There is a lot of discussion about the technologies for waste treatment, but that is only one part of the waste treatment system. Planning, monitoring, budgeting and training are also important.
Healthcare facilities should have a waste management policy and a waste management plan. The policy sets out the overarching priorities, and the plan goes in to more detail about its implementation, which is particularly important during the creation or upgrading of a waste management system. Standard operating procedures, training and other guides can set out the roles and responsibilities for employees undertaking different waste management tasks.
The Waste Management Committee takes responsibility for the creation and execution of the policies and plans and for making sure that the facility complies with all legal obligations. Where possible it should also go beyond the legal minimum and aim to meet the best achievable standards. The committee can also devise appropriate methods of recognizing and rewarding excellent behavior and curbing inappropriate or hazardous actions.
The committee should include representatives from senior management, procurement, finance, medical divisions, laboratories, housekeeping and maintenance as well as the waste workers themselves. One person should be designated as the Waste Manager and liaise with all those involved in waste generation and management inside and outside the facility.
Waste management should be monitored regularly. While setting up a new system, the baseline assessment is very important in providing reference data on which to base the plan. Some monitoring data may be required by the regulatory authorities while other data can show up the successes and failures in the systems so that practices can be improved. Financial reporting will show the benefits of waste reduction and segregating recyclable materials for sale.
The Waste Management Committee should also set targets for waste management; for example, to recycle a certain amount of waste, or reduce the number of accidents and incidents associated with waste management or the amount of hazardous materials purchased.
The waste policy and targets should be reviewed each year with the aim of achieving continuous improvement.
- WHO Blue Book. Chapter 5. The “Blue Book” is the World Health Organization’s guidelines on the safe management of healthcare waste. Although it has global application, it is particularly important in low to middle income countries where the infrastructure and national guidelines might not be fully developed. The current edition, published in 2013, was written by a large group of internationally recognised experts, including HCWH staff.
- Prüss-Ustun, A. et al (2013) Safe management of wastes from health-care activities, second edition. Publ: WHO, Geneva, 328pp. 978 92 4 154856 4
The World Health Organisation (WHO) has a large website including tools and information for use at the country and facility level, from policy documents to costing to legislation: http://www.healthcarewaste.org/
UNDP GEF elements of a waste management policy. This document is a model policy designed for healthcare waste facilities. When setting up a new waste management system, adopting this policy, rather than developing one from scratch, will speed the process of implementation up considerably. Any changes that are necessary can be made at the annual review.
- UNDP/GEF (2009) Recommended Elements of a Model Facility Policy on Healthcare Waste Management. Publ: UNDP/GEF Global Medical Waste Project, 5pp.
- IRAT- the Individualised Rapid Assessment Tool. Created by the UNDP GEF Global Healthcare Waste project, this tool is designed to give an assessment of the state of healthcare waste management in a facility within a single day.
- UNDP GEF guidance on Elements for a baseline assessment: This guidance lists the data needed from a healthcare facility before the introduction of best practices and techniques related to healthcare waste management. It also describes the rationale and procedures to gather and analyze the baseline data.
- UNDP GEF (2009) Guidance on Conducting a Baseline Assessment of a Healthcare Facility. Publ: UNDP GEF Global Healthcare Waste Project, 34pp
- Mainstreaming Environmental Management in the Health Care Sector. This document, produced by the World Bank, is focused on India but has much information that will be useful to waste managers everywhere.
- World Bank (2012) Mainstreaming environmental management in the health care sector: Implementation experience in India and a tool-kit for managers. Vol I & II. Publ: World Bank, Washington DC, 151pp.