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Green Solutions

Waste Management

Not a load of rubbish

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Health care generates massive amounts of waste. This includes plastics, bottles, cans, chemicals, electronic devices, sharps, food waste and paper. Municipal solid wastes, are sent to the landfill, where the organic material will decompose to release methane. Biohazardous clinical waste are sent for chemical treatment and incineration, which gives out greenhouse gases. Incinerators emit more CO2 per megawatt-hour than fossil fuel-based power sources. Other harmful toxins are also released from incinerators, such as dioxin, heavy metals, hydrogen chloride gas and furans. These chemicals are carcinogenic and negatively impacts our endocrine system and fertility.

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Incinerators emit more CO2

per megawatt-hour than

fossil fuel-based power sources.

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In Hong Kong, over 4,000 tonnes of clinical waste was produced in 2020. Data is lacking regarding the amount of municipal solid waste generated by the health care sector. Tackling the problem of waste generation is of top priority in achieving sustainable health care.

Reduce

  • Purchase only products that are necessary

  • Purchase products with sustainable end-of-life disposal plans, such as recycling, refurbishing and reusing

  • Reformulate surgical kits and packs to remove items rarely used

Reuse

  • Buy reusable products

  • Reprocess single-use device by third party reprocessors

Recycle

  • Recycle plastics, aluminium, paper, and glass

  • Send waste electronic equipment to government treatment and recycling centre (WEEE·Park)

Rot

  • Compost food waste in local facilities

  • Send food waste to government organic resources recovery centre (O·Park)

Good waste segregation practice to avoid incineration of municipal solid waste

  • Staff education and waste audits

Some practical ideas
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Successful stories

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Throwing trash into the right can

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At the Carolinas Medical Center, red bags are designated for the collection of biohazardous waste. The Green Operating Room Committee noted their staff was throwing much of everything that touched a patient into red bags, including materials that are not significantly soiled.

 

To promote better waste segregation:

  • Staff were educated on the difference between biohazardous waste and general wastes, and on the importance of good waste segregation practices.

  • The size of red bag trash cans was changed to the smallest one in the room, and placed in the corner of the room, so extra effort is required to dispose of an item in the red bag.

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Red bag waste reduced by 75%

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Annual saving of over US$ 50,000

When reprocessing becomes the trend

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Reprocessing single-use device is FDA approved. It is a common practice among top hospitals worldwide. More than 100 types of devices can be reprocessed and reused, including ultrasonic scalpels, trocars, laparoscopic and endoscopic scissors. Third-party reprocessors are held to strict decontamination, sterilization and functional testing.

 

From 1997 to 2007 in the United States, >50 million devices were reprocessed, and >10,000 tons of medical waste were diverted from landfills.

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Source: Stryker

John Hopkins Hospital
2010 - 2011

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Saves $1.2 million USD

Metro Health Hospital

2008-2011

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Saves >$235,000 USD

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Avoids 2 tons of waste

Advocate Christ Medical Centre 2010

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Saves $400,000 USD

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Avoids 5 tons of waste

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Using only what's needed

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Procedures and surgeries utilizes instruments and devices that come in pre-packaged kits. Many items in these kits are rarely used, and are disposed of the end of the procedure.

 

A thoracic surgeon at the University of Minnesota Medical Centre reformulated the chemotherapy port placement kits, and reduced the number of items in the kit from 44 to 27 without impacting surgeon preferences.

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Reduces waste 80 pounds a year

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Annual saving US$2000

Preparing the right portion of meals

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Since 2011, the Health Care Food Service Team at Pamela Youde Nethersole Eastern Hospital reduced patients’ meal portions by 20% and prepare meals according to actual demand.

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Saves several hundred thousands dollars per year

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Food waste reduction 42 tonnes per day

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Ideas and challenges

Has my organization established and defined goals for sustainable waste management? Has the vision been actively and adequately communicated to our staff?

 

Is good waste management practice being publicized and rewarded? How can it be incentivized?

Executive leaders
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Procurement managers

Do the products purchased have sustainable disposal plans? Does the manufacturer offer refurbishing or recycling plans?

 

What is the packaging for the products purchased? Is it recyclable and/or made of recycled material?

 

Can we engage our suppliers to reformulate pre-packaged procedure kits to remove items that are not necessary from the packs?

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How often do I consider the environmental attributes of products that I wish to buy? Specifically their energy efficiency, water conservation properties and end-of-life disposition

 

Are recycling mechanisms in place for paper, plastics, aluminium and glass? Has it been made known to clinical staff?

 

Can waste electronic equipment be sent for recycling and recovery?

Facilities managers
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How often do I consider the environmental attributes of products that I wish to buy? Whether the products are reusable, recyclable and come in with less packaging

 

How can I minimize the use of single-use plastics in my workplace?

 

Are there recycling mechanisms in place for plastics, paper, aluminium and glass at my workplace? Has it been made known to our staff, and is the culture of recycling being encouraged?

 

Are municipal waste being thrown into the clinical waste bags? How can waste segregation be encouraged and facilitated?

 

Can third party reprocessors be engaged for refurbishing single-use device?

Nurses
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How often do I consider the environmental attributes of products that I wish to buy? Whether the products are reusable, recyclable and come in with less packaging

 

Can prepackaged procedure kits or surgical sets be reformulated to remove unnecessary items?

Doctors
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Can the menu be redesigned to reduce food waste? Are the portions right for our patients?

 

Can food waste be collected and composted?

Catering managers
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