Improving Health Care’s Environmental Performance:

A Technical Assistance PerspectiveCatherine Zimmer, MnTAPNational Environmental Partnership SummitAtlanta, GAMay 10, 2006

Background

• MnTAP description• Mission

–Pollution Prevention (P2) focus• Tools and Resources• www.mntap.umn.edu

Partnerships• Connections to regulatory staff• Healthcare Environmental

Awareness & Resource Reduction Team (HEARRT)– Ongoing since 1997

• Hospitals for a Healthy Environment (H2E)– Statewide workshops in ’01 & ‘03

Strategies

• Talk up P2• Meet regulated community where

they’re at– Might need compliance assistance– Waste gets closer look for P2

Opportunities

• Pharmaceuticals– Epinephrine

• Formalin– Potential regulation

• Mercury– Lab reagents– Pharmaceuticals– Other equipment

Tools• Tech Diffusion Model

– Formalin recycling– Mercury Elimination

• Formalin fact sheet• Mercury Fact Sheets

– Lab Reagents– Pharmaceuticals

• Intern program

Challenges– Data management

• ~140 hospitals in MN• Multiple contacts in each• Multiple waste streams

– Data Collection• From facilities

– Get info prior to solution • From regulators

– Format differences

– Perceptions• Compliance questions• Non-regulatory

Benefits

• Improved recognition of waste• More interest in P2• Improved communications and

relationships• P2 information disseminated• Better documentation

The Stars Line Up! • Seven hospitals add formalin distillation

– Savings ~$250,000 annually• Mercury equipment elimination

– ~1000 pounds • Dade Behring

– Eliminates mercury from 6 out of 7 reagents• Three facilities eliminate B5 fixative

– Savings ~ $3000• Abbott Northwestern

– Eliminates mercury from five reagents– Eliminated “acid bath”: $610 disposal

savings• Occupational health savings $300-

13,500.

P2 Results (cont.)• Shriner’s Hospital

– eliminated epinephrine waste • 16 lb, ~$2000 disposal savings • Stay VSQG

• Hutchinson Hospital – eliminated most mercury

• Falls Memorial Hospital – eliminated mercury reagent– 242 lb, ~ $1000 disposal cost savings

H2E Results

• 147 Hospitals • 24 H2E Partners• 5 Mercury award winners• 3 Partner for Change awards

HEARRT Results

• Prior to 2003– Regular attendance ~20 – ~5 facilities

• Subsequent– Attendance ~50– ~12 facilities– Hospital Association

Next Steps

• Maintaining relationships• Regulatory integration

– Multi-media, pollution prevention inspections

• Continued technical assistance– 2006 Pharmacy intern projects

Summary

• Need both regulatory drivers and incentives

• Use variety of tactics and tools• Healthcare responsive • Regular Communication• Persistance