It is a waste of time, effort and resources to implement separate waste collection for healthcare facilities if staff and visitors are not on board with the initiative. Cromwell Polythene Managing Director James Lee explores the problem of good intentions failing at the point of disposal, and what can be done to tackle this.
You can lead a horse to water, but you can’t make it drink – so the saying goes. Similarly, you can supply the correct bins for waste segregation, but you can’t make people use them properly. There are four steps to follow when it comes to waste segregation at source in healthcare; ensuring there are enough bins, that they are in the right place, that they are clearly marked, and finally that instructions are being followed. It is all too apparent that the last step is a stumbling block for healthcare staff, patients and visitors.
A recent visit to hospital brought home this challenge – lifting the lid on a number of bins in public areas and patient treatment rooms revealed examples of non-compliance that are unfortunately all too typical. For instance a yellow UN bag for waste incineration had been placed in the visitors’ toilet bin, and was full of used paper towels. This simple error represents a lamentable inefficiency. Yellow UN bags are intended for the highest level of clinical infections waste and are handled accordingly at incineration – clearly a black bag would have been appropriate in this instance, and resulted in more cost-effective disposal.
At the same time, flowers, newspapers and food and drink packaging had been stuffed in bins for infectious waste (orange bags). It is of crucial importance that infectious wastes are always separated from recyclables and domestic/residual waste streams, ready for safe disposal through alternative treatment or incineration.
Time and again, items that could be recycled are being placed in the incorrect bins. The irony is that most people wouldn’t think twice about recycling and correct waste segregation at home, but many do not extend this behaviour to healthcare settings or other public places. The fact is that poor segregation will lead to increased costs of disposal and may result in prosecution if the waste is considered to be ‘mixed’ and is deemed no longer suitable for the waste treatment or disposal option you have chosen to use. Segregation onsite is vital to ensure that waste is stored, transported and ultimately disposed of in the correct manner to maintain compliance with clinical waste regulation.
Not an optional activity
Since in many instances waste segregation bins are already in place in hospitals, it is the hearts and minds that need to change. Staff training is fundamental to making good waste management second nature in healthcare, and while basic training need only cover the identification and separation of different waste types and the bins provided, in order to be effective the point needs to be driven home that correct use of the bins is mandatory, not optional.
However, a lot of healthcare providers rely heavily on agency staff, and this is where education and re-education is key. All staff – including temporary agency staff – should receive proper training on the crucial importance of correct waste management. This should take place throughout their time at any facility, not just at the induction stage, with clear incentives to comply, as well as disincentives for non-compliance.
Awareness-raising campaigns in healthcare settings should also target patients and visitors. Hand hygiene compliance in hospitals has been increased with similar initiatives. There is no reason why correct waste separation should be treated any differently, after all the benefits to the environment and society are of the same magnitude as infection prevention and control campaigns. If senior management made waste segregation training a key priority, it would not take much time for this initiative to pay for itself in efficiency savings.
Thankfully there is a lot of expert guidance available to help the healthcare sector improve rates of waste segregation at source. Information from the Chartered Institution of Wastes Management (CIWM) includes the Introductory Guide to Healthcare Waste Management in England & Wales, which provides a comprehensive overview of healthcare waste management. The CIWM’s guide to Managing Healthcare-Type Waste from Non-Healthcare Activities also provides valuable information about waste segregation, collection, record keeping and much more.
Waste management should not be an afterthought. It is time to stop wasting hospitals’ time, effort and resources and start implementing waste separation training and awareness raising campaigns in healthcare facilities. Working together, our industries can help change perceptions and inspire staff, visitors and patients to give this issue the respect and attention it deserves.
Cromwell Polythene is a major supplier of waste management solutions to the healthcare sector and an active member of the Sanitary Medical Disposal Services Association.