Did You Know?

The nation’s hospitals generate approximately 6,600 tons of waste per day!

Though we commonly associate hospitals with regulated medical waste generation, as much as 80 to 85 percent of a healthcare facility’s waste is non-hazardous solid waste – such as paper, cardboard, food waste, metal, glass and plastics.

How recycling and composting can help

According the EPA, recycling and composting programs recovered 32.1 percent of municipal solid waste in 2005 – equaling out to 79 million tons.

Why recycling and composting make “cents”

In addition to reducing impact on the environment, recycling and composting make good economic sense as well. According to the Joint Commission, in 2000 a hospital’s waste disposal costs ranged from $44 to $68 per ton. This provides an economic incentive for hospitals to reduce waste generation and disposal. Recycling reduces waste volume by diverting material from the landfill and can ultimately reduce a hospital’s waste disposal costs. Recycling certain commodities may even generate income for hospitals if a vendor or recycling center pays for the materials.

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Onward and Upward: Small Steps toward Greener Dining

Thinking about making your facility’s kitchen and dining room a greener operation? Following are H2E executive director Laura Brannen’s top picks for creating a truly green foodservice program.

Healthy Food Purchasing

Serving healthy food to sick patients is a natural progression – healthy foods equal healthier bodies better able to fight disease. Healthcare providers have an opportunity to be leaders in moving food markets for locally grown, organic, antibiotic-free food and this is evidenced by the meteoric increase in interest on the subject. This is great news, but it’s also just a part, albeit an integral part, of operating a green kitchen and dining room. Learn more at H2E’s food service page and Health Care Without Harm’s Food project.

Reusable Dishware

Serving organic coffee in polystyrene cups or promoting the purchase of sustainably grown foods while not minimizing waste or recycling in the kitchen are both inconsistent with a truly sustainable foodservice program. Good old-fashioned reusable dishware will keep unnecessary paper and plastic goods out of the landfill. See Health Care Without Harm’s Choosing Environmentally Preferable Food Service Ware fact sheet for further details.

Bio-based/Compostable Disposable Dishware for Take-out

When reusable dishware is not an option for take-out, look toward biodegradable packaging, dishware and utensils that will naturally breakdown when disposed off. These bio-based products are made from materials such as sugarcane fiber, corn and potato starch. Though made of natural materials rather than plastic, these products still hold up with both hot and cold foods. See Health Care Without Harm’s Choosing Environmentally Preferable Food Service Ware fact sheet for further details.

Recycled Content Napkins and Paper Products

According to the EPA, paper and paperboard products constitute the largest portion of municipal solid waste. Purchasing paper products made with recycled content reduces the amount of paper waste in landfills and saves trees that would otherwise be harvested. Trees left standing absorb carbon dioxide, while harvesting trees actually releases carbon dioxide into the atmosphere – both from the trees themselves and the exhaust from harvesting machinery.

Composting

Most of the waste coming from the kitchen can be diverted from the landfill through recycling and composting. Compostables include any organic materials – that’s anything that was once living – including paper goods, and of course food waste from the food-prep to post consumer. Learn more about composting throughout this issue and by reading H2E’s 10 Step Guide to Composting in a Health Care facility.

Recycling Tin, Aluminum, Plastics and Cardboard in the Kitchen, Dining Room and from Patient Trays

Food packaging is largely recyclable: tin, aluminum, plastics, glass and cardboard. Let your dining room visitors know that you’re recycling in the kitchen and make sure they return their recyclables on the food trays – you can even limit the number of trash cans in the dining room to ensure your compostables and recyclables are returned to the kitchen where they can be managed properly.

Integrated Pest Management

Everyone wants a sanitary kitchen free of pests. Many kitchens are switching to Integrated Pest Management (IPM) – a program that focuses on sanitation and facility maintenance to prevent pests rather than regular application of pesticides. Learn more about IPM in this issue and by reading H2E’s 10 Step Guide to Implementing an Integrated Pest Management Program.

Green Cleaners

Green cleaning products work as well as traditional products while reducing chemical exposure to workers and patients. There is a myth that green cleaning products are cost prohibitive, but today green products are cost-competitive. Learn more about green cleaning with H2E’s 10 Step Guide to Green Cleaning

Use the Dining Experience to Educate Staff, Visitors and Patients

Finally, the dining room or patient room service program provides a terrific opportunity to educate your staff, patients, and visitors about your commitment to providing healthy and sustainable food, to doing your part of a community health leader to minimize waste through recycling and composting, and to reduce your use of hazardous chemicals.

H2E’s recorded teleconference, Toxicity and Volume Reduction Opportunities in Food Services – A Case Study by Children’s Hospital and Regional Medical Center in Seattle, WA, tells of one hospital’s successes in how they manage their foodservice materials. From waste prevention, to greener cleaners, Integrated Pest Management, composting, reusables, and recycling, food services has a lot of opportunity for environmental improvements.

Laura Brannen joined H2E in 2001 as the full-time Director and has been working in healthcare environmental management for 20 years.

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Waste Not, Want Not

How Food Waste Recycling Positively Impacts the Environment
and Your Bottom Line

H2E sat down with Seattle-based consultant Rebecca Kinnestrand to find out how food waste recycling can help the environment while helping your bottom line.

H2E: Why should hospitals consider implementing a food waste recycling program?

Kinnestrand: Hospitals exist to care for the sick and injured, so it is natural that such an institution should reduce harm to the environment in which people live. Most hospitals have at least one kitchen and a significant outflow of food which makes them great candidates for food waste recycling.

H2E: How does a hospital go about getting started?

Kinnestrand: One way is to start with the low-hanging fruit. Pick things that impact the bottom line while simultaneously reducing the environmental footprint. One quick and easy way to do this is to start composting. Waste is considered to have no value and is also costly to dispose. There needs to be a mindset change that waste does have some value. You can resell cardboard and aluminum among other items, and food waste can be composted then bagged and sold for profit as a soil amendment. It is all well and good saying composting is good for the environment, but what hospitals may not know is that it is also good for the bottom line.

H2E: How can composting be good for the bottom line?

Kinnestrand: Food is one of the heaviest components of waste – especially if you are already recycling materials such as glass and aluminum. When we look at a hospital with a kitchen, usually the garbage container is composed of at least 20 percent recyclable organic material. Once you start composting you should be able to reduce the size of your waste containers and the tonnage you’re disposing of, thereby reducing your waste bill. Savings vary depending upon waste disposal costs, but if you’re offered compost collection it is most likely significantly less expensive than trash disposal. The only upfront cost for an organic collection program may be some new bins for kitchen, some biodegradable bags, and 10-15 minutes of staff training.

H2E: Typically what type of cost-savings do you see with composting?

Kinnestrand: In the Seattle area we’ve always been able to provide savings, typically 20-30 percent on the waste bill. I’ve run the financials on some large entities such as conference centers and estimated that one of them could save $30,000 in the first month – large hospitals have the possibility of finding similar savings. For example, Seattle Children’s Hospital – a medium-sized hospital – is diverting 1,400 lbs of waste a week and saving 40 percent on their annual waste bill and Virginia Mason Medical Center is diverting more than 700 pounds a day in food waste.

H2E: Are there other benefits to composting?

Kinnestrand: A “side effect” to food composting is that most hospitals find significant savings in water reduction as well. Millions of gallons of water are washed down disposal machines every day. The maintenance of those machines is very expensive as are plumbing costs when pipes and drains back up with food and grease. When disposing of food waste via compost, the water in the troughs does not run all day and in the case of Seattle Children’s Hospital, it saves them $18,000 a year and more than a million gallons of fresh water. Virginia Mason Medical Center is saving 1,000 gallons a day. On-site metering of the hoses before the initiation of a food composting program is the way to measure before and after progress.

H2E: How do you approach management about switching to composting?

Kinnestrand: That depends on who is making the decision. Often the head chef or chief engineer has to take it up the ladder. You need to get buy-in and the key to that is making a business case. If you can’t save money through food waste reduction then make the financial case that it will at least zero out. If the waste rate in your region doesn’t allow you to at least zero out then show other benefits such as possibilities for green marketing, employee satisfaction and adhering to the hospitals’ green mission statement. Line up your thoughts on why it should be done and a little about the process. When management realizes it comes down to buying a few bins and a little training they generally open to the idea. Show the simplicity and immediate benefit – it’s truly low-hanging fruit.

H2E: What about odors and pests?

Kinnestrand: The number one question I get is, “what about rodents?” because of Seattle’s water front. If we can do it in Seattle, it can be done anywhere. The key is implementing an Integrated Pest Management Program (IPM). This focuses on reducing pests through common-sense practices such as a good sanitation program, thereby reducing the need for pesticides. For composting it means having good tight lids on containers and having containers serviced frequently. You have to remember that food waste was in the garbage anyway and rats can get in the trash compacter as well as the garbage container. The way to mitigate odors and pests with any waste container is through frequent pick ups, tight fitting lids, use of biodegradable bags and sanitizing the bins.

For more information on composting, check out H2E’s 10 Step Guide to Composting in a Health Care facility.

For more information on Integrated Pest Management, check out H2E’s 10 Step Guide to Implementing an Integrated Pest Management Program.

Rebecca Kinnestrand is a Senior Associate on the green business team at Cascadia Consulting Group, Inc. Her expertise lies in assisting businesses to become “green” – strategically. Rebecca has consulted with numerous businesses and institutions on pollution prevention, waste reduction and recycling, water and energy efficiency, and green building practices.

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Real-World Perspective

A La Carte Options and Room Service Representatives:
Waste Management for the 21st Century

With the world “going green” Atlanta’s Piedmont Hospital saw an opportunity to jump on the bandwagon. But the hospital wasn’t latching on to the trend just to be a joiner. Former director of food service Dan Salas saw it as an opportunity to save money and the hospital soon learned that green initiatives weren’t just eco-friendly, but cost effective too.

Although green food service isn’t the first thing that comes to mind when imagining ways to save the environment through health care, Piedmont has found that the food service industry is an excellent area to cut down the waste. And the hospital has instigated several creative ways to do it.

Piedmont decided to set their goals high and hasn’t shied away from their ambitions. Implementing a paper recycling program, organizing a plan for recycling corrugated boxes and saving batteries and light bulbs from the trash are just a few of the initiatives.

Zácka Gomes, Nutrition & Food Services Manager, has seen first hand how these programs have reduced waste, one of the most successful being the On Call Dining program.

“Implementing room service had a major effect in waste reduction,” said Gomes. “We only provide patients with the food they ask for, subsequently they waste less.”

It may seem simple, but On Call Dining encompasses a detailed process and employs a number of people for smooth operation. The concept was brought to the hospital two years ago, and although the program is very labor intensive, it has since changed the perception of food service at Piedmont. While the main result is less waste, patient satisfaction also comes into play.

When a patient is admitted, a dietary associate meets with each patient to assist in their understanding of the room service process as well as their prescribed diet.

The Room Service Representative introduces themselves to each patient and presents their personal menu. The patient is able to call an extension and place orders from 6 a.m. to 10 p.m., providing a wide window of accessibility.

Rather than mass feeding all patients three times a day, the room service program caters to individual preferences and schedules, Gomes said. “If people order what they want, when they want it, most likely they will eat it.” Patient satisfaction is achieved and the added bonus is much less trash.

Due to the complexity of the physician’s prescribed diets, Piedmont offers 26 therapeutic diets that derive from the room service menu. In other words, Piedmont can prepare the same item 26 ways, depending on the patient’s restrictions. Being that this is done on an individual basis, there is no over production of food that other wise might not be consumed. The restrictions can range from low sodium and low fat for those with cardiac issues, to diets that control the amount of protein and potassium for individuals with renal problems.

In addition to a new philosophy of serving food that patients want when they want it Piedmont has a more physical method of reducing food waste. Enter the Pulper Extractor – a foodservice department’s dream. Employees scrape all food and paper products from cafeteria trays into what is called a Pulper Extractor. The staff is trained to use the Pulper Extractor which relies on employees to maintain the correct water amounts and adjust operation levels.

The waste grinding device acts similar to a disposer, with the pulper breaking waste down into small pieces. The result is then transferred to an extractor where all of the water is pressed out. Finally, the waste is drained and dumped into the trash. The machine at Piedmont can take as much as 100 pounds of waste and cut it down to about 20-25 pounds.

But Piedmont doesn’t stop there. Different departments within food service work together to minimize food waste. “Centralized production and cooking all food in small quantities, multiple times throughout the day, ensures safe and wholesome food choices with minimal waste,” Gomes reported. This is especially efficient for Piedmont’s food court which is open 22 hours a day.

Piedmont’s green efforts in food service also extend to the cleaning products they use in food preparation and serving areas. The hospital’s micro fiber system, a safe and effective cleaning system, operates without the use of chemicals which greatly reduces the presence of these harmful elements around the hospital.

While Piedmont does maintain internal standards for excellence in green waste reduction, Gomes said audit consultants have also remarked on their program, praising the hospital for their recycling efforts. Gomes remarked that the patient satisfaction ratings for food service at Piedmont are as high as the physician ratings, an uncommon feat in the healthcare industry.

“Piedmont is clearly a leader in green waste management and the food service department plays a major role,” Gomes said.

Piedmont Hospital is a 458-bed acute tertiary care facility offering all major medical, surgical and diagnostic services. Located on 26 acres in the North Atlanta community of Buckhead, Piedmont is a private, not-for-profit organization with 3,700 employees and a medical staff of more than 900 physicians.

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Take Poll, Win iPod!

Take our poll about green foodservice operations and you’ll have the option to enter your name in a drawing for a free iPod Nano. You can even choose what color you’d like to receive if you should win!

Take the survey!

Congratulations to Rina Lallu of Fordyce, AZ, winner of the random drawing from among last issue’s poll respondents!

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Upcoming H2E Teleconferences

Don’t miss out on the exciting topics coming up this Fall. Visit the H2E Teleconferences calendar to learn more.

September 28: Making Medicine Mercury-Free

October 5: Sustainable Food Procurement and Design

October 19: Data Collection Success: How to track data and identify measurable goals in environmental programs

November 2: Introduction to the Pharos Project

November 16: Climate Change & Health Care featuring Bill McKibben, author and Scholar in Residence at Middlebury College

and more…