Waste Management

Achieving cost savings and complying with Environment Agency regulations through improved waste management

Background
The Royal Cornwall Hospital Trust (RCHT) was facing severe problems with its waste management. Not only was spending on disposal spiralling, but it faced action from the Environment Agency for breaches of regulations.
Waste was not being correctly segregated and the systems were not sufficiently rigorous to prevent domestic waste streams being contaminated by clinical waste. In addition, as waste was not being appropriately managed, domestic waste was entering the clinical waste stream and so being disposed of at significantly higher costs.

The challenge
This situation required a swift turnaround whereby a simple system, addressing the issues of poor waste management, could be implemented in a busy hospital with 5,000 staff across three sites. It was time-sensitive and essential in order to avoid potential fines of up to £750,000 and the possible imprisonment of senior executives.
Once the solution had been identified, it became necessary to find funding for the equipment and training required. This was a problem as waste charges constituted a cost for all areas/department but any savings accrued, would be credited to the Waste Department alone. Finding funds to pay for this and getting sign-off for the project involved multi-level/department negotiations.

The approach
The first action was to observe key areas such as wards, clinics and the Emergency Department to understand how activity dictated the treatment of waste. This included speaking to a cross-section of the staff to find out, first-hand, the challenges they faced and where they felt improvements could be made. Not only did this yield important information but it also ensured engagement and buy-in from all concerned right from the start.
The second stage involved research of systems in use within other hospitals and similar organisations. Combining the waste management requirements across the RCHT’s three sites with proven best practices, it was possible to devise a system that met RCHT needs, adapted to suit each site. This was followed by a detailed implementation programme including the procurement of essential equipment and a detailed roll-out over a three-month period.
The final stage of the programme was more tactical and included removing clinical waste bins from public areas to avoid them being used by patients for domestic waste. Staff were provided with training and clear guidelines on how to dispose of various types of waste to avoid cross contamination.
The roll out was done on an area-by-area basis and involved an initial training programme for all staff including the waste operatives’ team who work across the site and were viewed as instrumental vis a vis maintaining ongoing compliance and flagging up issues. This was supported by regular support visits for several weeks to ensure that new processes were being maintained.

The outcome
Compliance with waste segregation and patient safety regulations were achieved, avoiding major fines and legal action as well as ameliorating site environments for everyone’s benefit.
In the course of the project, it became clear that by putting the right processes in place, significant savings could be made in waste disposal costs. Opportunities were also identified to sell some of the waste products creating income for the Trust:
A significant amount of waste was diverted from the more cost-intensive clinical waste streams, leading to significant financial savings. Improved waste segregation allowed for improved and more effective recycling which contributed to reducing overheads and identifying income-generating activity
Comprehensive training and staff support ensured that the new systems were embedded during the roll-out period. The provision of a training package and film to be used as annual mandatory training and/or induction training ensured ongoing compliance with the need to segregate waste.

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