1. BIOHAZARDOUS WASTE REDUCTION IN THE OPERATING ROOM OR QUALITY COUNCIL OR MANAGEMENT OR SURGICAL SERVICE TECHS ALL OR STAFF PP&G PURCHASING DEPARTMENT Confidential: For Quality Improvement Purposes Only

2. Project Aim Statement Due to the need to shut down the campus incinerator by June 30, 2010, the O.R. decided to take a closer look at our disposal practices. We wanted to reduce the amount of red bio- hazardous waste, vs. clear bag waste and potentially lower the cost of waste disposal to the hospital. The cost of disposal for the hospital is $45.00/Ton plus the cost of the truck which is $210.00 per trip. The current haul away is 10 – 20 tons a trip. Confidential: For Quality Improvement Purposes Only

3. Aim Statement Currently all waste at LUHS is incinerated. LUHS will be required to shut down its campus incinerator by 6/30/2010. The OR generates a large amount of red bag waste each day. Upon observation, red bags contain items that can be disposed of in clear bags. Red bags cost.65/each. Prior to project implementation red bag cost was $16,224. Goal The OR aims to reduce red bag usage by 50%, thereby reducing cost. Confidential: For Quality Improvement Purposes Only

4. The Aim…. Measurable Goal and Target Monitoring the number of bio-hazardous red bag used per day in the O.R. before staff re-education and after. Our target goal was to reduce red bag use by 50% after staff re-education red bag vs. clear bag disposal practice. Forces of Magnetism Force 7: Quality Improvement Force 10: Community and the Healthcare Organization Confidential: For Quality Improvement Purposes Only

5. SOLUTIONS IMPLEMENTED Re-educated all OR staff during in-service on 11/7/07 about the difference between bio- hazardous and clean waste. Re-designed garbage bins and made clear bags more available in the OR. Notified staff that a process was being put into place to monitor red bag garbage. Confidential: For Quality Improvement Purposes Only

6. In-Service to Staff New OR’s Open Confidential: For Quality Improvement Purposes Only

8. …STUDY ANALYSIS By enabling staff to differentiate usage of red bags versus clear bags and increasing clear bag availability, bio-hazardous waste was reduced dramatically therefore reducing cost. Red bag usage decreased from 96 bags/day to 21 bags/day. Costs decreased from $16,224 to $3,601 annually realizing a 78% reduction in cost. Confidential: For Quality Improvement Purposes Only

9. NEXT STEPS RECOMMENDATIONS FOR FURTHER STUDY OR ACTION Continue to monitor staff compliance on a monthly basis to demonstrate success of the project. Examine the benefit of providing even smaller bio- hazardous bags to particular operating rooms with less waste to further reduce cost of disposal. When the incinerator is shut down, examine the cost savings to dispose of bio-hazardous waste vs. clean garbage. Implement a recycling program in the OR that could include much of the current OR waste. Confidential: For Quality Improvement Purposes Only