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VOL. X NO. 1

Jan-mar 2014

Medical Waste Management www.medicalwastemanagementnews.com

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RFID Technology Gives Hospital (Clean) Hand Up

“W

By P.J. Heller

a s h yo u r h a n d s ! ” T h at admonition has been heard by people since childhood as one of the best ways to prevent the spread of infection and illness. It is a common refrain in many businesses. And nowhere is hand hygiene more critical than in healthcare facilities. “In the United States, hospital patients get nearly 2 million infections each year,” according to the Centers for Disease Control and Prevention. “That’s about 1 infection for every 20 patients. Infections that patients get in the hospital can be life-threatening and hard to treat. Hand hygiene is one of the most important ways to prevent the spread of infections.” The World Health Organization echoes that statement. “Most healthcare-associated infections are preventable through good hand hygiene – cleaning hands at the right times and in the right way,” WHO states. Hospital-acquired infections result in billions of dollars in healthcare costs each year — estimates range up to $20 billion — and lead to nearly 100,000 patient deaths annually. Hospitals are doing what they can to encourage medical staff to wash their hands, utilizing everything from video cameras, undercover personnel, rewards and radio

frequency identification (RFID) technology which records when medical personnel walk by a sink. At the OhioHealth hospital chain, a pilot program — described as a first-of-a-kind network of wireless sensors and data analytics along with RFID technology — measures and reports in real-time on hand-washing compliance in an effort to reduce healthcareassociated infections. The 17-hospital system launched the handhygiene monitoring program at its Riverside Methodist facility in Columbus, Ohio, and reports that it achieved more than 90 percent compliance with hand-washing standards. That’s an increase of 20 percent over its previous practices and substantially above the 50 percent national compliance level, it notes. “Superbugs like MRSA (methicillinresistant Staphylococcus aureus) can live for hours on surfaces, and we want to do everything we can to protect our patients from these kinds of serious infections,” says Michael Krouse, senior vice president and chief information officer at OhioHealth. The hand-washing pilot program, which began in early 2013, is a joint effort between OhioHealth, headquartered in Columbus, Ohio, Continued on page 3

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Medical Waste Management

JAN-MAR 2014

medical waste management Medical Waste Management www.medicalwastemanagementnews.com

Serving Healthcare Facility Waste Management Professionals

PUBLICATION STAFF Publisher / Editor Rick Downing Contributing Editors / Writers P. J. Heller Sandy Woodthorpe Production & Layout Barb Fontanelle Christine Pavelka Advertising Sales Rick Downing Subscription / Circulation Donna Downing Editorial, Circulation & Advertising Office 6075 Hopkins Road Mentor, OH 44060 Ph: 440-257-6453 Fax: 440-257-6459 Email: downassoc2@oh.rr.com For subscription information, please call 440-257-6453. M e d i c a l Wa s t e M a n a ge m e n t (ISSN #1557‑6388) is published quarterly by Downing & Associates. Reproductions or transmission of Medical Waste Management, in whole or in part, without written permission of the publisher is prohibited. Annual subscription rate U.S. is $19.95. Outside of the U.S. add $10.00 ($29.95). Contact our main office, or mail-in the subscription form with payment. ©

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RFID Technology Gives Hospital (Clean) Hand Up Continued from page 1 and IBM Research and IBM Global Business Services. IBM describes the program as a “milestone” in how healthcare facilities can more efficiently track their progress in hand hygiene promotion, plan for improvements and set new goals. “Hospitals everywhere are grappling with ways to prevent infections, and we believe Hand sanitizer dispenser showing IBM wireless technology. as MRSA and Clostridium difficile].” OhioHealth’s forward-thinking approach will ”Our goal is 100 percent hand hygiene, 100 raise the bar for the entire industry,” says Dr. percent performing the hand-washing in entry Sergio Bermudez, an IBM research scientist. and exit from a patient‘s room at all times,” “Innovative organizations like OhioHealth are Rutherford adds. leveraging the power of technology to provide Rutherford posts in a break room the smarter care for their patients to improve quality compliance rates of each staff member, including while reducing cost.” himself, using RFID serial numbers, allowing The program to measure hand-washing people to check their own results and to see how compliance at OhioHealth employs about 100 they compare to their colleagues. wireless sensors, using what is called low-power “People would go in and see where they were low mote technology, near hand-washing on that list. It seemed to motivate the ones that stations, hallways and room entrances on two were not as compliant to step up their game a separate floors of the hospital. The sensors little bit,” he notes. record when medical personnel wearing RFIDThe pilot program, on hold since November, enabled badges enter or exit a patient’s room, is expected to soon move into its second use the hand-washing station, and identify the generation as IBM updates the technology and person by serial ID. redesigns the sensors to allow them to better About 200 medical staff on the trauma blend in with the environment. As part of those and immediate-care floor and on the medical changes, Rutherford plans to install a computer telemetry floor are equipped with the badges. monitor in the break room which he says will Each floor typically has about 35 patients at provide “real-time, in-the-moment data for each any given time. Only a few physicians were given person based on their serial number. RFID badges. “So anybody who walks into that room “We have so many physicians, there were can see where they are at that moment on that only a select few people who were given these compliance data,” he says. “I’m excited about sensors to help identify them,” explains David that. I think that‘s going to help make it more Rutherford, RN, nurse manager at Riverside independent and make people even more aware Methodist. “Most of the data comes from the of how they’re doing and keeping it fresh in hospital staff that works in those two units.” their minds that this is an expectation that’s not According to IBM, a web page provides going away.” doctors, nurses, managers and executives with Rutherford says he would like to see the hourly compliance levels by staff ID, and a program expanded to other hospitals in the weekly report summarizes the compliance levels system and believes the technology could be per ID, job role, work shift, floor, and hospital. the wave of the future there and elsewhere. The The collected data is provided “100 times success of any such efforts, he says, depends on faster than the hospital’s previous surveillance hospital leadership. methods,” it notes. “If you embrace the technology, if you “Analyzing hand-washing data gives embrace the way the information is coming stakeholders deep insights into the compliance and you choose to do something with the levels of different departments, shifts, job roles, information, then you can make substantial as well as variations based on other social gains,” he says. “If you just have it as another behavioral factors,” IBM says. “The real-time thing that happens in the background and you information is used to alert hospital personnel don‘t do anything with it, then it‘s just waste.” when proper hygiene habits are not being Being able to get specific information on followed so that corrective action can be taken personnel with fast turnaround are two major to reduce germ exposure to patients” pluses. Rather than having to address staff with That’s just the kind of information that general statements about compliance levels, OhioHealth is seeking. Rutherford can deal with individuals on specifics. “OhioHealth is always looking for smarter “The thing that bothers people most . . . ways to protect the health of our patients,” is when you are a high performer and you get Krouse says. “Working with IBM, we will gain those general statements that say, ‘We’re not additional insights that will help us consistently doing well enough, the group is not doing well achieve total compliance with hand-washing standards and fight back against these bugs [such Continued on page 4 JAN-MAR 2014

Medical Waste Management

medical waste management

RFID Technology Gives Hospital (Clean) Hand Up

Continued from page 3 enough.’ And you say to yourself, ‘I’m doing mine just fine.’ This kind of technology has prevented me from having to make the general statements. “I can go to the people who were not performing and say, ‘You’re the one not performing and everybody else is,’ or go to the people who are performing and say, ‘Hey, you’ve done a great job. Your data expresses that and thank you.’ You can give people credit where credit is due. “Most people want to do a good job and when they can see how they’re performing, especially gauged against somebody else, they tend to do even better,” he says. The importance of proper hand hygiene in medical facilities was confirmed by researchers at Virginia Commonwealth University. Their nine-year study found that proper hand hygiene, along with other simple infection control methods, reduced rates of (MRSA) infection by 95 percent. “Our study showed that using a simple approach over a nine-year period resulted in low rates of MRSA infection,” says Dr. Michael B. Edmond, the lead investigator and head of the division of infectious diseases in the VCU School of Medicine. “Patient safety is the key benefit to this approach. We found that it not only prevents MRSA, but other infections that are transmitted via contact. It can also save hospitals a lot of money.” Despite those findings, studies have found that without encouragement, hospital employees wash their hands as little as 30 percent of the time that they interact with patients, the reports. It was not indicated when or where those studies were conducted. Meantime, a study recently published reported that physicians’ stethoscopes were more contaminated than the palms of their hands. “Stethoscope contamination is not trivial and is comparable to the contamination of healthcare workers’ fingertips, the hand region most implicated in microbial crosstransmission,” the study says. In addition to the RFID pilot program at Riverside Methodist, OhioHealth uses what it calls “secret shoppers” throughout its hospitals to gather information on hand hygiene compliance. The problem with the secret shopper methodology, Rutherford says, is that “you Continued on page 6

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Medical Waste Management

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RFID Technology Gives Hospital (Clean) Hand Up

Continued from page 4 can’t really have in-the-moment intervention or you can‘t have specific data because they [secret shoppers] get recognized as the observer and that changes the behaviour of the people.” With RFID technology, Rutherford gets specific information on each staff member and his/her compliance level. Staff members were initially reluctant to have themselves monitored 24/7, Rutherford admits. “They were skeptical about the information at first and it took a while for us to get people on board with understanding what was being measured and how they were being measured,” he says. “We also knew that we were in a pilot program and that the information wasn‘t perfect at first . . . Over time people have become more comfortable with it because they know that they’re all being measured the same way. It’s the consistency that makes people buy in.” In addition to using RFID technology to monitor hand hygiene in healthcare facilities, it can also be utilized for other uses there, ranging from optimizing and tracking the collection of medical wastes to ensuring greater patient safety and accurate patient identification at the point-of-care. “I think there are ways we can use the product [RFID] to improve on other ways that we do our work,” Rutherford agrees, noting that “it‘s just that right now we’ve chosen hand hygiene as our method.” “RFID is already proving it can cut costs by enabling more efficient and timely tracking of goods in industrial and retail supply chains,” IBM notes. “Similarly, the healthcare community is now seeing tremendous benefits in shipping and receiving efficiency, as well as patient identification, error reduction at point of care, medications management, and real-time asset and employee tracking. “... RFID clearly has the potential to transform healthcare,” it says. Photos courtesy of IBM and OhioHealth.

HPRC and Stanford Hospital & Clinics Conclude Clinical Recycling Pilot

Program Will Divert 110 Tons of Packaging Material from Landfill Annually

he Healthcare Plastics Recycling Council (HPRC) and Stanford Hospital & Clinics have concluded a six-month pilot study that analyzes data related to recyclable material types, volumes and flow through nine hospital departments as well as documents clinical recycling processes and lessons learned. The study developed comprehensive waste profiles across procedural, patient care and ancillary areas including operating room, ambulatory surgery, preand post-anesthesia, radiology, catheter-angiography and pharmacy at Stanford Hospital and Clinics in Palo Alto, California. “We set out to gain a better understanding of plastic waste characterization within healthcare facilities, and through the tenacious leadership of Stanford, we now have detailed insight and process recommendations for efficient, high-quality and cost-effective recycling of plastics,” says Tod Christenson, Director of HPRC. “The results of this pilot will provide invaluable experience-based guidance to other hospitals seeking to establish a plastics recycling program in clinical settings.” Stanford Hospital & Clinics’ clinical recycling program to-date will divert more than 110 tons of non-infectious packaging material from landfill annually, with plastics representing nearly 70 percent of that material. In addition, Stanford has realized significant financial benefit associated with the program, as recycling collection offered a 75 percent cost savings compared to municipal waste collection. The pilot study was fully funded and implemented by Stanford University Medical Center with technical support provided by HPRC.

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Medical Waste Management

JAN-MAR 2014

news briefs

IG Corners Veterans’ Hospital on Infection Control Lapses

olumbia, SC—According to an AP report on WashingtonTimes. com, the Williams Jennings Bryan Dorn Veterans Administration Medical Center here is under fire for poor leadership and inadequate training. An anonymous tip to Department of Health and Human Services’ Inspector General office in November 2012 led to a federal investigation of the hospital’s surgical practices. The caller blamed the hospital’s poor surgical care, policy violations and contaminated surgical trays for its higher than average infection rates. Investigators visited the hospital six times in 2013, finding a number of problems. The IG’s report called the hospital’s infection control “fragmented and inconsistent,” and cited numerous cases of shoddy record keeping, as well as instances of inadequate cancer screenings and patient monitoring. After the officials determined that problems in the ventilation system were causing dust to accumulate on equipment, operating rooms were closed. The IG team confirmed improper use of log books, as well as insufficient surgical clinic staffing and vacancies in anesthesia services. Their report says the hospital’s staffing and billing problems have contributed not only to troublesome surgical scheduling, but also to surgeries being postponed or canceled and referred to other medical centers in the area. What’s more, operating rooms were found to be lacking in crucial backup supplies, such as surgical mesh and sterilized instruments and equipment. The report noted that Dorn’s “vendors had refused to restock supplies due to disputes over billing or payment.” VA officials have acknowledged the problems with staffing and supplies, noting that some of them have already been remedied. But they also countered that some allegations were unsubstantiated, including claims that contaminated equipment contributed to surgical site infections Dorn has 95 operating beds and 75 community center living beds. The facility serves about 410,000 veterans throughout South Carolina, according to the report. The hospital’s operating areas remain closed as veterans are being referred to other medical facilities in the Columbia area.

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Hand Washing is Important Defense Against C. Diff Spread

ne in four healthcare workers’ hands are likely to be contaminated with infectious diarrhea germs, reports an upi.com article. A study published in the January issue of Infection Control and Hospital Epidemiology, found that gloves alone are not effective against combatting the spread of Clostridium difficile bacteria (C. difficile) in healthcare facilities. The study compared contamination rates among healthcare workers caring for patients infected with C. difficile spores and those caring for non-colonized patients. During the study, all patients with C. difficile were placed in single-bed rooms with dedicated equipment. Infection control measures that were used included gloves, disposable gowns and full length sleeves; daily room cleaning with a disinfectant; use of alcohol-based hand rub before donning gloves and hand washing with medicated soap and water after removal of gloves. The researchers concluded that hand washing using soap and water proved to be more effective than using alcohol-based sanitizers alone for removing C. difficile. This has prompted the Society for Healthcare Epidemiology of America to recommend that healthcare workers use soap and water after caring for infected patients. The highest contamination rate (42 percent) was found among nursing assistants, who perform more high-risk care such as bathing. “Because C. difficile spores are so resistant and persistent to disinfection, glove use is not an absolute barrier against the contamination of healthcare workers’ hands. Effective hand hygiene should be performed, even in non-outbreak settings,” explains Caroline Landelle, lead author of the study.

www.bondtech.net JAN-MAR 2014

Medical Waste Management

news briefs

Study Reveals Hospital ICU Infection Prevention Inconsistent

ashington, DC—According to findings published in American Journal of Infection Control, established infection prevention policies for ICUs are not being followed about half the time and this is a contributing factor in hospital-acquired infections (HAI) in intensive care units. A team of researchers from Columbia University and the Centers for Disease Control and Prevention (CDC) conducted a survey of 1,534 ICUs at 975 U.S. hospital ICUs to see if there was a correlation between adherence to prevention checklists and hospital-acquired infections in the units. The survey was part of a collaborative nationwide study, Prevention of Nosocomial Infections and Cost Effectiveness Refined (P-NICER), the largest of its kind. The research was funded by the National Institute of Nursing Research. Researchers used the survey to track clinician adherence to 16 prescribed measures for preventing three of the most common types of preventable infections in hospitals: central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTI). About one in 10 hospitals used checklists to prevent bloodstream infections. One in four did not have checklists to prevent ventilatorassociated pneumonia, and about one-third of hospitals had no policy in place to prevent catheter-associated urinary tract infections, according to the study report. “Evidence-based practices related to CAUTI prevention measures have not been well implemented,” the authors said. “These findings are surprising, given that CAUTI is the most frequent healthcare-associated infection. Clearly, more focus on CAUTI is needed, and dissemination and implementation studies to inform how best to improve evidencebased practices should be helpful.” One way that hospitals can improve compliance with infection control rules is to have an electronic monitoring system that tracks health care worker behavior to ensure they are following infection control rules. Previous research has shown that these systems reduce infection rates. Only about one-third of the ICUs in the study had this type of system. Another approach is to have staff members that are certified in infection control, such as preventionists. Yet more than one-third of the hospitals in the study did not have a full-time person with such qualifications, the researchers noted. “Hospitals aren’t following the rules they put in place themselves to keep patients safe,” team leader Patricia Stone, a professor of health policy at Columbia University School of Nursing, said in a Columbia news release. “Rules don’t keep patients from dying unless they’re enforced.” The study report notes that, at any given time, one in every 20 inpatients is suffering from an infection related to hospital care. In monetary terms, the cost of HAI is staggering – close to $33 billion in the U.S. each year.

Massachusetts Law Requires Institutions and Businesses to Recycle Food Waste

uincy, MA—Massachusetts businesses and institutions that produce more than a ton of food waste each week must divert that waste from landfills, beginning October 1, 2014, according to a PatriotLeader.com article. The state recently passed legislation that affects 1,700 colleges, high schools, hospitals, nursing homes, resorts, convention centers, supermarkets, restaurants and other businesses throughout the state. According to the new regulations, food waste must be donated or redirected to composting sites. Any remaining food waste will be shipped to an anaerobic digestion (AD) facility, where it will be converted to clean energy, or sent to composting and animal-feed operations. Residential or small business waste is exempted from the new mandate. Food materials and organics make up 25 percent of the current waste stream going to landfills. The legislation is intended to move the state toward its goals of reducing the waste stream. Targets for Massachusetts’ zero food waste program aim at 30 percent less going to landfills by 2020 and 80 percent less by 2050. Infrastructure projects, such as facilities to manage the organic material resulting from the ban, are in planning stages. State programs are in place to offer assistance and incentive to site anaerobic digester (AD) operations on farms, wastewater treatment plants and other public and private locations. The state is providing technical assistance and up to $1 million in grants to help offset construction costs. The first AD grant of $100,000 has been awarded to the Massachusetts Water Resources Agency (MWRA) for a wastewater treatment plant. The MWRA currently processes sludge in 12 digesters and utilizes the biogas that is created to provide heat and electricity for the plant. A pilot project later this year will introduce food waste into one of the chambers and tests will be carried out to determine the effects of co-digestion on operations and biogas production. The state Department of Environmental Protection (MassDEP) launched RecyclingWorks, an awareness and education program aimed at helping businesses and institutions increase recycling and comply with the Massachusetts waste disposal bans. The program provides free webbased resources and guidance, including a searchable service provider database, a phone hotline and direct technical assistance. MassDEP continues to provide technical and financial assistance to municipalities and is adding funding to its existing Recycling Loan Fund to support projects to grow infrastructure for managing organic materials. Many Massachusetts businesses have already established costeffective food waste separation programs. A partnership between MassDEP and the Massachusetts Food Association has resulted in 300 supermarkets implementing successful food waste separation programs that save up to $20,000 a year per store location.

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Regulations, compliance, technology…it can be a lot to keep up with—which is why we host the Healthcare Waste Conference annually. You’ll have the chance to learn from our esteemed speakers as well as your peers—and you’ll walk away with new insights and best practices. This year’s Healthcare Waste Conference will focus on the top issues of the day—those that affect your business every day. Do you ever wish you/your company could do any of the following? • Make better decisions • Test-drive potential solutions to your business challenges • Network with peers who may have answers to your questions • Save money and time If so, this event is for you! Who Should Attend? • Healthcare and medical waste generators, transporters, and service providers • Healthcare waste manufacturers, distributors, and users of treatment technologies, devices, equipment, packaging, and other products used in the medical waste business • Federal, state, and local regulators and enforcement personnel • Consultants and financial advisers Visit www.healthcarewasteconf.com to REGISTER TODAY. And, good news!—your registration for the Healthcare Waste Conference includes complimentary access to the WasteExpo Exhibit Hall and one ticket to the Monday evening reception at Atlanta’s famous and fabulous Fox Theatre! Allied Publications:

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JAN-MAR 2014

Medical Waste Management

news briefs

AMCS Group Acquires PC Scale Technologies

MCS Group, the European supplier of end-to-end software and on-vehicle technology to the recycling and waste management industry announced recently that it has acquired PC Scale Technologies (PCST), of Oxford, PA, USA, a provider of software and technology solutions for the recycling and solid waste industry in North America. With the acquisition, AMCS Group becomes the largest provider and global leader of software and technology solutions to the recycling and waste industry. AMCS’ CEO, Jimmy Martin, says, “As a division of AMCS Group, the acquisition of PC Scale leverages our common technology and combined industry expertise. With a combined staff of over 180 employees, we will have significantly more resources in the North American market. The new division of AMCS Group will be led by PCST’s current COO, Ken Good.

Pittsburgh Hospitals Cited for Illegal Medical Waste Disposal

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ittsburgh, PA—With a total of 16 waste dumping violations between them, University of Pittsburgh Medical Center and Allegheny General Hospital are promising better employee adherence to policies and procedures, according to an article on TribLive.com. Fines imposed by the PA Department of Environmental Protection (DEP) are pending while the two medical facilities evaluate the causes of the slip ups and work to improve their employee training and awareness programs. “It’s obvious that they’re still having a little bit of a problem,” said John Poister, a DEP spokesman. “We’re monitoring the landfill, and we’ll continue that until we’re satisfied no more stuff is going to turn up there.” Last December DEP received a complaint about red bag waste at a Waste Management Inc. facility. DEP investigators found medical waste – blood bags, surgical sponges and a substance thought to be human tissue – from UPMC and Allegheny Health Network hospitals. The red bags were mingled with eight to ten truckloads of waste delivered between October 2013 and January 2014. By state law, medical waste must be sterilized before going in a landfill. It can be processed by autoclave on site or by an outside contractor. DEP Field Operations Supervisor Paul Minor wrote that the hospitals should “immediately review your handling procedures” and cease any further unsterilized shipments to unauthorized facilities. A spokesman for Allegheny Health Network said the seven-hospital system has put its approximately 17,000 employees through a re-education program in order to prevent more incidents. UPMC has ramped up its employee training, as well.

JAN-MAR 2014

Product/Equipment Profiles Skyline Medical Inc. Introduces the STREAMWAY® System

kyline Medical, Inc. offers new technology for the surgical waste fluid management market. Our Company’s core product is its unique, innovative STREAMWAY ® System, which offers a safe, efficient, and environmentally friendly direct-to-drain solution for automated surgical fluid disposal and waste management. MedicalSkyline Waste Medical’s STREAMWAY® System is an FDA-cleared, surgical fluid 1/2 pg 4c horizontal disposal device that virtually eliminates operating room workers’ exposure to potentially infectious surgical fluids. The STREAMWAY System collects, measures and disposes of surgical waste fluids resulting in improved OR safety and efficiency. Benefits of the STREAMWAY® System include: • Increased safety for staff and patients by reducing exposure risk • Reduced overhead costs to hospitals and surgical centers • Enhanced operating room efficiency thereby making surgeries more profitable • Eco-friendly as it reduces the millions of biohazard canisters that go into landfills each year For more information call 651-389-4800 or visit our website at www.skylinemedical.com.

Xenex Announces HCAHPS Improvement Program to Help Hospitals Raise HCAHPS Scores

enex Disinfection Services, a provider of UV room disinfection systems for healthcare facilities, recenlty announced the availability of its HCAHPS Improvement Program, which is designed to help hospitals raise their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) cleanliness scores. The Centers for Medicare and Medicaid Services (CMS) is phasing in a combination of incentives, penalties and public reporting requirements to affect operational behaviors and outcomes in U.S. hospitals. Xenex has long been able to demonstrate the cost effectiveness of its room disinfection system in reducing the considerable costs of caring for patients that acquire infections; however, with the added financial motivation of the new CMS programs, many Xenex customers are discovering an additional financial benefit from their investment as a result of improvements in their HCAHPS scores. For more information contact Xenex at 800-553-0069 or visit our website at www.xenex.com.

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Medical Waste Management 11

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Pressure Mounts on Stericycle Medical Waste Facility

orth Salt Lake, UT—The continued operation of a Stericycle medical waste incinerator plant here is at a crossroads, according to reports on TheStreet. com and Salt Lake Tribune.

The company is contesting allegations of falsifying air quality testing records. And now, at a time when its operation permit is about to expire, news reports have surfaced pointing to a U.S. Department of Justice

criminal investigation into Stericycle’s alleged manipulation of emissions tests. According to a report on TheStreet.com column, the Utah state Department of Environmental Quality has received requests for information from the US Environmental Protection Agency’s criminal investigation division. Simultaneously, Utah state legislators, Sen. Todd Weiler, and Rep. Greg Hughes, are working to help resolve issues over the Stericycle facility, but in different ways. Weiler’s Senate Bill 196 which would prohibit the Utah Division of Solid and Hazardous Waste from permitting medical incinerators within two miles of homes, passed through committee 2014 Security Shredding & in late February. Hughes with broad support 2014 Security Shredding & has been preparing HJR6, a House resolution, Waste Conference 2014 SecurityMedical Shredding & which would pave the way for Stericycle to Medical Waste Conference move to another area. Medical Waste Conference Atlanta, GA NovemberWeiler’s 18-20, bill2014 had originally specified all Atlanta, GA November 18-20, 2014 medical waste, but wording was revised to list Atlanta, GA • November 18-20, 2014 Cobb Galleria Centre only potentially infectious materials, such as Cobb Cobb Galleria Galleria Centre Centre human tissue and chemotherapy drugs that 2014 Security Shredding & could contaminate water if buried in landfills. The bill does not apply to existing operations. Medical Waste Conference Stericycle has been eyeing a rural Utah Atlanta, GA • November 18-20, 2014 county for building a new medical waste incinerator, but relocating may depend on CONFERENCE Cobb Galleria Centre the outcome of its legal problems, as well as laws being introduced in the state legislature. Permitting and construction at the remote site the company has selected also will take at We’ll Show You How to Generate New We’ll Show You How to Generate least aNew year. We’ll Show You How toProfitability Generate New Revenue and Increase Although Weiler’s bill would not Revenue and Increase Profitability restrict residential development adjacent to Revenue and Increase Profitability Building on 2013’s successful launch, Security Shredding & Medical Waste 2014 on companies 2013’s successful launch, Shredding & Medical Waste 2014representative said he will feature equipment Building and product that supply to bothSecurity the document incinerators, the state will feature and product companies that supply to both the document Building 2013’s successful launch,equipment Security Shredding & Medical Waste 2014 shredding medical/pharmaceutical waste industries. This event will include We’llonand Show You How to Generate New hoped community zoning codes would address an exceptional lineup ofand educational sessions designed to give you the insight and shredding medical/pharmaceutical waste industries. This event will include will feature equipment productand companies that supply to both document such issues. Revenue and Increase Profitability tools that you to generate new revenue and increase profitability. an exceptional lineup of educational sessions designed to give you the insight and shredding and need medical/pharmaceutical waste industries. This event will include Utah Rep. Merrill Nelson, whose district on 2013’s successful launch, Security Shredding & Medical Waste 2014 that you need to generate new revenue andand increase profitability. anBuilding exceptional lineup oftools educational sessions designed to give you the insight would host the new incinerator, has endorsed will feature equipment and product companies that supply to both the document Call for Papers tools that you need to generate new revenue and increase profitability. shredding and medical/pharmaceutical waste industries. This event will include the proposed move. Medical waste is a an exceptional lineup ofCall educational sessions designed to give you the insight and Papers Are you interested in speaking atfor Security Shredding & Medical Waste 2014? If necessary byproduct of world-class health care, tools that you need to generate new revenue and increase profitability. you are for an experienced professional in the industry, this is your invitation to Call Papers Stericyle’s violation was its only one you interested in speaking at for Security Shredding &and Medical Waste 2014? If Submit yourAre idea online at http://goo.gl/xhL6Ke consideration. Buildingparticipate. on 2013’s successful launch, Security Shredding & Medical Waste 2014 Call for Papers in 24 years of operations, said Nelson. He you areatan experienced professional in the industry, this is your invitation to Are you interested in speaking Security Shredding & Medical Waste 2014? If With questions, contactand Eric Skates at: eric@semcoproductions.com or will feature equipment product companies that supply to both the document characterized it as a “technical violation” that participate. Submit your idea at http://goo.gl/xhL6Ke for consideration. you are aninterested experienced professional in the industry, this online is Waste your invitation to Are you in speaking at Security Shredding & Medical 2014? If call (678) 822-9812. you are an experienced professional in the industry, this is your invitation to resulted in no harm. participate. Submit your idea online at http://goo.gl/xhL6Ke for consideration. shredding and medical/pharmaceutical waste industries. This event will include participate. Submit yourWith idea online at http://goo.gl/xhL6Ke for consideration. questions, contact Skates at: eric@semcoproductions.com or citizen opposition to the For information about exhibiting or attending the Eric show, email Tim Fearney Meanwhile, an exceptional lineup ofcall educational sessions designed to give you the insight and (678) 822-9812. With questions, contact Eric Skates at: eric@semcoproductions.com or at:With tim@semcoproductions.com or call: (678) 822-9804. questions, contact Eric Skates at: eric@semcoproductions.com or Stericycle plant continues. Neighboring call (678) tools that you need to generate new revenue and increase profitability. call (678)822-9812. 822-9812. residents Visit us online for conference details,about hotel exhibiting reservations, and more. the show, For information or attending emailhave Tim blamed Fearneythe Stericycle incinerator For information about exhibiting the show, email Tim Fearney Registration is about opening soon!ororattending for incidences of cancer and are pressuring the at: tim@semcoproductions.com or call: (678) 822-9804. For information exhibiting attending the show, email Tim Fearney at: tim@semcoproductions.com or call: (678) 822-9804. facility to shut down or move out of the county. at: tim@semcoproductions.com or call: (678) 822-9804. Visit usdetails, onlinehotel for reservations, conferenceand details, andBrockovich more. Visit us online for conference more. hotel reservations, Activist, Erin has lent her support Registration opening soon! details, Visit us onlineis for conference hotel reservations, and more. Registration is opening soon! to the citizen groups. A recent state study opening soon! at Security Shredding & Medical Waste 2014? If Are youRegistration interestedis in speaking indicated surrounding communities had higher Media Sponsors Managed By you are an experienced professional in the industry, this is your cancer invitation to epidemiologists maintain that rates, but the elevated rates participate. Submit your idea online at http://goo.gl/xhL6Ke for consideration.are probably not directly tied Media Sponsors Managed By to the facility. A group of doctors has urged A MINING MEDIA COMPANY Media Sponsors Managed By hospitals With questions, contact Eric Skates at: eric@semcoproductions.com orto boycott Stericycle as it contests Media Sponsors Managed By emissions violations with the Utah Department A MINING MEDIA COMPANY call (678) 822-9812. of Air Quality. The state health department had collected A MINING Fearney MEDIA COMPANY For information about exhibiting or attending the show, email Tim soil samples from the neighborhood near the A MINING MEDIA COMPANY at: tim@semcoproductions.com or call: (678) 822-9804. Continued on next page

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news briefs Continued from previous page Stericycle facility to look for traces of heavy metals and dioxin. The agency is also neonatal health records for the locale. Dwight Morgan, CEO of Sterimed, told the Salt Lake Tribune that his company (Stericycle’s parent) is continuing to talk with two customers even as they accept medical waste bids from competitors. The University of Utah’s hospital and clinics contract with Stericycle to dispose of some of their chemotherapy waste. Stericycle’s North Salt Lake medical waste incinerator, built in 1989, is one of the few such incinerators still operating in the US and the only such facility between the Pacific Ocean and Utah. Truckloads of medical waste come from a number of western states to the facility. The incinerator processes about 7,000 tons a year, according to the Utah Division of Air Quality. The disposed waste ranges from pharmaceuticals and laboratory tools made of plastic and glass to human tissue and fluids and animal tissues and carcasses. Alicia Connell, a resident of the North Salt Lake neighborhood that abuts the Stericycle property, says, “Incineration is old, outdated and simply unnecessary since there are several alternative technologies that can process waste with zero emissions.” According to Stericycle’s legislative affairs chief, Selin Hoboy, upgrades to the company’s North Salt Lake facility include some $1.5 million worth of new equipment, to lower emissions at the plant. The improvements include a newer generator which means fewer bypass events in which emissions are released into the air. Currently, the plant has bypass events about six times a year, but that is less than one-tenth of 1 percent of the operation, Hoboy said. Stericycle’s head of corporate communications, Jennifer Koenig, says that only 10 to 15 percent of the medical waste picked up by Stericycle is incinerated. “The majority goes to an alternate facility,” she says. “While technology has advanced, alternate solutions still must be proved reliable, cost effective and environmentally sound,” Koenig says. Stericycle is making a concerted effort to reach out to the community and local leaders more, Koenig said, to explain what they do and the environmental impact they have.

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www.medwastecontainers.com

Curtis Bay Medical Waste Services Acquires Waste Management Healthcare Solutions New England Customers and Turnkey Facility Assets

urtis Bay Medical Waste Services, a growing comprehensive medical waste service company, has acquired the Waste Management Healthcare Solutions New England based customer service operation and the turnkey medical waste processing facility assets. Curtis Bay currently operates an established New England medical waste transfer station in Haverhill, MA, and continues to expand its geographic footprint in the New England market. “Curtis Bay continues to actively evaluate strategic mergers and acquisitions, while remaining focused on serving its growing customer base,” said Steve Groenke, Chief Executive Officer for Curtis Bay Medical Waste Services. He added, “The acquisition of the Waste Management Healthcare Solutions New England based operation is an opportunity for our growing organization to expand our medical waste customer base in the New England market.”

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JAN-MAR 2014

Medical Waste Management 13

news briefs

VA Program Reduces MRSA Germ Cases at Linen Suppliers Long-Term Care Centers Report: Contaminated exington, KY—Study findings show that a “bundle” of simple infection-control measures are effective at reducing the number of infections caused by dangerous antibiotic-resistant bacteria, Linen is Not Red methicillin-resistant Staphylococcus (MRSA) according to an article on HealthDay.com. VA hospital records show that MRSA infections have dropped 36 percent since the program was Bag Waste launched in 2009. This is the first time that such a large decline in MRSA infections in long-term

care facilities has been reported, according to the authors of the MRSA Prevention Initiative study. Their findings were published in the January 2014 issue of the American Journal of Infection Control. The 42-month long study was conducted at 133 VA long-term care centers. The researchers discovered that the number of infections was reduced by screening of all patients, using gowns and gloves when caring for patients colonized or infected with MRSA and practicing good hand hygiene. One additional tactic, emphasizing caregivers’ individual responsibility for infection control, also was a key factor. Dr. Martin Evans, of the VA Medical Center in Lexington, Ky., and colleagues concluded that MRSA infections in long-term care centers can be controlled effectively if personnel apply the techniques correctly, and especially, with implementation and adherence in a large number of facilities.

www.bemishealthcare.com

14 Medical Waste Management

JAN-MAR 2014

ission, KS—Tossing away all contaminated linen as red bag waste or regulated medical waste (RMW) is a waste in itself – and it is an expensive one, according to an article on InfectionControlToday.com. Two trade associations, which represent healthcare laundry operators, The Association for Linen Management (ALM) and the American Reusable Textile Association (ARTA), wanted to know the reasons why as much as 25 percent of their members’ linen was not being returned. In 2013 the groups collaborated on a survey of 200 nurses and healthcare professionals at five U.S. medical systems. What they learned was revealing – 95 percent had recently disposed of at least one linen item as Red Bag waste, even though linen is reusable, not waste. The survey showed that management and personnel understanding of Occupational Safety and Health (OSHA) regulations, as well as hospital policy, has been weak, if not altogether wrong. Specifically, the proper handling of healthcare linen contaminated by blood/bodily fluids and what’s being taught in healthcare facility training programs are at odds. The groups wrote a joint letter to OSHA, citing their findings and the financial impact. They requested the agency to clarify its rules. Hospitals, they said, pay between 18 - 33 cents per pound to dispose of Red Bag waste. Then, there’s the added cost replacing discarded linen. OSHA responded to the ALM/ARTA findings with a “Letter of Interpretation” response: The definition of “regulated waste” does not include contaminated linens that will be laundered and reused. 29 CFR 1910.10330(b). The word “waste” is defined as “garbage” or “trash.” Webster’s II New College Dictionary, 1995, p.1247 (definition 6). Furthermore, “[c] contaminated [l]laundry is separately defined in this standard. The definition is “...laundry which has been soiled with blood or other potentially infectious materials [OPIM] or may contain sharps.” 29 CFR 1910.1030(b).” ALM and ARTA have launched an awareness campaign that includes letters to medical system administrators. The groups are also producing education materials for their members to use in training and educating healthcare clients on the correct (and less costly methods) for handling contaminated linen.

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