Case Studies

The Challenge

With approximately one million physician practices and clinics throughout the United States, the volume of medical waste generated from these practices is staggering. Even though the Centers for Disease Control and Prevention estimates that only 10% of the waste generated in a medical office is actually regulated medical waste, most practices do not properly segregate their waste streams and end up filling red bags with what is actually trash. In fact, every facility audited by Sharps consultants since its inception in 1994 has been found to over-classify its waste.

Many offices use traditional and costly pickup services for their waste disposal. While these services are well suited for managing large quantities of medical waste, they are overkill for the typical medical office. The Sharps Recovery System utilizes the existing U. S. Postal Service infrastructure to transport medical waste which is usually 50% less expensive than the traditional medical waste pick-up service. Why arrange a special pick-up when the existing USPS system runs every day?

One particular medical practice located in the state of Florida contacted Sharps inquiring about the Sharps Recovery System. It was clear there were several medical waste disposal challenges the practice faced. Red bags were placed in each exam room and a large open collection box was located in sterilization. An audit revealed that the red bags in the rooms were filled with trash such as table paper, gauze, gloves, tray covers, urine cups, a patient's soft drink cup, needle caps and more. When asked about the process used when the pickup service arrived, the assistant stated that she or one of the nurses had to make patients wait, assure sharps containers and bags were pulled from the rooms and placed in the box, close the box, place the state-specific labeling on the box and sign the manifest. Often the manifest copy left for the office was misplaced during the rush to get the transaction handled and get back to patient care.

When discussing potential options, the Sharps representative reminded the assistant that changes need to be reflected in the office bloodborne pathogens exposure control plan and biomedical waste management plan. When the plans were reviewed, it was discovered that they had not been updated in several years.

In addition to the clinical issues faced by the medical assistant, the office manager was consistently frustrated when she opened an invoice. There were "add on" fees every month. She was paying for the boxes no to be being picked up, but for monthly service fees, administrative fees, a fuel surcharge fee, box and bag fees, box set-up fees, and missed pickup fees. Even if the office had no box to pick up, the office was still charged a fee each and every month of their five year contract!

The Solution

The medical office chose the SharpsAdvantage Program. The Advantage program was the best value and included a fill-in-the-blank OSHA manual on CD with a biomedical waste management plan included. "The manual is a complete OSHA manual with all the other OSHA programs as well as the bloodborne pathogen plan, so it's something we really needed."

With the help of the Sharps team, the office was able to reduce the volume of medical waste generated and determined that the 18-Gallon Medical Profession System was the right size for them. It was large enough for their needs, but not so large that it would not be full in 30 days and ready for disposal as is required by Florida state storage regulations for non-sharps waste. The 18-gallon system included a Sharps RightClassification poster that the office posted to help staff properly segregate.

"We love the fact that the 18-gallon has a lid! The old box we had didn't have a lid and that was always a concern." Red bags were removed from exam rooms, and small red bags were placed in exam room cabinets. During cleanup, if a red bag is needed for a saturated dressing for example, it is retrieved from the cabinet, filled, and placed directly into the 18-gallon container. By not having the red bags in containers in the rooms, patients and staff alike couldn't use them for trash. With regard to sharps containers, by using the 18-gallon system, the office could continue to use its own sharps containers. When full, they are simply closed and placed into the 18-gallon container.

When reviewing state regulations, the office determined they needed a spill cleanup procedure. The Sharps Biohazard Spill Cleanup and Disposal system was selected to comply with this requirement. "It includes everything we need to help us comply with OSHA and the state. We just placed the entire system in the cabinet in the lab and indicated its location in our new OSHA manual and biomedical waste management plan."

The Result

The most telling result from switching from a pickup service to the Sharps Recovery System is the cost savings. The office was able to RightClassify their waste streams and therefore cut the volume of medical waste generated by more than 70%. "We are still working on proper segregation, but we are getting so much better thanks to Sharps!" Also, the fact that there were no added fees was a big plus noted by the office manager - one price for all services and no surprises.

From the clinical side, not having to interrupt patient care to deal with medical waste was cited as the number one benefit. The box could be closed, packaged and shipped on the assistant's schedule, not that of a pickup driver. The staff also says the lid is a true benefit.

Finally, after Sharps addressed the most concerning challenges of the office – cost and convenience - the added benefit of their waste being repurposed into PELLA-DRX instead of going to a landfill provided the office with a marketing tool that spoke to their patients, and potential patients about their environmentally sound waste disposal practices.