Our goal is to send zero non-hazardous waste to landfill. However; in 2021, the ongoing COVID-19 pandemic—coupled with recycling infrastructure and market complexities—continued to create barriers to progress. In response, we mobilized cross-functional support for overcoming landfill waste diversion obstacles through the reestablishment of our Zero Waste Committee. With representation from caregivers in Sustainability, Environmental Services, Food Service and Supply Chain, this committee has insight into upstream sources of waste, diversion partnerships and programs, collection and contamination rates of various waste streams, waste infrastructure and the efficacy of different education and engagement campaigns. In 2021, the Committee mapped out our various waste streams and diversion programs, and identified action steps for improvement. They focused on building internal waste diversion capabilities by:

  • Engaging with vendors to review and improve data collection processes.
  • Revising and creating new signage and educational materials.
  • Exploring potential new waste diversion solutions.
  • Developing new and existing relationships with organizations focused on waste diversion.

Additionally, caregiver engagement and outreach remained a key priority. Many caregivers — especially members of our green teams, committees and communities — model waste reduction behaviors, lead waste reduction pilots and ensure the success of existing programs. Through presentations, activities and events, our caregivers continue to inform and inspire one another to reduce and properly sort waste.

Landfill Diversion

Landfill Diversion

Our landfill diversion efforts include reducing, recycling, reusing, reprocessing, composting and donating, and involve collaboration across many teams. In addition to reducing our environmental footprint through these efforts, we also seek opportunities to make a positive community impact. For example, in 2021, we donated 139,290 pounds of surplus medical supplies for distribution to local, domestic and international communities in need.

In 2021, we diverted more than 8,068 tons, or 27% of our waste from landfill. This measure includes waste from construction and debris (C&D), and was a 3% decrease from our 30% diversion rate in 2020. Our recycling rate, including C&D, decreased from 27% in 2020 to 24% in 2021. While the tonnage of items we recycled in 2021 increased over 2020, it did not grow proportionately with our total landfill waste tonnage, which exceeded pre-pandemic levels.

Enterprise Landfill Diversion by Quarter

Main Campus Landfill Diversion Improvement

Reprocessing and Recycling

Reprocessing and Recycling

Single-use device reprocessing

Since 2011, we have been collecting single-use devices from our operating rooms for reprocessing to prevent them entering the waste stream. Once collected, these instruments undergo rigorous sterilization and quality assurance processes and are resold at a discounted rate. Cleveland Clinic purchases some of these items back for reuse, in addition to other healthcare providers.

In 2021, we collected approximately 20 tons of single-use devices for reprocessing, and have collected 256 tons of devices for reprocessing in the past 5 years.


Our comingled recycling program is one of our most visible and recognizable commitments to sustainability. To this end, Cleveland Clinic’s Sustainability team and green teams are actively engaged in promoting and improving this program. Through our internal learning and collaboration platform, Connect Today, we created and shared content to promote recycling at work and at home. Some examples included:

  • A directory of county recycling websites representing the locations of all of our Ohio and Florida hospitals.
  • Recycling guides for all of our recyclable waste streams.
  • Calendar events for environmental holidays, such as America Recycles Day, which included educational resource links and a list of ways to make a positive impact on the day.

Our green teams also held events at their facilities to celebrate Earth Day and America Recycles Day, and provided other engagement activities to promote recycling throughout the year.

Material Recovery Facility (MRF) | Cleveland Clinic

In the fall of 2021, Cleveland Clinic’s Sustainability team conducted a site visit to a local Material Recovery Facility (MRF) to learn more about current recycling trends, challenges and pandemic impacts. The visit provided valuable insight into common contaminants placed in recycling bins and damage they can cause to equipment, which the Sustainability team shared with our Zero Waste Committee and green teams to inform educational materials and signage. Additionally, the Sustainability team conducted an audit of comingled recycling bins at our main campus to better understand which non-recyclables are common contaminants in our blue bag recycling program specifically. During this audit, the Sustainability team found plastic bottles that contained a significant amount liquid in recycling bins. As a result, we will focus messaging on ensuring recyclables are empty and dry.

In addition to our comingled recycling program for bottles and cans, we have recycling programs for several other waste streams, including paper and metal. Some highlights of our 2021 efforts include recycling:

  • 3,861 tons of paper.
  • 2,107 tons of comingled recyclables.
  • 118 tons of scrap metal.
  • 462 tons of cardboard.


Comingled Recycling

Hazardous and Regulated Medical Waste

Hazardous and Regulated Medical Waste

Important items for healthcare delivery, such as sterilization and laboratory chemicals, pharmaceuticals and electronics can generate hazardous waste. To ensure the safe handling, storage, transportation and disposal of all hazardous wastes, we have several policies and standard operating procedures (SOP), including but not limited to: Hazardous Materials Transportation SOP, Hazardous Chemical Identification and Communication Policy, Hazardous Chemical Delivery and Storage Policy and Hazardous Drug and Pharmaceutical Waste Disposal Procedure. We work with a U.S.-based vendor to manage our hazardous waste within the U.S. and do not import, export or ship any hazardous waste internationally. In 2021, we transported 23 tons of hazardous waste from our Ohio and Florida hospitals and family health centers for treatment.

Regulated medical waste (RMW) contains potentially infectious material and requires special handing and treatment. These requirements increase the cost and resources needed to process RMW waste. Cleveland Clinic is able to process RMW at some of our facilities where we have equipment to do so, but engaging our caregivers in proper waste sorting conserves even more resources. Proper sorting ensures that we are not expending resources treating landfill waste as RMW waste. Our Greening the Operating Room (OR) Committee members educate fellow caregivers on proper waste sorting, audit waste streams and share ideas for improvement.



In 2021, Cleveland Clinic continued to engage caregivers in ecochallenges, or 3-4 week engagement campaigns that encourage individuals to take actions that benefit individual, community and environmental health. Through the Ecochallenge platform, caregivers could join our Cleveland Clinic Sustainability team and select daily and one-time actions to take during the challenge. By logging daily progress, caregivers could see their individual and team impacts and points add up throughout the 3-4 week campaigns. Caregivers were also very active on the team feed, sharing photos, responses to reflection questions and lessons learned. To promote engagement, the more caregivers participated in the challenges, the more times their names were entered into drawings to win eco-friendly gift bundles and other prizes.

Caregiver Ecochallenges | Cleveland Clinic

In 2021, Cleveland Clinic Sustainability created teams and recruited caregivers to participate in three Ecochallenges: Earth Month: Drawdown in April, Plastic Free in July and the People’s in October. Highlights of our team impacts across all three challenges include:

  • Diverted 426 single-use plastic items (cups, bottles, containers, straws and cutlery) from landfill by switching to reusable items.
  • Picked up 694 pieces of litter.
  • Planted 21 trees.
  • Sourced 76 meals locally, and consumed 53 vegan or vegetarian meals in place of meals containing meat.
  • Spent 4,611 minutes outdoors exploring local natural areas, going for neighborhood walks, picking up litter and/or taking a break from screens.
  • Avoided 367 pounds of CO₂ emissions by adopting more sustainable transportation options.
  • Dedicated 851 minutes to learning about sustainability issues.

Individual actions also included conserving energy and water, increasing intake of fruits and vegetables, mindfulness practice, meditation, exercising, additional sleep time, advocacy actions and several other activities that benefitted environmental, community and individual health.

Beach Cleanups

Beach Cleanups

As a follow up to the Plastic Free July Ecochallenge, we hosted volunteer beach cleanups in Northeast Ohio at Sims Park and Wendy Park through the Alliance for the Great Lakes Adopt-a-Beach initiative in August 2021. Caregivers and their family members picked up hundreds of bottles, cans, pieces of plastic, papers and other waste items along the shores of Lake Erie, and ensured their proper disposal. Lake Erie is an important source of fresh water, which sustains a diverse array wildlife, provides recreational opportunities, supplies drinking water and supports agriculture. Through the Alliance’s Adopt-a-Beach program, 15,000 volunteers pick up 18 tons of trash across all five Great Lakes each year, more than 85% of which is plastic.1

1 “Great Lakes Plastic Pollution”, Alliance for the Great Lakes, 2022, accessed 2 October 2022, greatlakes.org/great-lakes-plastic-pollution-fighting-for-plastic-free-water/