Bio Re-grade

By Kiley Jacques on June 4, 2014

Big changes are being made in the small town of Peterborough, New Hampshire.

"We’ve worked hard to reduce our regulated medical waste," says director of environmental services Elizabeth Fazio of her colleagues at Monadnock Community Hospital in Peterborough, New Hampshire. She is quick to point out the importance of education when making such a change. "All clinical employees need to know what does and does not go into a biohazard waste receptacle," she notes.

Monadnock’s specific "less waste" goals include efforts to increase recycling to 15 percent total waste (measured in pounds); secure an 80 percent recycle and diversion rate for major renovations and new construction projects; and reduce medical waste to less than 10 percent of the total waste or less than three pounds per adjusted patient day.

"It’s all voluntary," says vice president for community relations Laura Gingras. "We are the first of the smaller critical access hospitals to get involved." Not only are they involved, they are tackling all six aspects of the Healthier Hospitals Initiative (HHI)—a free national program designed to help hospitals increase the use of sustainable products while also lowering costs. HHI includes the challenges of Engaged Leadership, Healthier Food, Leaner Energy, Less Waste, Safer Chemicals, and Smarter Purchasing. Monadnock Hospital is making notable gains in each of the six areas.

"Our efforts for waste reduction have increased with regard to hazardous waste," says Fazio. "We have changed how we pack biohazardous waste." She is currently in negotiations with a medical waste vendor who recycles the regular medical waste (pathogenic and chemotherapeutic waste products excluded). "The HHI target is that no more than 10 percent of waste material be biohazard. We are at six percent," says Fazio. Additionally, the Monadnock staff sends only full containers of biohazardous materials, never partial, to justify the shipment—they even freeze placentas until a shipment is full and ready for sending.

To meet HHI standards, hospital staff continually research alternative, more environmentally friendly products. Fazio has found many products with Green Star certification that work well and are affordable. The hospital now uses EcoLogo brand products for floor stripping and finishing, as well as more peroxide-based products for general cleaning.

The environmental services staff members serve as a resource for information and ideas; they often test new trial products and provide feedback. The hospital has instituted a "rapid cycle testing process" for use when a staffer has an idea that might help meet HHI targets. "I have staff that research products at home and bring me the data," says Fazio. "[They] will try something for a week or two and see if it works. This has been an extremely rewarding experience."

Image Courtesy of Monadnock Community Hospital

HHI’s level one goal requires that hospitals switch to a line of exam gloves that contain no polyvinyl chloride (PVC)—Monadnock has already done so. The next step is reducing the amount of PVC, formaldehyde, and halogenated flame retardants in the hospital’s furnishings, including window treatments, waiting room furniture, patient room recliners, and exam tables and chairs; this is an ongoing project—old items are replaced with products more in line with HHI’s objectives. "The next goal we will accomplish will be in healthy interiors," says Fazio. Currently, they purchase only PVC-free blinds, and Fazio has worked with manufacturers to find fabrics that meet HHI standards but are also durable and easy to clean.

Recent efforts have included ways to recycle more. "We are currently in the process of increasing our paper recycling," says Fazio. The new program will be a joint effort with Crotched Mountain Rehabilitation Hospital. Children from Crotched Mountain come to the hospital as part of their work-study life skills program. "It is a win-win for both organizations," notes Fazio.

The hospital is even looking at how to expand the green idea to include the food they provide—their goal is to increase the percentage of locally grown or sustainable food by 20 percent annually.

The ultimate goal of the folks at Monadnock Community Hospital is to achieve success in all six areas of the HHI. So far, they are making the grade. "HHI continues to be an effort that we, as an organization, are very committed to."

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