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Nationwide, hospitals generate an estimated 6,000 tons of waste per day. Highly complex and regulated, achievements in responsible management of healthcare waste are hard won. Cleveland Clinic has made a commitment to reduce the amount of waste we generate and to divert as much waste as possible away from landfills, a diminishing resource. In addition to standard practices of waste management and traditional recycling programs, we are taking the lead in our community by working with local businesses and authorities to develop recycling markets to divert materials from landfills. We work collaboratively with our supply chain to reduce the amount of waste generated from product consumption and are donating and repurposing materials to in-need populations. As an example of our progress, several of our hospitals have exceeded a 30% landfill diversion rate in 2010.

From kitchens to procedure rooms, hospitals generate a wide variety of waste material in every corner of its facilities. While it’s true that hospitals generate much of the same material as any other business, such as paper, food waste and consumer recyclables, we are also faced with specialized or even hazardous waste streams that add to the complexity of waste management. Examples include lab chemicals, dental amalgam, bio-hazardous materials, electronics waste, and pharmaceuticals. Each of our 37 waste streams requires its own process, compliance assurance measures and education programs to ensure compliance, landfill diversion, cost management and discipline. Successful programs provide value to our patients and our organization, the environment, and the business community. For example, increasing the ease of paper recycling helps us meet our landfill diversion goals, generates valuable material for other businesses, reduces cost and helps us protect our patients’ personal health information.

The best way to manage waste is to avoid generating it at the outset. Our environmentally preferred purchasing practices put pressure on vendors to reduce product packaging, deliver products on reusable pallets, have end-of-life management plans, or make sure that products and packaging are recyclable. In an effort to improve patient and worker safety, the healthcare sector increasingly relies on disposable materials, while driving up waste volumes. Finding select opportunities to safely reuse, reprocess or remanufacture products can control waste and costs in both clinical and non-clinical environments. For example, we have deployed reusable cases to sterilize instruments, reducing our use of disposable materials without impacting effectiveness. Waste can also be prevented by delivering just-in-time inventory, optimizing supply storage and making sure multiple item kits or packs have only what’s needed.

Waste, by definition, is to "fail to take advantage of or use". Recycling, for instance, is another way to take advantage of materials previously determined to be waste, as is donation or composting material. If we examine waste streams in this light, new opportunities arise to reduce waste or for businesses to take full advantage of the materials value. We perform waste audits to determine our best opportunities and seek value within our waste streams. A key example is our program to capture operating room packaging for recycling. Unable to find an outlet for this material, we began by finding a market for the material, connecting our waste hauler to the market and designing a safety-focused process for collection. This program is now being offered to other hospitals across the nation.

Caregivers across Cleveland Clinic are learning about proper waste disposal and making better choices every day. Putting structures in place is key to ensure successful use of the recycling, waste management and waste minimization programs. Tactics like color coding waste streams, planning sufficient space to store recyclables in buildings, educating caregivers and designing processes that make doing the right thing the easiest choice are all parts of our comprehensive approach. Our 2008 Service Center exemplifies designing for success. In addition to supporting idle reduction strategies, the building’s supply logistics systems capture cardboard at the docks and delivers just-in-time supplies to reduce expired supplies and packaging waste.