• For outdoor maintenance tips see Waste Reduction Tips for Landscaping.

For more information visit these web sites:

• Composting Council of Canada
• Composting News
• Internet Recycling and Composting Resource Page
• Recyclers World central composting category
• US EPA composting

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