Solving Hospital Waste with Sustainable Healthcare

A more sustainable U.S. healthcare system spells huge hospital savings by preventing expensive hospital waste.

What are your primary concerns when you visit a hospital? The quality of your loved ones’ lives? Receiving a life-changing diagnosis? How your insurance and finances will affect your future care?

Chances are, hospital waste and the management of all the trash bins surrounding you are the furthest things from your mind.

But when it comes to hospital waste, healthcare sustainability is a public priority.

In recent case studies, Health Care Sustainability Initiative found that the U.S. the healthcare industry has the ability to save as much as $15 billion over the next 10 years simply by adopting more sustainable practices.

An infrastructural redesign of a hospital’s waste management program translates into energy efficiency, waste reduction, and environmentally-friendly purchasing trends. In turn, these efforts respectively save millions of dollars and promote the positive health of the surrounding community and set higher standards for the nation’s well-being. Thus, it is important to focus on recycling hazardous waste.

Wasted Resources/Abundant Misspending

Not unlike other global healthcare providers, the U.S. healthcare system is up against challenges from the proliferation of aging Americans, widespread chronic disease, limited primary care providers, and a lack of funding.

The financial urgency of solving hospital waste issues is no false positive. Hospitals’ second highest expense—right behind labor—is supply chain costs. Sustainability Roadmap to Hospitals reported that the average hospital provider spends more than $72 million, nearly one-third its annual operations budget, a year on supply chain functions.

Just about 7,000 tons of daily waste is generated by hospitals, costing $10 billion in yearly disposal costs.

Major trends in 2016 already point towards smarter designs, including integrated care platforms that offer flexibility in the rapidly-changing clinical world. In turn, hospitals and health systems are shifting their focus to sustainable healthcare facilities and higher quality practices in the long run.

While healthcare facilities are the second highest ranking buildings in national energy use per square foot—fourth for total energy use—data collected from the U.S. Green Building Council suggests roughly one percent of healthcare buildings are registered with Leadership in Energy and Environmental Design (LEED), let alone certified. That’s about 0.4 percent.

The first healthcare structure to meet LEED platinum certification criteria was in 2007. The Cornell study pointed out that was seven years after the first office building was bestowed with a LEED Platinum status. And of 581 LEED Platinum buildings in the U.S. in 2013, merely 13 were healthcare facilities.

“Historic data shows that current trends in energy consumption indicate a need to accelerate the sustainability movement in healthcare. Making healthcare buildings sustainable will make a significant difference in national energy use, ” explained Assistant Professor of Design and Environmental Analysis, and Co-director of Cornell’s Health Design Innovations Lab, Rana Zadeh.

Energy

More than 136 million people visit the emergency room each year, all relying on hospitals’ modern resources. According to the U.S. Energy Information Administration, currently the 3,040 largest hospitals in the country use over five percent of the energy consumed by the entire commercial sector.

Surprisingly, medical technology and life-saving machines only make up a small portion of energy consumed at hospitals. The main culprit is climate control, water heating, and lighting. Climate control alone can range from 16 percent in the south to 40 percent in northern states.

In its 2015 Hospital Energy and Water Benchmarking Survey results, the energy efficiency and sustainable design engineer firm Grumman/Butkus Associates noticed while the 20-year trend of diminished fossil fuel use continued, electricity use was not declining.

Carbon footprint results remained pretty steady over time: roughly 60 pounds of carbon dioxide equivalent per square foot, each year, but trending slowly into lower numbers after 2010.

“Hospitals are investing in efficiency measures and making progress, but have much further to go. Some of the low-hanging fruit is gone, but there are still many cost-effective opportunities remaining for reducing energy usage and costs,” explained G/BA Chairman Daniel L. Doyle.

Of the 117 facilities surveyed, some healthcare facilities used over 200,000 British Thermal Units (BTU) per square foot in fossil fuels over the course of one year, versus that of the general-mid range of facilities at 150,00 BTU per square foot each year, and those using 100,000 BTU per square foot annually.

In term of electricity, several hospitals consumed over 40 kilowatt-hours per square foot, compared to mid-range consumers (25 kWh per square foot), and few with less than 20 kWh per square foot each year.

Doyle noted that “The downward usage trend reflects a movement to eliminate city-water-cooled equipment, as well as the increased use of low-flow and occupancy-based plumbing fixtures. Water usage is an emerging issue. There is still much room for improvement.”

These improvement efforts are contingent upon taking a few first steps.

First, retrocommission and the examination of the facilities where underperforming equipment can be identified. According to the Health Care Sustainability Initiative, retrocommissioning alone can cut up to 15 percent of a building’s energy use.

Next, improving light sources, fixtures, and controls, making the most of natural sunlight, and, in turn reduce the overall load from equipment use.

Optimizing airflow—through upgraded fan systems, efficient ventilation, and maximizing free cooling whenever available—can lead to decreasing the 8 percent of moving conditioned air and the 25 percent of energy spent solely on heating and cooling in a hospital.

Investing in suitable containers and equipment, together with implementing effective garbage collection techniques, will further improve medical waste management procedures. Adherence to regulations and consistent evaluation of waste generation rates are essential components of efficient management.

Upgrading to a properly sized HVAC system, working with local utility companies, Energy Star, American Society for Healthcare Engineering’s Energy to Care Program, installation of Healthcare Clean Energy and Practice Greenhealth’s Healthcare Energy Impact Calculator tool, and consideration of LEED certification are all great options for optimal energy efficiency.

Waste

On average, 32 pounds of waste is generated per hospital bed on any given day. According to the Western Sustainability and Pollution Network, biohazardous waste is 13 times more costly to dispose of than regular trash, and red waste has a price tag of $450 per ton to dispose. Incorrect disposal of items like IV bags and paper towels into red waste bags alone can cause an increase of five times the cost.

Red bag waste—or regulated medical waste (RMW)—is biohazardous waste that has the potential to expose people to infectious diseases. It includes blood, body fluids, discarded sharps, inoculated culture media, tissue, and slides.

University of California, San Francisco Medical Center has employed a simple way to diminish overuse of red waste disposal bags: removing and replacing red bag bins from patient rooms with small rolls of red bags in a drawer of patients’ rooms.

By focusing on reducing red waste, avoiding unnecessary hospital costs is built into the supply chain. Inova Fairfax Hospital saved $200,000 by reducing red bag waste.

Smart Supply Chain: The Kanban Inventory Method

Leaner stocking methods mean less wasted resources and money. To prevent supplies being left unused, the Kanban inventory method is a smarter means to maintain supply inventories across departments and allow hospitals to track and reorder supplies efficiently.

Each year, water supplies are polluted with 250 million pounds of unused pharmaceuticals that are discarded by U.S. healthcare facilities.

Kan—color—and ban—the card used for inventory—when paired together, are visual cues that indicate how much stock is on hand and re-ordering needs for stock, including surgical equipment, gloves, paper, and more.

Reducing excessive purchasing habits is part of a leaner supply chain that promotes smarter shopping and creates less hospital waste. The University of Chicago Medicine’s Bernard A. Mitchell Hospital identified over $600,000 wasted on expired medical supplies after a supply chain audit.

By reducing overage over the course of a year, the University of Minnesota Medical Center in Minneapolis reduced their hospital waste by 5,332 pounds and yielded $81,278 in savings.

Opportunities Ahead

The bottom line is, national wellness and wealth are both at stake here.

Sustainable healthcare means making affordable choices for hospitals and their communities, and red waste, energy, and smarter supply chain are just a few key elements to consider. What’s the recommended prescription for infrastructural change?

Integrating long-term solutions to end healthcare facilities’ cycle of over-consumption and wasteful patterns requires one very significant first step: commitment.

Reasoning behind the direction can range from financial savings, corporate responsibility, improving the patient’s experience, employee wellness and retention, positive public image, or improving the health of the community by reducing pollution.

Whichever matters most, the priority in focus is ensuring the continued safety and care for millions of U.S. patients.