The U.S. healthcare industry accounts for 8.5% of the nation’s total carbon footprint emissions. Globally, if it were its own country it would be the fifth largest emitter on the planet. To prevent further warming of the planet and catastrophic events that could overwhelm the health care industry, it is pivotal that hospitals cut down on its carbon emissions. 

Going Zero Waste is a solution to reducing emissions upstream and downstream, but this is not without its growing pains. Over 150 Hospitals, 50 leaders in Environmental Services & Sustainability across 15 states in the U.S. were surveyed by Zabble, uncovering 6 prevalent pain points that stand out when on the road to achieving Zero Waste:

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1. Unused Medical Supplies

Discarding unused medical supplies is costing hospitals millions every year, and exacerbating climate change. According to the Journal of Neurosurgery, a study published in 2016 found that an average neurosurgical operating room wastes about $968 per procedure, that amounts to $2.9 million per year.   

In 2019 the Massachusetts General Hospital (MGH) Emergency Department conducted a waste characterization study and identified that within a 24 hour cycle over 200 unused items were thrown away in medical and solid waste containers. Items included syringes, glass bottles, thermometers, sanitizing napkins, containers and curtain sharps like scalpels and hypodermic needles, plus tubing for medical devices. The waste characterization study, published by the Western Journal of Emergency Medicine further concludes that 1,481 lbs of waste is generated everyday in the ED. This equates to 3,110 kg of Carbon Dioxide in pollutant emission output or driving 7,700 miles per day. Discarding unused supplies is wasted time, energy, money and natural resources extracted. Methods for reducing waste is a win-win for the facility's budget and the Earth.

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2. Improper Disposal

When items are improperly disposed this can cost upwards of $100k in excess hauling costs and fines every year. In addition, a facility is losing out on disposed resources that are either unopened, or reusable. Prevalent are food items, and medical equipment such as syringes, glass bottles, containers and curtain sharps like scalpels and hypodermic needles. Additional findings from the 2019 MGH waste characterization study found that 85% of waste thrown into the Red Bags was not Regulated Medical Waste (RMW). Hauler fees for processing RMW compared to non-regulated waste are 10x more than landfilling and 30x more than recycling. Improperly disposing of medical waste can make up to 20-40% of total waste volume because this includes sharps, pathological waste, trace chemotherapy waste, and more. Sarah Hsu, with the Warren Alpert Medical School at Brown University, and lead author of the MGH study noted: 

“...if we could divert through better sorting some fraction of medical waste that now goes into red biohazard bags to regular solid waste, it would open up significant cost-saving opportunities for hospitals.”‍

3. Food Waste

According to the U.S. Department of Agriculture, the United States wastes as much as 40% of its food supply, and only 4% of that gets composted. This means A LOT of food ends up in landfills, 21% according to the Environmental Protection Agency. When food waste ends up in landfill it generates Methane, a greenhouse gas that traps 20x more heat than Carbon Dioxide. In a Hospital setting, one patient can generate 4.4 lbs of waste a day, and 6% of that is food. Needless to say, there is a lot of room for improvement especially for recovering editable food for donation. Sutter Health of Sacramento is doing just that and their food donation program is wildly successful. Vickie Sargetis, Director of Food and Nutrition at Sutter Health of Sacramento recently presented at CleanMed Connect 2021, the premier national conference for leaders in health care sustainability. Within 16 months Sutter Health donated 72,000 lbs of food, or 60,000 meals to organizations in the surrounding Sacramento region using tools to track food waste, and streamline food donation drop off and delivery. ‍

4. Invoice Confusion

Due to invoice confusion over 14 hours or more a month can be eaten away trying to identify anomalies and insights across invoices from multiple vendors with different billing cycles and formats. Whether you have a 50 bed facility or a 500 bed facility, understanding the complexities of invoicing and correcting missed waste pick ups can be tedious. Specifically hauler invoices, they are a source of waste data available to medical facilities that offer incomplete and non-standardized details which can be hard to aggregate. To potentially save time and money one can outsource to invoice processing services. Additionally, as technology improves there is software that can digitize and automate your invoices for you. This allows you to keep the analysis in house and store the analytics on a secure cloud-based dashboard. Zabble has discussed this topic in the past. Ultimately, having insight into your invoices will lead to efficiency gains for staff to focus on other tasks.

5. Lack of Empathy

Another pain point for hospitals is the lack of empathy from staff in spite of 50 hours/month allocated to communicate and address incorrect disposal items. A lack of empathy is a lack of understanding which in turn creates an opportunity for further learning. The disconnect can be simply because people do not know. The 2019 MGH waste characterization study really opened the eyes to staff. Jonathan E. Slutzman, MD, investigator in the Department of Emergency Medicine at MGH and senior author of the study noted:

“People working in emergency departments have no idea how much waste they routinely generate, nor that the environmental impact is totally at odds with their professional mission to improve health and save lives...A greater awareness of the harm that’s being done, along with the opportunities that are available to turn that situation around, should be on the agenda of every hospital in America.”

Social psychology via Nudge Theory (by Richard H. Thaler, and Cass R. Sunstein) or Community Based Social Marketing (by Dr. Doug McKenzie-Mohr) influence sustainable behavior change, by making it easier to choose sustainably. Prompts, pledges, social norms like having green team champions, or initiatives that gamify recycling through friendly competition are all examples that can make the difference in creating empathy towards ones zero waste initiatives. A key step when influencing behavior change is meeting people where they are at.

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6. Difficulty of Reuse/Reprocessed/Donations

Medical facilities often have difficulty finding vendors who accept bulky and hard-to-recycle items limiting the reliability that a clean stream is available for pick up. Hard to recycle items include bulky medical devices, lab equipment like freezers, appliances and furniture. For these items to be reliable manufacturers use high quality and durable materials such as metals, and curtain plastics. In electronic devices we see these materials mixed. Mixed materials make it extremely hard to recycle because the material cannot be assigned to one material class. Many manufactures rely on single-use medical devices in order to forgo the responsibility to recycle, refurbish, and forgo the regulatory requirements for FDA approved Reusable Medical Devices design and reprocessing. In a Zero Waste world manufactures would design all their products to be reused or upcycled thus contributing to sustainable circular economy. Donating medical equipment, appliances, and other materials is tricky, but not impossible. The American Society of Hand Therapists (ASHT) has compiled a great list of organizations that will accept and distribute gently used medical equipment for medical teams nationally and internationally.

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These pain points are certainly not the Achilles heel of hospitals achieving zero waste, but instead, offer the opportunity to move towards a sustainable health care industry in the 21st century.

For more information on how Zabble is addressing these pain points and enabling hospitals to achieve zero waste contact us and one of our experienced Zero Waste advisors will get in touch with you.