What do I do with this material?
As you examine how staff use these materials and how much of each material is being used, consider taking off your “health care facility” hat and putting on your “reduce, reuse, recycle” hat. As you go through this thought process, ask yourself the following questions:
Is this material critical to my (our) department’s daily business needs? Or do I really need this material, this printout, this item? If yes, then ask:
- How can I (my department) minimize the use of material “X”?
- How can I reuse this material or have this material be reused by someone else?
- Who will recycle this material?
Keep in mind, waste that is not being created is waste you don’t have to manage or pay for further processing. The waste management hierarchy is reduce, reuse, and then recycle.
Examples and Tips by Department
Listed below are examples of different departments within a healthcare facility, examples of waste materials found in those departments, and tips on how to rethink them.
Material types: Aluminum, glass, plastic, cardboard, shrink-wrap, food waste, disposable/compostable to-go containers, steel, tin, equipment, utensils, reusable service ware, gloves, towels.
Tips for the cafeteria/kitchen:
- Use washable plates, eating utensils, glasses, and cups for cafeteria and patient service. (As an alternative to washable cutlery consider using compostable cutlery).
- Consider the best use of unserved food and food prep waste--follow the food hierarchy: prevent food waste, feed people (donate to local shelters), feed animals, and then compost remaining materials.
- Offer discounts to those who use a reusable mug.
- Sell reusable mugs with no-spill lids as a fundraiser.
- Establish an area for patrons to separate their waste from their recyclables. Clearly label bins. Put the garbage and recycling bins side-by-side.
- Switch to dispensers (juice, water, etc.) for patients instead of individual cartons.
- Establish a "think before you use" campaign to decrease use of disposable items.
- Use environmentally friendly cleaning solutions.
- Purchase durable items and items that can be reused or returned.
- Reuse items for another purpose.
- Consider cooking oil collection for use as biodiesel.
- Donate textiles (to be turned into a reusable product) or equipment through programs like iReuse and MedShare.
- Request your suppliers to eliminate extra packing materials and packaging.
Material types: Cardboard, shrink wrap, garbage bags, cleaning supplies, batteries, old equipment, cleaning rags, gloves.
Tips for custodial services:
- Read the report Cleaning for Health: Products and Practices for a Safer Indoor Environment for environmentally preferable cleaning products and methods that have been effectively used in office buildings, schools, hospitals, and other facilities in the United States and Canada.
- Examine the contract you have with the hauler of "red bag" or regulated medical waste. Ask what the contractor does and does not provide to you. If there are gaps, request assistance and/or renegotiate the contract so that you have clean and reusable containers. Use signage and education to reduce regular trash from going into red bags.
- Eliminate the use of plastic trash bag liners in containers where it is unnecessary, such as paper bins. Clearly label the paper collection bins.
- Use clear bag liners for recyclables where needed and black liners for trash.
- Use washable microfiber mops.
- Buy cleaning substances in large gallon drums that can be refilled by your supplier.
- Use concentrated cleaning solutions.
- Reuse packing materials and packaging.
- Be aware of items banned from the trash. For example, batteries and fluorescent bulbs cannot be thrown in the regular trash. Contact your garbage hauler for information regarding proper collection and disposal.
- Use nontoxic, low VOC interior paint, and recycled paint for exteriors (recycled paint is collected from consumers and remanufactured).
- Contact your hazardous waste hauler regarding pick-up of additional hazardous or universal waste materials.
- Offer appropriate sharps collection and clear signage for hospital staff and visitors.
- Use a certified collector/recycler for electronic waste.
Material types: Cardboard, shrink wrap, foam packaging peanuts, bubble wrap, pallets; collection point for recyclables.
Tips for the dock area/shipping/receiving areas:
- Provide recycling bins to collect aluminum cans.
- Have a bin(s) for waste and recyclables that are clearly labeled and placed side-by-side.
- Designate areas of the dock for collecting materials, such as shrink wrap, peanuts/expanded polystyrene foam, and cardboard.
- Repair pallets or repurpose wood that is not repairable. Donate wood to a local Habitat for Humanity facility.
- Request vendors and suppliers to minimize packaging.
- Reuse packing or ask vendors to take it back.
- Ask your vendor to be responsible for the types of packaging materials that they use (for example disposable versus reusable). Request that materials are recyclable or biodegradable (for example, cellulose-based peanuts). Consider asking your vendor to use reusable containers to deliver your materials and backhaul them for future use.
Emergency Rooms/Exam Rooms
Material types: Gowns, blue wrap, tools, biohazard/sharps containers, patient care supplies, prescription supplies, toiletries, equipment (beds, monitors, trays), gloves.
Tips for the emergency rooms/exam rooms:
- Blue wrap is a highly specialized polypropylene (# 5) plastic product used as a durable, sterile, protective cover, to wrap and store sterilized instruments trays in the operating rooms. Consider collection of clean material for recycling.
- Consider exam gowns that can be reused/re-sterilized.
- Use reusable sharps containers that are collected, emptied, washed and returned for reuse.
- When upgrading equipment, donate older equipment to underserved clinics, vet clinics, or MedShare.
Material types: Antifreeze, oil, rags, tires, filters, cones, signage.
Tips for fleet:
- Have fleet staff determine their own driving patterns (log mileage for a designated time range) and explore options and incentives for reducing their mileage.
- Use wireless phone services or walkie-talkies for staff to have informal meetings or ask and answer questions.
- Inflate tires to appropriate tire pressure.
- Consider retreaded tires for trucks.
- Establish cooling stations and/or rain stations for visiting drivers to avoid running the truck engine.
- Use re-refined oil and environmental oil filters.
- Consider case studies of California fleets using re-refined oil.
Home Health Care
Information from this page can be applied to in home care. CalRecycle's Health Care Waste at Home page provides specific information regarding sharps, medication, and mercury use in the home.
Hospital Center Facility
Material types: Furniture, construction and demolition, deconstruction, road work, benches, paint.
Tips for the hospital center:
- Donate materials such as furniture, art work, clean drums/plastic containers, equipment to iReuse and MedShare.
- Work with contractors to divert Construction and Demolition (C&D) materials. CalRecycle's C&D Debris Recycling website offers guidance for reuse and recycling of C&D debris.
- Consider repurposed benches, recycled plastic lumber benches, and other environmentally preferable purchasing choices.
- Contact your hazardous waste hauler regarding pick-up or drop off of hazardous materials such as paint and sealers.
Material types: Glass ware, sharps, bio-hazards, petri dishes, hard plastic shipping containers, cardboard, expanded polystyrene containers, disposable packing materials, gloves.
Tips for the laboratory:
- Discuss program efficiency options with your vendor (can vendor use reusable containers for delivery of materials and then backhaul the containers from the previous delivery).
- Discuss collection system for sharps and bio hazards with your collection vendor.
- Contact your hauler to determine if there is a local collection program for expanded polystyrene containers. If not, request that your suppliers use reusable/recyclable packaging material.
Material types: Grass, trees, shrubs, other organic materials, mulch/wood chips, plants, fertilizers, pesticides.
Tips for landscaping:
- Use mulching mowers and leave grass clippings on the lawn so they can decompose naturally (grasscycling).
- Landscape using plants that grow slowly or have plenty of growing space so they do not need to be trimmed often.
- Use native and/or drought tolerant plants to reduce water and energy use.
- Chip on-site for mulch, and compost on-site or through a city/county green waste program.
Medical/Surgical Supply Rooms
Material types: Gowns, blue wrap, tools, plastic tubing, biohazards/sharps, patient care supplies, equipment (monitors, trays), gloves.
Tips for the medical/surgical supply rooms:
- Work with suppliers to reduce unused items from custom surgical packs.
- Contact your manufacturer when one item in a surgical tray is causing the whole pack to outdate early (e.g., tetracaine in a spinal tray).
- Switch from disposable to reusable medical instruments (for example, stainless steel trays, laparoscopic instruments).
- Purchase washable surgical, isolation gowns and sterilization trays.
- Mend gown ties so they last longer.
- Convert surgical drapes into biopsy cloths.
- Sanitize and reuse plastic fracture pans.
- Sanitize and reuse graduated measuring containers.
- Donate clean, unused operating room equipment and supplies for reuse domestically (to universities and vet clinics) or through MedShare.
- Minimize the use of blue wrap and recycle clean blue wrap a highly specialized polypropylene (# 5) plastic product used as a durable, sterile protective cover to wrap and store sterilized instruments trays in the operating rooms.
Material types: Diapers, reusable baby bottles, nipple lids, disposal bottles, plastic inner liners, burping rags, toiletries, magazines, baby clothes, cleaning supplies, linens.
Tips for the nursery room:
- Use reusable items that can be resterilized, such as nursery bottles and burping rags.
- Reduce the quantity of disposable items. Do not over-purchase.
- Reuse items for another purpose such as a cleaning cloth.
- Donate linens and textiles to be turned into industrial rags.
Material types: Paper, prescription dispensers, patient folders, office supplies, forms.
Tips for nurses station:
- Use refillable pencils and pen cartridges.
- Set photocopier to make double-sided copies, print only what you need, reuse single-sided sheets, and recycle more paper.
- Reduce blank patient output pages from automated reporting (for example, if patients don’t have a drug prescription).
- Stock 100 percent recycled-content paper in the printers, copiers, and fax machines.
Material types: Paper, office supplies, forms, computers/fax machines/copiers, toner cartridges, food waste.
Tips for offices:
- Print only what you need, set photocopier to make double-sided copies, reuse single-sided sheets, recycle and reduce office paper.
- Distribute information electronically via e-mail or intranet. If electronic distribution will not work, then post information on a central bulletin board for staff to check.
- Provide education for the proper disposal of universal waste (U-Waste). U-Waste includes fluorescent lamps, cathode ray tubes, instruments that contain mercury, batteries, and others.
- Consider collection or composting of food waste such as break room scraps, meeting leftovers, and employee leftovers.
- Customize the distribution of reports (for example, daily census).
- Keep records on double-sided copies for paper documents, or electronic.
- Consolidate multiple forms and reduce extra copies.
- Keep written reports and memos to a minimum and limit distribution, or send electronically.
- Purchase 100 percent recycled-content paper for copying, stationery, and business cards.
- Cut down on multiple subscriptions of medical publications--ask staff to share.
- Provide recycling bins to collect aluminum cans and glass/plastic beverage containers.
- Use concentrated cleaning solutions.
- Ask your vendor to be responsible for the types of packaging materials that they use. Request that materials are recyclable or biodegradable (for example, cellulose-based peanuts). Consider asking your vendor to use reusable containers to deliver your materials and backhaul them for future use.
Material types: Gowns, linens, toiletries.
Tips for patient-care supplies:
- Determine if cloth towels can be used, reused, and then later made for rags.
- Replace paper towels with air dryers where feasible.
- Reduce the quantity of items. Purchase durable, reusable products and items that can be repaired.
- Look for ways to reduce battery waste:
- Alternative Power Products. Products that utilize power obtained through mechanical means, such as winding, shaking, or squeezing.
- Electrical Storage, Present, Past and Future. Adescription of all types of rechargeable batteries.
- Rechargeable Battery and Charger Sources. Where to buy rechargeable batteries and chargers.
- Inform patients about Medication Waste Disposal--a listserv and information page.
- Educate patients about local programs, such as Green Pharmacy Take Back Program.
- Donate linens and textiles to be used as feedstock for other products.
- Provide decubitus-care mattresses instead of foam "egg-carton" mattresses.
- Eliminate duplicate admission kits.
- Replace disposable admissions kits (water pitchers, glasses, and bed pans) with reusable’s in patient rooms where feasible.
- Use washable, resterilized linens, mattress pads, gowns, and emesis basins where possible.
- Educate patients about old mercury items and offer collection.
- Convert blankets and quilts into potholders. This could be a volunteer project, and the products could be sold for a hospital or community fundraiser.
- Set up system where nursing staff evaluate personal care items such as aspirin packets, tissues, shampoo, baby wipes, and diapers for reuse through donations (following infection control guidelines) instead of automatically disposing them.
- Inform patients about CalRecycle's Sharps Waste page and listserv.
Material types: Blue wrap, paper, plastics, disposable packaging.
Tips for purchasing:
- Reduce the amount of material you buy to accomplish any task.
- Reuse durable products and purchase refillable, or returnable products.
- Buy in bulk whenever possible to reduce packaging.
- Select or ask vendors to follow packaging preference criteria, for example if a vendor can offer no disposable packaging, minimal packaging, or take back for reuse.
- Reuse packaging and other available material for out-going deliveries.
- Improve ordering practices so perishable products don't become outdated and unusable.
- Cut down on multiple subscriptions of medical publications--ask staff to share.
- Buy medical devices that do not contain mercury or lead to reduce the release of toxins into the environment.
- Recycle copier and printer toner cartridges Ask the manufacturers about take-back programs or locate a local business to refurbish or recycle the cartridges.
- Properly dispose of thermometers, sphygmomanometers (blood pressure monitors), esophageal dilators, and weighted tubing that contain mercury. These items are regulated as hazardous waste under the Department of Toxic Substances Control's (DTSC) Universal Waste program.
- Buy concentrated cleaning solutions for staff to mix as needed. In addition, buy environmentally friendly cleaners.
- Ask your vendor to be responsible for the types of packaging materials they use. Request materials that are recyclable or biodegradable (for example, cellulose-based peanuts). Consider asking your vendor to use reusable containers to deliver your materials and backhaul them for future use.
- Practice environmentally preferable purchasing.
- Buy recycled content products whenever possible.
- Encourage reuse among employees and departments. Establish a reuse room or centralized “trading post” table for surplus or unwanted materials and supplies.
- If the facility is remodeling, donate old furniture and textiles locally, and donate equipment through programs like MedShare.
Sterile Processing and Surgery Area
Material types: Blue wrap, reusable containers, tape, tools, gloves, masks, gowns, hats, tubes, sterile material to soak up fluids, bandages.
Tips for sterile processing and surgery area:
- Blue wrap is a highly specialized polypropylene plastic product used as a durable, sterile protective cover to wrap and store sterilized instruments trays in the operating rooms. Consider collection of clean material for recycling.
- Contact your manufacturer when one item in a surgical kit is causing the whole pack to outdate early, or ask if a nonused item can be left out of the prepack entirely.
- Switch from disposable to reusable medical instruments (for example, stainless steel trays, steel instrument sterilization boxes).
- Purchase washable surgical and isolation gowns that can be sterilized and reused.
Material types: Film, developing chemicals.
Tips for the X-ray room:
- Consider possible backhaul and recycling of old and used film.
- Evaluate changing to a less-toxic x-ray developer or digital equipment.
Visiting Rooms/Family Waiting Room
Material types: Magazines, books, furniture, art, beverage bottles, cans, cafeteria food containers.
Tips for the family waiting room/visiting room:
- Cut down on multiple subscriptions of medical publications by asking staff to share and donate journals and magazines.
- Provide recycling bins to collect beverage cans and bottles.
- Consider ambiance of cafeteria to encourage more sit-down eating and less take out with disposables.