Handling Waste in a Healthcare Trust – Implementing Sustainable Change through Employee Engagement

North East Recycling Forum Presentation

March 1st 2012

PERSONAL BACKGROUND

Worked for IKEA for 14 years Fast-paced, volume-driven, bottom-line

focused. Co Renowned for hard-earned ‘green’

credentials. Wasn’t always that way Began at the back door 1998/99 By 2001 every store has Environment

Specialist Initial focus on waste and costs Control over waste established Moved issue into store – why is this

happening? Stock Loss Groups, Recovery Dept’s, etc. By 2009 – 85% of dry waste being recycled in

UK

JOINING AN NHS TRUST

Like stepping back in time! Trust representative of a lot of trusts in UK. Risk averse (All about compliance) Focus on clinical service delivery. Anything

else seen as peripheral. General appreciation for ‘environmental’

work lacking. Benefits to organisation not fully understood

or appreciated.

Saving £13,000 p.a.

Saving £3,000 p.a.

BY JULY 2011…

Recycling in 40+ leased, managed and owned buildings.

Cost savings of >£30,000 p.a. on domestic waste

Recycling approx 60% of volume. Supporting local organisations with unwanted

furniture. Staff support for changes and observed

behaviour change. New, more dynamic draft waste policy. Legal, compliant and environmentally

healthier operation.

BUT HOW DID WE GET THERE?

Investigation of alternatives: Biffa – Dry Mixed Recycling (Trafford Park)

BUT HOW DID WE GET THERE?

Wybone bins Risk, Fire, Infection

Control approved Two-bin solution Easy to implement Easy to use Minimal

management

Investigation of alternatives:

BUT HOW DID WE GET THERE?

Employee engagement Trust-wide e-mails Intranet Posters Communication on bins Communication beside bins Communication via line managers Face to face discussion Waste Manager on site during implementation

Removing waste paper baskets Unpacking and labelling new bins Discussing benefits of new system (sometimes

heated!) Empowerment of domestic service staff

WHAT CAN I RECYCLE?

WHAT CAN’T I RECYCLE?

OVER-COMMUNICATE! WORDS AND IMAGES

HEALTHCARE WASTE – THE SITUATION Most waste coming out of wards, bedrooms,

treatment rooms, classified as ‘clinical’ The only route for bulk ‘clinical’ waste was

incineration. Incineration = £600 per tonne disposal Bulk incineration cost the Trust £40,000 in

2010 HCW contract cost Trust £80,000 in 2010 in

total No distinction made between infectious,

potentially infectious, offensive and domestic waste in clinical areas of buildings.

Completely Mixed Waste! Perception that everything was being

burnt!

A LOT OF THIS GOING ON

A NEW CONTRACT – H.E.S.

Y&H Clinical Waste Consortium tender Won by Healthcare Environmental Services Installation of an autoclave in Normanton. 18-01-03 ‘Orange’ infectious waste -

autoclaved. 18-01-04 ‘Tiger’ offensive waste - landfilled Removal of domestic waste from clinical

stream? Significant opportunity for:

Segregating waste streams, Securing compliance Saving money Protecting the environment Recycling (!)

TWO-STAGE APPROACH

1. Secure Routines: Bagging, tagging and segregation Engage with porters, domestics, 3rd party FM, etc. Explain reasons for change – sell; don’t tell. Check for understanding. Open discussion Follow up regularly

2. Investigate Alternatives and Implement Change Outlets for waste fractions secured Identify opportunities areas (treatment rooms) Introduce new-style ‘Duo’ bin (Wybone) 2 bins taking 4 waste streams Segregation at source secured Minimal training of clinical staff:

all done using communication and awareness “There is no appetite for extensive re-training on waste…”

MOVE FROM THIS…

TO THIS

OFFENSIVE V’S INFECTIOUS WASTE

‘BELT & BRACES’ APPROACH TO COMMUNICATION

RESULTS FROM THIS INITIATIVE

Compliance secured Environmentally preferable solutions Domestic waste removed from HCW steam Majority waste in treatment rooms =

domestic! Greater understanding of 18.01.03 &

18.01.04 Costs reduced.

Average monthly bill was £7,000 Now £2,500

External Interest in this way of working.

SUMMARY

1. Provide the right tools and easy to follow routines

2. Communication, Communication, Communication.

3. Engagement is keyFace up to people:Be seen on the dayBe seen implementing the solutionBe seen “getting your hands dirty”Engage and Explain. Try not to justify.Don’t use ‘environment’ to win the

argument!

WINNING ARGUMENTS (IN THIS ORDER)

1. Financial2. Legal3. Policy/Strategy4. Efficiency/Workload5. Environment