Medical Center Hospital of Vermont, Burlington, Vt., will introduce early in 1992 a special program called MedCycle, which recycles "clean" or pre-op waste from the operating room waste stream, as a part of its general recycling program, says Hollie Shaner, waste reduction coordinator and co-founder of MedCycle.
MedCycle was scheduled to become a permanent program at the 520-bed hospital in September, but was postponed after the city instituted mandatory general recycling regulations that forced the hospital to evaluate its existing program, Shaner said.
MCHV tested MedCycle in May with an $11,000 grant from the Vermont State Agency for Natural Resources. Its goal was to separate and collect dry, non-patient-contact waste before a patient entered the OR.
"If hospitals regulate what they red-bag, they could save a significant amount of money," Shaner said. "A lot of hospitals red-bag all of their OR waste and they need to look at what comprises that waste. Our study showed that there's a tremendous amount of waste being trashed that doesn't have to be red-bagged. It's an extra step, but it works."
Shaner's consulting firm, CGH Environmental Strategies, is one of the organizers of a Dec. 4 seminar called "Waste Reduction Strategies for Hospitals," which will discuss recycling and medical waste issues today and what the future holds. The seminar is being funded with a $2,000 grant from the Vermont State Agency for Natural Resources and is sponsored by the Assn. of Vermont Recyclers.
Vermont law stipulates that infectious waste falls under the category of hazardous waste. MCHV considers "anything dripping in blood, anything with a known pathogen and sharps to be infectious waste and red-bagged," she said.
Cost reduction
MCHV did not test MedCycle as a potential source of revenues but as a cost-reduction program. It reduced tonnage and municipal solid waste pickups during the month-long pilot project.
Average waste tonnage dropped to 5.9 tons per pickup from the normal average range of 6.3 tons to 7.9 tons per pickup. The facility pays $67 per ton in tipping fees, or charges to put the solid waste in a landfill, and the program resulted in savings of $27 to $134 per month, she said.
MCHV pays $75 per pickup for a local company to haul the waste away. Before the hospital started its general recycling program three years ago, the hauling company made four pickups a week at an annual cost of $15,600. The general recycling program for paper and cardboard cut pickups to three times a week at an annual cost of $11,700. MedCycle will cut pickups still further to two a week at $7,800 annually.
MedCycle process
Under MedCycle, recyclable trash is placed in specially marked, 34-gallon blue bins with wheels set up in 18 locations throughout the Surgical Services wing, including 13 OR suites, recovery room, pre-op hold area, surgicare (day surgery), anesthesia and perfusion workrooms. Bins are lined with blue trash bags. Other trash is placed in normal black bags. All this is done before any patient enters OR.
Bins were purchased at a local Ames store for $9.99 each and are guaranteed for eight years.
"We didn't want the carts to look like everything else in OR. We wanted something different, something recognizable and easy to clean," she said. "Blue meant recycle."
Nurses deposit filled blue bags in one of two laundry carts serving as central depots. Housekeeping collects the bins from the central depots and wheels them to a holding area. During the test, MedCycle volunteers wheeled the bins to a 1,000sf storeroom in the basement of an adjacent building where trash was sorted. Five carts circulated throughout the study.
MCHV enlisted the help of two developmentally disabled people from a local mental health agency to sort waste into 19 categories: Assorted clear plastic films, blue plastic films, foil, "blue wrap," polypropylene bottles, polystyrene, white boxboard, brown boxboard, glove liners, mixed composite packaging, "white wrap," blue tissue paper, assorted foams, rigid plastic trays, white paper, colored paper, reusable medical supplies, reusable bags, and garbage (primarily adhesive tapes and rubber gloves).
Although the MedCycle test used free labor, the new program will either get people from the Vermont State Department of Vocational Rehabilitation and pay them 50 cents an hour, which is state-subsidized, or will use people who volunteer for the program in the hospital.
More than 75% of the waste volume, resulting from 982 surgical procedures, consisted of approximately 38% blue wrap, 11.5% composites, 9% solution bottles, 6% white virgin boxboard, 4.5% garbage, 4.5% corrugated cardboard and boxboard and 3.5% plastic film and bags.
"We were trying to show people that not all waste coming from the hospital is hazardous, and I think we've succeeded in doing that," Shaner said.
MCHV already recycles white office paper, corrugated cardboard, newspaper, metal and aluminum food and beverage containers, yard waste, plastic bottles, polypropylene, clear glass and foam packing peanuts. Old office equipment is donated to a local charitable organization. Plastic bags in which pharmaceuticals are shipped are distributed to community organizations.
The general recycling program started in the storeroom and office areas and is now hospital-wide.
Teamwork counts
To get MedCycle started, Shaner and co-founder Connie Leach, a waste management consultant, produced training videos explaining the state law, which requires a 40% reduction in solid waste by the year 2000, the pilot program and what would be recycled. Although it took eight months to set up the one-month trial, MedCycle achieved a 90% participation rate.
"We had teamwork right from the start. The OR volunteered to do the trial, housekeeping volunteered to move the trash, nutrition provided breakfast the morning MedCycle began its test run and public relations provided coverage in the internal newsletter," she said.
"One department cannot do this on its own," she said. "Each hospital has to create its own reality. What works here may not work in another setting."
