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Hospital Waste in County Monaghan. Nial O’Connor LAPD Project Monaghan Co. Co. Hospital waste in Ireland. Report by Comptroller and Auditor General into value for money and waste management in hospitals Summary of findings Two types of waste risk and non risk waste - PowerPoint PPT Presentation
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Hospital Waste in County Monaghan
Nial O’Connor
LAPD Project
Monaghan Co. Co.
Hospital waste in Ireland
• Report by Comptroller and Auditor General into value for money and waste management in hospitals
• Summary of findings– Two types of waste risk and non risk waste– Cost of handing waste is significant – especially risk
waste– Level of recycling poor in comparison to other
countries– Different levels of waste in different types of hospitals
Average waste output per bed per day used
0
1
2
3
4
5
6
7
AcuteHospitals
MaternityHospitals
CommunityHospitals
PsychiatricHospitals
Kg
of
wa
ste
pe
r b
ed
da
y
Risk Waste
Non-Risk Waste
Composition of non-risk waste in one acute hospital
Healthcare Textiles6%
Protective equipment (e.g gowns)
8%
Paper towels, etc16%
Food Waste15%
Other Packaging 11%
Glass Packaging7%
Office Paper6%
Newspapers and Magazines
8%
Cardboard16%
Other Non-Packaging7%
48% recyclables
International comparison
Background to Prevention Project in County Monaghan.
• Currently working with 3 hospitals
• Did not have agreement with hospitals before submission to EPA
• Considerable effort required from LAPD team to get projects up and running.
Background
• Level of environmental management different in each hospital ranging from poor to medium
• Must go through the waste management hierarchy first. In developing Prevention Plans – recycling still a key element – walk before you run
Monaghan General Hospital
Landfill80%
Recycling20%
St. Marys Hospital
Landfill, 100%
Waste Management Practices Monaghan Hospitals
St. Davnets
Landfill70%
Recycling30%
St. Marys Hospital
Landfill, 100%
St Davnets
St. Davnets
• St. Davnitts Hospital– Mental Health service along with other services e.g.
disability etc. spread out over a number of different buildings. Mostly 9-5 now.
• Environmental improvements being undertaken include waste, energy use and water use.
• Finance a driver for change but also some staff are motivated by environmental considerations
St. Davnets Phase 1.
• Established working committee – admin and maintenance
• Sub committee of nurses aides then established. They deal with the waste!
• Benchmarking completed – waste characterisation study and desktop analysis of energy and water use.
• Walk around survey with CTC
Waste in St. Davnitts
• Total landfill weight for 2006 was 101554 kg. figure from waste contractor
• BDU = 100 beds* 365 = 36500 bdu• 101554/36500 = 2.78 kg per bed day unit
Benchmarking
• Water 2.34m3/sq. metre floor area/annum
• Small acute or long stay hospital with personal laundry facility – 1.56 m3/sq. metre floor area/annum
• Heating 635kwh/m2/year (excluding pool) 22% above typical (carbon trust)
• Electricity 75 kWh/m2/yr – compare with offices circa 50 kWh/m2/yr
Waste management
• Waste management currently done on an ad hoc basis costing metal health circa €50,000 a year. (non risk only + 6k for risk waste)
• Standard weekly charge• Other services also paying for collection• 70% of waste being landfilled• Some recycling talking place on an ad hoc basis• Different levels of recycling talking place in
different areas of hospital• Not enough receptacles for recycling in hospital• No management policy on waste
Waste Characterisation study
– Difficult to undertake – incontinence wear, food waste, no central location foe bins
– Weighed landfill waste– Characterised recycled waste – Bank Holiday week– Data not great– learnt from our mistakes.
Landfill wieghts weekday (Wednesday-Thursday)
0
10
20
30
40
50
60
70
80
Carpenters w
orkshop
Com
munity S
tores
Day A
ctivation Unit
Disability T
raining Workshop
Houses on m
ain avenue
Kitchen
Laundry
Local Health S
ervice
Oriel H
ouse
Regional D
isability Services
St. Judes
Ward 4
Ward 8
woodvale
area
wei
gh
ts
Total Recycling by areaCare for the elderly
1% Community Stores11%
Day Activation Unit4%
Disability Training Workshop
7%
Kitchen14%
Office Area7%
Oriel House4%
Regional Disability Services
5%
Ward 815%
St. Judes3%
Ward 151%
Ward 44%
woodvale8%
Local Health Service13%
Laundry3%
Landfill weights weekend and bankholiday
0
20
40
60
80
100
120
area
weig
ht
Recycling Waste Survey
0
100
200
300
Waste Material
Kg
Energy and Water
• Significant cost associated with Energy
• 1,035,480 litres of 3500 sec fuel oil costing over €380,000 per annum
• Additional costs – labour, insurance, chemicals, etc
• Electricity costs are €172,958
• Water circa €40,000 p.a. (water in only)
Phase 2
• Prevention Plan given to management from that the following tasks where identified– Review current waste collection service– Improve levels of recycling and diversion away from landfill– Awareness for staff on waste related issues– Monitoring of waste, water and energy– Prevention opportunities in waste management especially on
wards and kitchen - accounts for roughly ½ landfill 1/3 recyclables
– Water and energy use in swimming pool and kitchen– Training on risk waste– Good housekeeping in water and energy management
St. Mary’s Phase 1
• Community Hospital “care of elderly”• Working more with management than
committee• Pre intervention everything being landfilled• Benchmarking complete in energy and
water• Waste characterisation study complete –
incontinence wear!• Prevention Plan given to management
Waste in St. Mary’s
• Landfill in 2006 137.14 tonne
• 2.6 kg per bdu
• Costs €23971 (€174 p/t)
• Risk waste 2.2 tonne costing €2384 in total (€1083 p/t)
• Risk waste accounts for 1.5% of overall waste but 10% of the overall cost
Waste study
• Asked for food waste to be Segragted
• Incontinence wear!
Total waste
0
500
1000
1500
2000
cardboard organic landfill
ward waste
0.0%5.0%
10.0%15.0%20.0%25.0%30.0%35.0%
Paper
Cardb
oard
Glass
Plastic
Met
al
Organ
ic
Textile
s
Woo
d
Compo
sites
Specia
l/irre
gular
Shop waste
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
Paper
Cardbo
ard
Glass
Plastic
Met
al
Organ
ic
Textile
s
Wood
Composite
s
Specia
l/irre
gular
Kitchen Waste
0.0%5.0%
10.0%15.0%20.0%25.0%30.0%35.0%
Paper
Cardbo
ard
Glass
Plastic
Met
al
Organ
ic
Textile
s
Wood
Composite
s
Specia
l/irre
gular
Energy Management
Energy Benchmarking (Carbon Trust)
Typical Good St. Mary’s
Heating KWH/M2 332 252 550
Electricity KWH/m2 71.8 48.4 105
Total cost of energy 2006 =€188,278.40
Electricity = €59878
Oil = €128,399.58
Water Management
• Using 60m3 per day (equivalent of 100 houses)
• €41,829 per year
St. Mary’s Phase 2
• Awareness with all staff poster, fliers etc
• New waste collector hired wheelie bins – saving €8,000 – 10,000 p.a.
• Recycling scheme introduced on wards
• New measures for ordering dinners from wards introduced – prevention of food waste
St. Mary’s Phase 2
• Water flow logged – leak detection
• Energy monitoring in kitchen and laundry
• Moving through the waste management hierarchy
• Review meeting with management on regular basis
Monaghan General
Monaghan General Hospital
• Working with management to improve environmental performance which is currently good
• Good segregation of waste but could be improved
• Level of recyclables going to landfill still considerable
Waste in Monaghan General
• 122. 697 in 2006 tonne non risk waste
• = 3.4 kg non risk waste/bdu (below benchmark)
• .5 kg risk waste/bdu
• Recycling 20% of non risk waste – more can be achieved
Total KG for waste characterisation study
0
200
400
600
800
1000
Cardboard Food Waste Landfill Recycling
Series1
Recycling Overall
Paper39%
Cardboard11%
Plastic13%
Other28%
Composites3%
Glass3%
Metal3%
Overall compostition of landfill bins
Paper7%
Organic1%
Plastic5%
Wood1%
landfill75%
Cardboard8%
Metal3%
Landfill Male Medical
Paper11%
landfill74%
Cardboard8%
Composites1%
Metal1%
Plastic5%
Main Kitchen Landfill
Plastic1%
Metal1%
Landfill81%
Composites2%
Cardboard15%
Monaghan General
• Prevention Plan given to management
• Some tasks undertaken by Hospital Administrator
• Awaiting the establishment of committee
Observations
• Central Procurement– Buy the cheapest – does not always represent the
best value for money
• Disposable nature of a lot of products– Gloves, medical products, hand wipes, latex gloves
• Nature of waste – incontinence wear!• Infection control• Training for risk waste for staff needed• Prevention possible in some areas through
better housekeeping
Challenges
• Need to Keep momentum going
• Getting access to key personnel
• Moving from Recycling to Prevention
• Budgets and time constraints in health sector
• Awareness vs. motivation for staff
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