Waste Not
One of the key concepts in the book and movie mentioned last time is that waste is not always obvious. Sometimes what we see as part of our job is not necessary and therefore qualifies as waste. I recently sent in a reimbursement request without some required info. BC/BS had to write me and answer two phone calls. That’s waste for everyone, even tho it was somebody’s job to handle those problems. Perhaps if their instructions were more explicit . . . or they kept info on providers . . . or they only insured compulsive patients.
Some waste is more wasteful than other waste. Red-bag trash is hazardous material and costs dollars per pound to dispose of. Special handling, tracking, etc. Expensive. State health departments have rules about what goes into red-bags--generally, stuff that has a potential to cause disease. I’ll spare you the descriptions, but not everything. If I cut my finger in the kitchen, I don’t have to search for a red bag. Blood on a paper towel or a 4 x 4 doesn’t count. Into the normal trash, and off to the landfill.
But not everyone reads the rules. The last hospital I was in, had ONLY red bags in their intake area, so EVERYTHING went into the expensive waste system. (From my limited observation, NOTHING there required red-bag disposal) Why do they do that? The simple answer is that no one cares. People who work in that area are not trained or motivated to look for waste. No one is looking at what it costs to get a patient ready for surgery and where we could save money. If you made the room a little warmer, you wouldn’t need so many blankets--less money for laundry. And if you kept the patient warm in the OR, you wouldn’t need the individual warmers ($$) in recovery.
These are trivia in the big picture of potential cost savings in hospitals. Estimates mentioned last time from hospital administrators were 40 to 50%. Actually, they were thinking mostly about overuse savings--tests done that were not necessary. So, my examples would go on top of that. The nice thing about such savings is that they go on forever, and most of them don’t cost any money to implement.
Some waste is more wasteful than other waste. Red-bag trash is hazardous material and costs dollars per pound to dispose of. Special handling, tracking, etc. Expensive. State health departments have rules about what goes into red-bags--generally, stuff that has a potential to cause disease. I’ll spare you the descriptions, but not everything. If I cut my finger in the kitchen, I don’t have to search for a red bag. Blood on a paper towel or a 4 x 4 doesn’t count. Into the normal trash, and off to the landfill.
But not everyone reads the rules. The last hospital I was in, had ONLY red bags in their intake area, so EVERYTHING went into the expensive waste system. (From my limited observation, NOTHING there required red-bag disposal) Why do they do that? The simple answer is that no one cares. People who work in that area are not trained or motivated to look for waste. No one is looking at what it costs to get a patient ready for surgery and where we could save money. If you made the room a little warmer, you wouldn’t need so many blankets--less money for laundry. And if you kept the patient warm in the OR, you wouldn’t need the individual warmers ($$) in recovery.
These are trivia in the big picture of potential cost savings in hospitals. Estimates mentioned last time from hospital administrators were 40 to 50%. Actually, they were thinking mostly about overuse savings--tests done that were not necessary. So, my examples would go on top of that. The nice thing about such savings is that they go on forever, and most of them don’t cost any money to implement.
Comments
Bob,
When I came to this position, I was informed that one of my duties was to do "faciity reviews" which included looking at the status of biohazardous waste. When I first started off, we had two trash cans in each exam room - one for regular trash and one for biohazardous trash. Of course the red bag in each exam room was big and filled with non-biohazardous trash. I inserviced the staff on what is and is not biohazardous material - no effect. I then removed all the big red bags in the exam rooms and, instead, each exam room is stocked with sandwich size red bags. In the rooms where there is a possibility of large amount of biohazardous waste (treatment room and GYN room) a large red bag is folded in the draw with the smaller red bags, ready for use. It is amazing how much this has decreased biohazardous waste!!! Now the contents of our red barrels is 95% sharps containers!!!!
Posted by: John Harrison, RN, MHSA | January 29, 2007 02:41 PM
Good approach. Sounds like "mistake proofing". Make it hard for folks to do it wrong.
Posted by: R. Burney MD | January 31, 2007 11:02 AM