Hospitals often generate a large amount of waste during medical treatment, such as syringes and circuit tubes. In the past, these could only be thrown into garbage bags and then sent to incinerators for burning, thereby generating carbon emissions. According to a 2019 report by Health Care Without Harm (HCWH), the global medical sector produces approximately 2 billion tons of carbon dioxide equivalent every year. If it were treated as a country, it would be the fifth largest carbon emitter in the world. However, the World Health Organization (WHO) states that up to 85% of these wastes are generally harmless and can be recycled, sterilized and reused.
Because one of the duties of the general affairs department is responsible for waste disposal, Liang Jingyuan, director of the general affairs office of the National Taiwan University Hospital, began to think about what she could do for medical sustainability. She admitted that administrative units, as logistics, are usually seen as playing a supporting role. For example, this department needs to write off, that unit needs to apply for procurement, and the general affairs department assists in processing. Although it is in a relatively passive position, "But don't feel that you are powerless".
Trial operation of kidney dialysis and hemodialysis waste, recycling nearly 16 tons in the first 7 months
Liang Jingyuan started planning the recycling process in the hospital in 2016. Originally, she only needed to throw medical waste into garbage bags; now she needs to go through multiple classification and recycling procedures, which immediately affects the work of medical staff. In this regard, Liang Jingyuan believes that the support mentality must be established well. "The process should be formulated by the front line, and the general affairs should cooperate and assist them in improving it."
To this end, she invited cross-department supervisors such as the nursing department and the accounting department to "visit the garbage disposal manufacturer together to learn about the back-end processing procedures, classification, sterilization and reuse of traffic triangle cones and other remanufactured products." Liang Jingyuan mentioned that they saw artificial kidneys are among the items that can be sterilized by manufacturers, and it was decided to use hemodialysis waste in dialysis rooms, including artificial kidneys, as a pilot site.
Originally, the waste after kidney dialysis only needed to be put into the red garbage bag representing infectious waste. Now, the artificial kidney fluid needs to be emptied, the hemodialysis needle must be thrown into the recycling bin, etc. There are several more steps. In the fast-paced medical industry, some colleagues may feel that doing this is a waste of time.
In order to reduce the difficulty of recycling for medical staff and facilitate centralized processing for sterilization and reuse by manufacturers, colleagues in the general affairs office specially designed needle recycling bins and asked manufacturers to open molds so that the height of the recycling bins can be placed under the bed and can be taken out at any time and placed in place. The entire set of artificial kidneys and blood circuit tubes costs about one kilogram per person, and nearly 16 tons of waste were reduced in the first 7 months of the trial.
Only by making things easier can reforms be effective. Reducing the weight of the carts makes recycling smoother.
"It seems like it is just a simple sterilization and reuse process. In fact, it requires the cooperation of many units and disciplined promotion, so there should not be too many items at the beginning." Liang Jingyuan said that medical staff have busy work and do not want to increase their administrative work. Therefore, the first principle of the General Affairs Office in promoting policies is "to make things easier, reforms will be effective."
After the trial was successful, the hospital's sterilization items were expanded from 3 to 16 items, and the demand for recycling increased. In 2018, yellow garbage bags for sterilization recycling waste were added to separate them from incineration. However, the initial results were not satisfactory. "The nursing staff's work cart is made of stainless steel and is already very heavy. With the medicines, laptops, etc. that need to be given to the patients, there is not enough space. The garbage bags can only be hooked with hooks."
After the team negotiated with the nursing department, it took three years to completely replace the nursing work vehicle with a lighter plastic steel material in 2022. It was also designed to be stepped on by feet and open two trash cans at a time, making it easier for medical staff to sort and simplify the recycling process. . These details have become the key to the success of National Taiwan University Hospital's sustainability initiatives. Today, National Taiwan University Hospital can recycle 126.5 tons of biomedical waste plastic every year and make it into car lamp housings, electric fan blades, etc.
Before joining National Taiwan University Hospital, Liang Jingyuan was responsible for procurement auditing work in the central government. After coming to the medical industry, she changed from a supervisory role to a subject of supervision. Firstly, she must comply with procurement regulations, and secondly, she must introduce sustainable measures. "I When I was about to leave, my colleagues laughed at me and said, "Are you stupid?" But I think you can lead changes here to make the work process of medical colleagues smoother. Once this is done, a sense of accomplishment will come."
It may seem like just one more process, but it actually requires the cooperation of many units and disciplined promotion.
