A Whole Systems Approach to Medical Waste Management

Evan Bircher has been in healthcare EDS support services for about 26 years, 24 of which has been with HHS. Having started as an assistant director, he has worked his way up through the system, taking on a director position for several years and now to a VP position.

What are some of the widely prevalent challenges you notice in the Medical Waste Management landscape?           

The greatest challenge was due to COVID when it first started because they changed the perspectiveof handling medical waste. When COVID first started, we treated it like it was airborne medical waste, which required a whole lot more safeguards than regular standard bio hazardous waste. So once that was lifted and it was then considered standard or regular medical waste, which was fine.

Any pain points we may have is in pick up; if your regulated medical waste doesn't get picked up fast, then you have it in an out outdoor storage facility. And if the container that the medical waste is stored in fills up, then you may or may not have a place to put it. Stack containers of regulated medical waste needs to be secured. If we run out of containers,   then this can be a problem, which rarely happens if they don't schedule a pickup fast enough.

Also, transporting the waste through the facility is not a pain, but it is labor intensive. You have to have a flatbed trolley, put the containers in the trolley, and then move it from various points throughout the facility. If you had that picked it up directly from the trash rooms on each floor, that would be ideal, but there's not a company that we're aware of that does that.

What are the current market trends you see shaping the Medical Waste Management landscape?

Some things have changed such as the type of containers or carriers used. Now you use the hard side of the plastic container that are easier to stack and that’s been a truly innovative step.

One of the other pieces to the regulated medical waste is that you have to collect the department of transportation manifests for every time your load is picked up. And that used to be largely a paper involved process as you had to keep up with a paper manifest and keep them in a binder. And now they have become electronic such as an electronic system for those manifests. You still keep the paper manifest as backup but the originals are now done electronically.

What are the strategic points that you go by to steer the company forward?

Taking the company forward we're always looking for innovative opportunities to maximize productivity. In addition to the regulated medical waste you also have sharps waste, sharp needles, and surgical equipment and so on. They get put in sharp containers and some of the innovations in the industry now are that a company will go to the specific sharpcontainers itself and change that out right there on the wall. And then they take that container, bring it back to their facility and empty that container. They disinfect that container and then they put that container back into service versus all of those containers going to the landfill which was waste. And continuing to be put in the landfill was waste, they take that plastic out of the waste stream and they recycle those containers to where they're used over and over again. This is a huge innovation for the bio waste medical industry; taking all that plastic out of the landfill and recycling those containers.

Also the other innovation that I've seen is how the amount of cardboard that was used has now been taken out of the landfills, because of hard plastic containers. They are disinfected once the containers are empty, and then reused, eliminating the cardboard. So those have been two innovative steps that I've seen throughout my career.

Please shed some light on how HHS handles the medical waste?

We are required to wear the PPE suits to protect our staff. So we have gloves, gowns, face shields and goggles and all of that's at our disposal and also hand sanitizers in every direction. So handling medical waste is highly regulated by HHS ad we ensure our staff is wearing the proper PPE whenever they are handling it or any kind of waste and not just regulate a medical waste. We're always looking to partner with companies that have innovative technology to better help the transportation within the facility of the regulated medical waste and handling of regulated medical waste for the safeguard and better practice productivity for our staff. Our customers come to us and we manage these contracts for the facilities themselves and they do come to us as experts on the handling of medical waste. And more often than not, we are included in working in any new potential contracts and helping them steer themselves towards.

How would you see the evolution a few years from now with regard to disruptions and transformations within the arena?

The process of destruction of medical waste has changed throughout the years. There are only certain landfills that are accepted now for the truly infectious medical waste. There were only two in the Cub and the country that handled that type of waste. But through the years, they've greatly reduced the amount of plants necessary to handle medical waste due to the different innovations that they've had and destroying that regulated medical waste before it goes to the landfill with whatever surplus is leftover after it's been autoclaved or incinerated.

When I first started in the industry in 1994, they still had incinerators at hospitals and those are all now gone. That's all been decommissioned and they do not incinerate waste anymore. There are few sites due to the environmental impact that the smoke produced after the incineration. I believe by and large, everything now is autoclave. They go into a big steam up and that doesn't produce the waste into the environment from smoke and it's all contained within the unit. And basically the big ball of plastic comes out of there from whatever's left over after it's been, hit with high pressure steam and melted down disinfected. And then that capital of plastic is what gets dropped into the landfill. At some point, you're seeing it every day with, a lot of industries going away from plastic. I don't know if that's going to happen within the next 24 months. But at some point somebody is going to start looking at as to how much we can lessen that even further, the amount of waste that goes into turn landfills, whether it's driven on a national, private, governmental, or private level. So there's been a lot of innovation through the years but it's not as quick as is you would think. Probably in the next 5 to 10 years we will see additional innovations come down the pipe.