Cleveland Clinic has a goal to divert 100% of our non-hazardous waste from landfills by 2027. Our efforts include reducing the amount of waste we generate, reprocessing devices, recycling and composting programs and creative reuse initiatives. These efforts involve collaboration across multiple departments and individual caregiver participation. In addition to our enterprise waste reduction initiatives, many caregivers champion waste reduction and recycling efforts in their functional areas, especially members of our green teams, committees and communities.

Landfill Diversion

Enterprise Landfill Diversion by Quarter | Cleveland Clinic Main Campus Landfill Diversion Improvement | Cleveland Clinic

COVID-19 and Waste at Cleveland Clinic

The COVID-19 pandemic increased the use and visibility of disposable items, such as facemasks, gloves and hand sanitizer. The widespread use and littering of these items across the nation and around the world raised awareness of the pandemic’s environmental consequences, generating a national conversation on the issue of waste and COVID-19. At Cleveland Clinic, the pandemic had a mixed impact on our waste reduction and recycling efforts. Our overall use of materials declined in 2020 due to a slowdown of both clinical operations and construction, and we generated nearly 16% less waste compared to 2019. Additionally, our recycling rate, which includes waste from construction and debris (C&D), decreased from 29% in 2019 to 27% in 2020. Our enterprise landfill diversion rate including C&D was 29% in 2020, compared to 32% in 2019.

The decline of our recycling and landfill diversion rates are primarily attributable to decreases in the volume of construction material and paper we produced. Due to the pandemic, we postponed our renovation and construction work and transitioned administrative teams to a work from home model. Our construction work will recommence, but a portion of our caregivers will be working from home permanently on a full-time or part-time basis moving forward, which we expect will impact our recycling rates.

Hazardous and Regulated Medical Waste

Hazardous and Regulated Medical Waste

While we work to reduce the amount of hazardous waste we generate, important items for healthcare delivery such as sterilization chemicals, pharmaceuticals, electronics, laboratory chemicals and radiological films contain hazardous properties. We have several policies and standard operating procedures (SOP) to ensure the safe handling, storage, transportation and disposal of all hazardous wastes, including but not limited to a Hazardous Materials Transportation SOP, Hazardous Waste Management 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 2020, we transported 20 tons of hazardous waste from our Ohio and Florida hospitals and family health centers for treatment.

Our Greening the Operating Room (OR) Committee educates and engages caregivers on proper waste sorting in our ORs, and champions recycling pilots and programs, reprocessing efforts and transitioning away from single-use items where possible. One of the Committee’s focus areas is reducing the amount of regular trash and recycling items placed in regulated medical waste (RMW) receptacles. Efforts include sharing the environmental and cost benefits of proper waste sorting, standardizing the number of bins in our ORs and reducing the size of our RMW bins where possible. Additionally, Cleveland Clinic processes a portion of our RMW at main campus, Hillcrest Hospital and Akron General Hospital where we have equipment to do so, reducing the transportation footprint of managing this waste.

Reprocessing, Recycling and Composting

Reprocessing, Recycling and Composting

Single-Use Device Reprocessing

Caregivers prepare operating rooms by arranging sterile clinical instruments that surgeons may need during a procedure, however, surgeries do not always require the use of all instruments. We have been reprocessing these devices since 2011 to prevent them from entering the waste stream by following a strictly regulated process for sterilization and quality assurance. Once completed, we reuse or resell the reprocessed items at a lower cost to healthcare providers. In 2020, we reprocessed approximately 44 tons of single-use devices through this program.


To better understand current recycling trends and challenges, including ways the COVID-19 pandemic was impacting recycling, Cleveland Clinic Sustainability visited a local Material Recovery Facility (MRFs) in the spring of 2020. Through this visit, the team learned more about common contaminants placed in recycling bins and the damage they can cause to recycling equipment, recycling markets and the value of different recyclable materials. This tour was part of the Sustainability team’s ongoing efforts to improve Cleveland Clinic’s recycling programs. Additional 2020 recycling initiatives included engagement with vendors to identify and reduce recycling contamination, updating signage, making and communicating about changes to recycling programs due to COVID-19, exploring new recycling programs and identifying ways to expand existing programs. Despite disruptions related to the COVID-19 pandemic, in 2020 we recycled:

  • 3,492 tons of paper
  • 2,008 tons of comingled recyclables
  • 99 tons of scrap metal
  • 245 tons of cardboard

Cardboard was in high demand in 2020 because the COVID-19 pandemic led to an increased demand for shipping items. In response, our Sustainability team increased communications with our green teams and caregivers about our cardboard recycling programs. As a result, we recycled more cardboard in 2020 than we did in 2018 (229 tons) and 2019 (216 tons).

Comingled Recycling by Tons

Composting Food Waste

The COVID-19 pandemic significantly impacted our composting program in 2020. When possible, we continued composting pre-consumer food scraps from our nutritional services at our main campus and Euclid, Avon, Fairview and Lutheran hospitals with our local, Cleveland-based vendor. We composted approximately 23 tons of food waste in 2020.

Kick the Can Campaign

Recycle, garbage, paper shredder can

To reduce COVID-19 transmission risk at our facilities, Cleveland Clinic transitioned more than 7,000 caregivers to a work-from-home model in March 2020. Following this transition, EVS was still collecting trash from individual waste bins at administrative locations for a reduced number of caregivers, some of whom were working only intermittently on site. Recognizing an opportunity to conserve resources, Sustainability and EVS worked together to inventory existing trash and recycling bins, develop plans to create centralized trash and recycling stations and remove excess bins at 13 Cleveland Clinic facilities. The Kick the Can initiative yielded the following positive outcomes:

  • Saved time for EVS caregivers
  • Reduced waste from trash liners
  • Decreased recycling contamination by aggregating bins and signage