Renae McBrien - Victorian Healthcare Association · THINK BEFORE YOU PRINT Confidential paper is expensive to destroy Approx $14 a 240L bin Business Case accepted for onsite shredder

Renae McBrienRadiographer

Horticultural TherapistCommunity Garden and Recycling Consultant

“We have a responsibility to reduce the environmental impact of the health care service and to improve our hospital environments to increase our wellbeing and connection with nature.”

Hospital Waste – What can we do?

USA produces 4 billion pounds annually = 6500 Tonnes a day

USA Carbon Footprint

10%Australian Carbon Footprint7%

of hospital waste that reaches landfill is actually recyclable or compostable.

The Carbon Footprint of Health Care Systems

Of the 7% is waste from Australia Hospitals alone

50%

Of Australian Hospitals waste is Operating Theatres and Wards

50%

Originates from Operating Theatres70%

Of USA Hospitals recycle30%

62%

Carbon Footprint of Australian Health Services

Why does the Health Service have a responsibility?

Economical

Ethical

Efficient

EnvironmentReduce

Reuse

Recycle

7KEY FACTORS

Sustainability

in Health Care

how the process works.

• 23c a BAG – wall mounted

• 42c a BAG – Wheelie Bin size

• $30 000 a month on bags

• 12c per kg to remove

• Emptied every 4 hours regardless of contents

• REDUCE the number of GENERAL WASTE in your department

General Waste = Landfill

❖Over 1.84 million kg of General Waste in 2017/18❖ Cheapest waste stream to remove❖ Everything will end up in landfill❖Need to reduce our General Waste❖ Increase our Recycling of this waste

▪ Cheapest way to remove waste ▪ Govt Landfill tax on waste heading to landfill▪ Qld $75 per tonne - will have a huge impact on our waste

budget.▪ Staff should always use this bin for general waste and not

clinical waste bins

Clinical Waste = Incinerated Waste❖Over 700 000 kg of Clinical Waste in 2017/18❖ Expensive waste stream ❖All Clinical Waste is incinerated❖ Excrement, body fluids, blood soaked waste, blood

products, drugs and clinical lines

▪ Incineration process reduces the waste volume to 10% which is used in bitumen road construction

▪ Incineration burning process releases toxic gases into the environment

▪ Keep General Waste out of Clinical Waste to reduce costs

▪ Aim to reduce clinical waste bins and move them to strategic positions so they are not “over used” with general waste

Recycling Streams + Education

Audit the Number of Bins In Your Area“Ban the Bin”


How many bins do you have?Could you share a bin?

Audit the number of bins in your department to reduce our cost and use of plastic bags.

Cleaning staff will remove general waste on timed rotation, regardless of how much waste is in your bin.

Huge amounts of money a year is spent on Plastic Bin bags, that are not recyclable and end up in landfill

❖ Reduce the number of bins ❖ Reduce the number of bag liners used❖ Reduce the cost of bin liners❖ Reduce the amount of bags going into landfill

These are the number of bins in one X-ray room!

Buy a Keep Cup – Use the Keep Cup

Launch across QEII – FREE GARDEN SEEDS Metro South Health

bring your own cup and

grow a garden

QEII Let’s Late

8am to midday Monday 10 June to Sunday 30 June

FREE

when refilling your keep-cupBring and use your keep-cup at QEII Let’s Late

during June to receive a free sample of Renae’s

hand-dried veggie and herb seeds

*All seeds organically grown and donated by the Community Garden Coordinator


CARDBOARD RECYCLING ▪ Education of staff to flatten cardboard to reduce volume

▪ Target for all cardboard to be recycled not just packing boxes, we aim to recycle every drug box, glove box etc.

▪ Clinical bins to be introduced into drug rooms for example

▪ Cost Neutral Recycling on most contracts

PAPER / CARDBOARD RECYCLINGTHINK BEFORE YOU PRINT

▪ Confidential paper is expensive to destroy

▪ Approx $14 a 240L bin

▪ Business Case accepted for onsite shredder at PAH

▪ Waste Team won an Innovation Award for Shredder

▪ Consider partnering with Metro South for QCH paper

▪ $100 rebate per tonne and is recycled into grey paper

Document shredding on-site + rebate

Estimated savings per month

$3764

PAPER RECYCLINGRedlands to PAH

▪ Redlands paper was costing $18 a 240L Bin

▪ Already MSH transport vans going between our hospitals everyday

▪ Transport paper from Redlands Hospital to PAH each Thursday.

▪ 280kg on average per fortnight

▪ Potential to partner with MSH

▪ Transport QCH paper to PAH shredder to reduce costs.

Annual Potential Saving to the Metro South Waste Management

$4732 Redlands Save $3640PAH Rebate $1092

PVC Recycling uses Australian workers in Melbourne to wash, chip and recycle our PVC, it is then shipped to NZ where it is turned into garden hoses and play mats etc.

NEW ZEALAND FACTORY have said they “Can’t get enough recycled PVC for their demands”

PVC RECYCLINGPolyvinyl Chloride

PVC is a stretchy, malleable plastic.

Never breaks down and is terrible on environment

Only 3 things can be recycled in this bin

❖ Saline Bags - cut off 2 introducers

❖ Oxygen Tubing - no filters

❖ Hudson Masks - remove elastic, metal & plastic valve

- Baxter pays for all PVC waste recycling through ACE Waste

- Cost neutral but avoids landfill tax and general waste

- Recycled out of landfill and recycled directly into garden hose

PAH recycles on average 400kg per month


PVC RECYCLING Needs a little extra care… and staff education

• Remove metal, elastic and plastic from Hudson Mask• Remove ports from saline bags • Remove patient details on medicine sticker before recycling• Recycle all saline bags regardless of medicine in bag


PVC RECYCLING

First Month = 3 full bins of PVC!

❖ Partner with Baxter and ACE Waste to deliver this single recycle stream.

❖ Cost Neutral project that reduces landfill tax

Aluminum Gas Cylinder Recycling

KIMGUARD / SURGICAL WRAP RECYCLINGPolypropylene

Kim Guard = BLUE BAGS

Blue Surgical Wrap only

Recycled back into surgical trays for

Smith and Nephew

Recycled into clothing fibres, industrial fibres,

food containers, dishware, speed humps,

gardening apparatus


Investigate key clinical areas with single use electrical wires - OT, ICU, Cath Lab, Dermatology etc. Educate staff to recycle safely

Returns $1.60 per kg

Copper Wire Recycling = $$$$$

PAH Monthly Averages

200kg PAH 6mths

$1290


Princess Alexandra Hospital Copper Recycling

▪ Some Hospital Soft Plastic can be recycled

▪ Target is clear plastic, that is not contaminated with any glue e.g. syringe waste plastics

▪ Clear staff education needed

▪ Image intensifier covers currently recycle around 1000 a year = 300kg of soft plastic

▪ Shrink wrap from Pharmacy

▪ Clear plastic covers used in Radiology to cover Detector

Soft Plastic Recycling

METAL RECYCLING

▪ Metals are very destructive on our environment as we mine to remove them from our earth.

▪ Metals are also very intensive to produce into alloys

▪ Metals are very easy to recycle – melt and remold for the lifetime of the metal

▪ $500 per tonne rebate through CDS Brisbane Metal Recycling Co.

▪ Infection control approved bins required.

▪ Blue Handle single use Stainless Steel Instruments

▪ Remove out of Sharps into Grey puncture proof Bins

▪ Infection Control approval

▪ 1kg Stainless Steel recycled = 1kg Stainless Steel

▪ Potential to have a huge impact on waste budget

Bins Cost $55 each

STAINLESS STEEL RECYCLING

Collaborated with Infection Control

Trial with lift top bins (sanitary bins)

First CDS Textile Sleeve Recycling Program

eWaste – Electronic Recycling

▪ Computers and electronic equipment

▪ We need to get down to the ward level

• Clinical Vacuum Pumps

• Pico / Pravena125

• CSSD Broken equipment

▪ Cost neutral however products are recycled and removed from landfill

▪ Avoids landfill tax

BATTERY RECYCLING

▪ Toxic chemicals and metals can leak from

batteries when they erode in landfill and

contaminate the environment.

▪ Materials such as lead, cadmium,

mercury, lithium, manganese, nickel and

zinc are used to make batteries.

▪ These materials are all non-renewable,

can be recycled.

Wax Recycling

▪ Radiation Therapists use Wax to mold to patient contours for radiation therapy.

▪ Natural wax products can be recycled back to Candles

▪ Trial in Feb 2019 to start recycling this product and reduce landfill.

Beeswax Wraps – Sustainable Fundraising

• Together with our patients we made sustainable beeswax wraps in our garden therapy program

• Beeswax wraps and have raised over $2500 for Cancer Wellness Groups and for Spinal Injuries Garden Club.

• Converted Hospital Waste into income.

Little Blue Towels Recycling Program

Bottle Caps

Recycling Bottle Tops that are melted down into Prosthetic Limbs for children

Donations in Kind – International Aid

EXCESS MEDICAL EQUIP RECYCLING

▪ Email from Endoscopy about excessive single use tourniquets

▪ This is ONE weeks surplus of tourniquets

▪ Recycled back into our wider community

▪ Greenslopes Wood Turners Club took 20 tourniquets to help hold timbers etc.

▪ The remaining will be going to Australia Zoo Wildlife Warrior Vet Clinic.

▪ We should repurpose this excess waste in our wider community at every chance we can!

▪ All out of date medical equipment recycled to local vets, Australia Zoo or International Aid Groups.

Rubber Gloves Terracycle program – cost involvedWorking with Qld Dept of Environment to sponsor Qld’s first recycling program

Theatre Hats

Sustainable Procurement

❖ Cleaning Products – reduce chemicals into our waterways and environment.

❖ Redlands Hospital converted to Tersano Sustainable Cleaning Solutions and have saved 204 000 L of cleaning chemicals into our waterways since 2015

Sugar Cane Kidney Dishes

▪ Clinical Trial at PAH - 650 units over 4 weeks.

▪ 100% of clinical staff recommended and endorsed the product.

▪ Compost in domestic compost system in 21 days

▪ Recycle in to Cardboard Stream = $100 rebate

▪ Huge reduction in the carbon footprint for PAH

700,000single use plastic items removed from PAH each year

Circular Economy Recycling

❖ Educate staff to recycle sugarcane kidney dishes back into Cardboard recycling stream.

❖ Brisbane cardboard recycled back into cardboard packaging and kitty litter.

PAH Usage 16,500 per year

Annual Savings to PAH = $ 2 517.25

Plastic Denture Cup

BioAid Biodegradable Cup

34c each

19c each

$5 662.70

$3 145.45

Plastic Flexible Straws

Cost per unit 0.0138c plastic to 3c for biodegradable corn starch resin straw


Hospital Organic Waste

❖ Coffee grinds

❖ Food Scraps from tea rooms / kitchen

❖ Dead Flowers from wards

❖ Leaf litter from hospital landscapes

▪ Organic Waste ending up in landfill and does not break down.▪ Geofabric and waste compression at landfill sites does not allow oxygen and ▪ micro-organisms to enter the system for organic waste to biodegrade.▪ Create an onsite compost bin and worm farm!


GARDEN – March 2017

GARDEN – March 2018“Our Community Garden”

Sensory Garden▪ All plants are chosen to excite one or more of your 5 senses.▪ Taste, Touch, Hearing, Sight and Smell▪ Nothing grows in neat lines, nothing grows to be on show▪ Garden showcases the cycles of nature▪ Garden evolves through rhythms of nature and landscape updated weekly

# SPEND20Staff suffer stress during work day and often are involved with confronting life threatening situationsGarden is important for staff wellbeing

2018- 2020 Workforce Services Wellness Strategy to include Community Gardens across Metro South for staff wellbeing

Staff Celebration of NRRTWOver 50 Staff enjoyed morning tea together in the Community Garden

to promote Radiographers and Radiation Therapists at the PAH

Pamphlets for families on wardsAdventure sheet to find hidden things in the garden

PATIENT CENTRED PROGRAMSMonthly Garden Party for all Patients

Aligns with Planetree Philosphy to improve the wellbeing of our patients and improves social interaction and mental health

PATIENT CENTRED PROGRAMSMonthly Garden Party for Patients

Aligns with Planetree Activity Calendar

PATIENT CASE STUDIESNative Bee Workshops

Bring a live working hive into hospital for native bee education program

• .

PATIENT CASE STUDIESIntensive Care Unit

• Patients intubated and trachy do NOT leave high care units unless for medical procedures. • Often in high care for months and need exposure to nature and external environment • Patients often suffer acute delirium post surgery require sensory stimulation as a part of their

rehabilitation

INTENSIVE CARE UNITWellbeing Space

▪ ICU 30 Bed Facility – highest level of care with 24hr 1:1 nursing care▪ Patients are in a “coma” and on life saving equipment, ▪ Multi-traumas, spinal injuries, life threatening conditions▪ Post op major surgery CABG, Liver / Renal Transplants, Whipples etc


No Water, Infection Control policy restricted soil in ICU


• End of Life • Family celebrations• Difficult Family Consultations• Dementia and Delirium care post surgery• Patients can feel fresh air, humidity, sunlight, view the city

SPINAL INJURIES UNITGarden Club – Horticultural Therapy


SIU Kitchen Cooking Class for Patients


SIU Kitchen Garden for PatientsProjects giving purpose to our SIU Patients empowering their independence, wellbeing and self worth.


Spinal Injuries Unit Rosella Jam EKKA 2019


SIU Garden ClubCommunity Stalls

• Socialisation and Skill Development

• Garden club to be self funded

• Created a sense of community for our patients

Health Community Response

• 3.6 million views globally of War on Waste

• Over 1000 emails from hospitals looking for solutions

• Responses from USA, UK, and NZ Hospitals

• Renae McBrien - Finalist WASTE INNOVATION 2019 BNE Cleaner Suburbs Awards

• $20 million funding from Federal Govt announced in 2019 to develop our national “War on Waste”

Health Care Community requires a new sustainable direction.Health Care needs Sustainable leaders.

Are you the change your Hospital needs? Are you ready to make change?

Documents

Renae McBrien - Victorian Healthcare Association · THINK BEFORE YOU PRINT Confidential paper is expensive to destroy Approx $14 a 240L bin Business Case accepted for onsite shredder