Henry Ford Hospital (HFH) in Detroit, Michigan, is the flagship hospital within the Henry Ford Health System (HFHS). HFH is a tertiary care hospital and level 1 trama center with over 850 beds specializing in fields of cardiology, neurology, orthopedics, organ transplants, and cancer.
The protection of our environment ultimately impacts public health and drives numerous regulations pertaining to health care waste management. Many medications are considered hazardous waste under state and federal law. Others are non-hazardous, but may contaminate drinking water supplies when disposed down a drain. Detroit and most metropolitan areas have detected pharmaceuticals in municipal drinking water supplies, and state and federal regulators are increasing enforcement of pharmaceutical waste disposal requirements.
Proper separation of waste is required by federal, state and local regulations. It ensures the protection of the environment, specifically the water supply. There is also a cost factor – hazardous waste is 100 times more expensive than regular trash and therefore impacts a hospital’s bottom line to keep regular trash out of pharmaceutical and infection waste containers.
RRS worked with HFH to evaluate the costs and benefits of a pharmaceutical waste collection program to responsibly dispose of all hazardous and non-hazardous drugs. A pilot program was initiatived in select HFH departments, and subsequently to the in-hospital pharmacies, over the course of two years. The phased-in approach allowed for evalutation of some key elements of a successful program:
- Strategically develop a collection program rollout plan.
- Evaluate various bin types and colors, reusable versus disposable, removable plastic liners, hands-free open, and label designs.
- More accurately estimate the projected volume of waste by unit, location of collection points, as well as size and number of bins.
- Remove non-hazardous wastes, return unopened medications to Pharmacy for manufacturer rebates, utilize just-in-time dispensing and inventory control.
- Evaluate special needs in several units (operating room, emergency room, clinics).
- Take into account who would collect, storage and space needs, frequency, and tracking.
- Determine full program costs over a multi-year period including labor, equipment and disposal.
- Engage stakeholders and users of the program.
- Provide comprehensive staff training, signs, and policies.
- Evaluate, measure and audit program success.
After piloting and evaluating the program, in early 2012, RRS assisted HFH in drafting an RFP for comprehensive Pharmaceutical Waste Services throughout HFHS and received proposals from ten different vendors. After a review process including scoring of the cost and technical proposals, clarifying questions, and interviews of the top candidates, a system vendor was selected. HFHS sites are now operating the program as part of their commitment to providing a safe, secure, and therapeutic environment for all patients, staff, visitors and the community.