1. Department Specific Hospital Assessment Tool (Version 1.0) Dinesh Somuri Akhil Kadiyala Dr. Ashok Kumar Department of Civil Engineering University of Toledo

2. Objectives  Create a pollution prevention tool for assessment of hospital waste generated in various departments in a hospital.  Tool must award an index/score to each department of the hospital that helps in better understanding of the improvements that can be made in different avenues.  Tool needs to provide cleaner alternatives and easily compare the sustainability of one hospital with other.

3. Methodology  A comprehensive literature review on the types of pollutants produced in each department of hospital, types of treatment methods adopted, types of recycling techniques used and various facilities in the hospitals is done.  The tool is developed based on the knowledge obtained from the literature.  The tool is developed based on simple YES/NO questions.  Points are allotted to each question that relates to standard practices and regulations.  Recommendations are provided to become compliant in the end along with scores.

4. Sections in D-HAT 1.0  Title Sheet  Instructions  Surgery Department  Emergency Department  Psychiatric Department  Dialysis Department  Laboratories  Nursing Home Care  Radiology Department  Scores Sheet

5. Home Page of D-HAT 1.0

6. Questions on Surgery Department  Types of wastes produced in the department.  Separate waste storage areas.  Labeling of wastes.  Treatment procedures followed.  Recycling of the surgical tools.

7. Screenshot of Questions under Surgery Department

8. Questions on Emergency Department  Segregation of wastes.  Waste carrying containers.  Sanitizing and reuse of graduated measuring containers.  Employee Training.

9. Screenshot of Questions under Emergency Department

10. Questions on Psychiatric Department  Weekly area inspection for signs of spills or container deterioration?  Provision of a source reduction plan.  Treatment of wastes produced in the department.  Do you recycle batteries, fluorescent lamps, paints and mercury.

11. Screenshot of Questions under Psychiatric department

12. Questions on Dialysis Department  Inspection of waste.  Handling universal waste separately from other hazardous wastes?  Heating/Ventilating upgrades.  Replacing of lab chemicals that uses mercury.

13. Screenshot of Questions under Dialysis Department

14. Questions on Laboratories  Alternatives to PVC and DEHP containing products.  Segregation of chemotherapy wastes.  Solid waste reduction strategy.  Disposal of lead containing items in aprons and lead packaging.

15. Screenshot of Questions under Laboratories

16. Questions on Nursing Home Care  Usage of reusable medical instruments instead of disposable instruments.  MSDS sheets maintenance and availability to all employees.  Recycling of universal wastes like batteries, paints and paint thinner, fluorescent lamps etc.

17. Screenshot of Questions under Nursing Home Care

18. Questions on Radiology Department  Treatment of radioactive isotopes.  Use of non-toxic or less toxic alternatives for janitorial chemicals.  Reduction/Elimination of chlorine-containing supplies, and reduction in the amount discarded that goes to the medical waste incinerators.

19. Screenshot of Questions under Radiology Department

20. DHAT Specifications  To run D-HAT 1.0 Microsoft Excel is needed.  DHAT 1.0 can be downloaded from http://p2tools.utoledo.edu/ppistools.htm http://p2tools.utoledo.edu/ppistools.htm  NOTE: “Development of a Tool for the Assessment of Department Specific Hospital Waste” to be published in Environmental Progress.

21. Evaluation Method  The overall DHAT evaluation score is obtained by adding sectional scores.  The sectional scores and overall scores can be seen below in the Scores screenshot.

22. Screenshot of Suggestions in Surgery Department

23. Screenshot of Suggestions in Emergency Department

24. Screenshot of Suggestions in Psychiatric Department

25. Screenshot of Suggestions in Dialysis Department

26. Screenshot of Suggestions in Laboratories

27. Screenshot of Suggestions in Nursing Home Care

28. Screenshot of Suggestions in Radiology department

29. Conclusion  A user friendly tool that consists of YES/NO type questions has been developed.  The tool provides a summary of all the applicable regulations and practices that the various departments of a hospital are in compliance with and not in compliance with.  The sectional score helps in the detailed evaluation of compliance related issues and take corrective measures to become compliance.