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Are You Throwing Away Dollars?

After nearly 20 years serving as a consultant to the healthcare industry, I have a diagnosis for one thing that commonly ails the financial well-being of hospitals. In a word, it’s garbage. Too much unsorted garbage, to be precise. Across the country, medical waste collection and disposal have become increasingly costly and complex responsibilities, creating more strain on an already challenged business of providing affordable hospital goods and services.

Currently hospitals generate more than two million tons of medical waste each year. For a typical urban healthcare facility, that can translate into more than half a million dollars spent on getting the stuff carted away. Slowly but surely, hospital waste is bruising the bottom line of healthcare facilities. Factor in the current crisis in energy expenses which drives disposal costs higher, and you can imagine that the pain is only going to get worse.

But wait. There’s good news for this ailment. Expensive hospital waste can be drastically reduced without impacting patient care or disrupting staff. Or breaking the law. As every administrator knows, the AIDS epidemic and a host of other factors set the stage for a new waste stream with new regulations that created dramatically higher costs---especially for “red bag” disposal which can be 700% more expensive to dispose of than standard trash. In addition, there are now more complex categories of other healthcare waste, ranging from confidential records to types of plastic, food, and more. Each material has its own price per pound for disposal; many have potential for recycling. All represent big money in the trash bin.

I realized this in the late eighties, when I first started studying the potential for recycling in hospitals. My goal wasn’t to be the trash man, collecting these materials and carting them away, but instead to help each facility segregate their recyclables so that what was left—costly regulated trash—would be greatly reduced. I worked to prove that hospitals could save thousands of dollars by sorting their trash. In the process, they could also begin to reform their image as an industry of polluters. Back then, my company installed the first composting system on a healthcare property, turning food into fertilizer. Little did I know, we were ahead of the curve and setting the pace for what was to come.

Fast forward almost two decades later and I see that practices which were once a matter of choice for my clients in the 80’s are now a mandate. “Sustainable” and “Green” are fast becoming business imperatives, not just earth-friendly philosophies. The healthcare industry has responded with admirable initiatives like Hospitals for Healthy Environments (h2e) and Healthcare Without Harm, both of which “talk trash” with the very best of eco-intentions. They offer long-overdue smart policy advice. Nonetheless, wise ideas and good intentions are not the same thing as positive action. To make cost-cutting, earth-saving waste collection a reality in hospitals, systems have to be created to make it easy for employees to change their trash-tossing routines. At the same time, they have to be motivated to change—they have to care.

Making healthcare staff care about where garbage goes is a big part of what my company, Antos Environmental, does in our on-site work. But we also create practical waste collection systems that are simple to use and understand so employees maintain their motivation. We do this by first meeting with hospital administrators and key department heads to introduce our system-wide approach and to enlist their support. Then we visit each waste-generating unit—with a special focus on large volume departments such as the OR and laboratories—where we review current handling protocols, measure current waste streams, and establish baseline data about the hospital’s operations.

Next, we work to develop a comprehensive strategy to significantly reduce waste and operating costs. We continuously re-measure the hospital’s operations, providing fresh data on progress. This can actually mean going through the trash, item by item, to check on staff compliance. Such feedback is essential as we reinforce the application of new protocols.

All of our work is done with a deep understanding of hospital economics. By measuring the volume and cost of waste materials, based on adjusted patient-per-day volume, our systems generate hard dollar savings, month after month. Measurable, sustainable cost savings have resulted in more than 95% of the projects we’ve completed in the last 20 years. Those numbers alone speak to the potential for every healthcare facility to profit from a 21st-century system of waste collection. But so does the voice of experience. Here’s what one of our clients, Kent Zergiebel, director of environmental services at Yale New Haven Hospital has to say about revenues from refuse: “Antos has drastically reduced our costs through new waste systems, renegotiating hauler contracts, and effectively educating all 6,000 of our employees. We’re well on our way to the goal of 50% savings.”

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September 2008

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