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Region 2's Healthcare Compliance Initiative: Environmental Results From An Integrated Strategy

Region 2's Healthcare Compliance Initiative: Environmental Results From An Integrated Strategy. Leveraging Limited Resources To Obtain Better Compliance. Goals For Compliance Initiative. Improve environmental compliance and safety at main and off-site healthcare facilities.

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Region 2's Healthcare Compliance Initiative: Environmental Results From An Integrated Strategy

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  1. Region 2's Healthcare Compliance Initiative: Environmental Results From An Integrated Strategy Leveraging Limited Resources To Obtain Better Compliance Region 2 Healthcare Compliance Initiative

  2. Goals For Compliance Initiative • Improve environmental compliance and safety at main and off-site healthcare facilities. • Change the culture to one in which environmental compliance is a priority. • Ensure compliance of entire sector; not just those reached through inspections. • Ensure continued compliance by implementing permanent changes. Region 2 Healthcare Compliance Initiative

  3. Approach • Region 2 combined the following strategies to address compliance issues in these sectors: • Compliance assistance • Compliance incentives (voluntary audit/disclosure) • Compliance monitoring • Enforcement • Pollution prevention • Environmental management systems (EMS) Region 2 Healthcare Compliance Initiative

  4. Region 2 Healthcare Compliance Initiative

  5. Results: Compliance Monitoring & Incentives Programs Region 2 Healthcare Compliance Initiative

  6. Results:Environmental Protection From Audits Region 2 Healthcare Compliance Initiative

  7. Results:Environmental Benefits Region 2 Healthcare Compliance Initiative

  8. Root Causes Of Noncompliance Systemic violations appear to stem from: • Inadequate resources for people, equipment and training to carry out environmental activities; • Limited or no environmental compliance accountability for individual departments, laboratories, and staff; • Limited authority vested in environmental compliance officials; Region 2 Healthcare Compliance Initiative

  9. Root Causes Of Noncompliance • No clear environmental compliance chain-of-command; • Scattered, incomplete, and missing environmental compliance documentation; • Incomplete institutional knowledge regarding environmental regulatory requirements; and • Broad use of hazardous materials when effective substitutes exist Region 2 Healthcare Compliance Initiative

  10. Healthcare Violations Region 2 Healthcare Compliance Initiative

  11. Healthcare RCRA Violations Region 2 Healthcare Compliance Initiative

  12. Laboratories Dental clinics X-rays units Nuclear medicine areas Pharmacy Maintenance areas Physical therapy Underground storage tanks Laundry Morgue Operating rooms Nursing units Hazardous waste storage areas Medical technology unit Construction areas Satellite accumulation points Common Hazardous Waste Violations Region 2 Healthcare Compliance Initiative

  13. Healthcare CAA Violations Region 2 Healthcare Compliance Initiative

  14. Healthcare CWA Violations Region 2 Healthcare Compliance Initiative

  15. Healthcare TSCA Violations Region 2 Healthcare Compliance Initiative

  16. Healthcare EPCRA Violations Region 2 Healthcare Compliance Initiative

  17. Top 15 Violations From 68 Resolved Voluntary Disclosures Region 2 Healthcare Compliance Initiative

  18. Top 15 Violations From 68 Resolved Voluntary Disclosures Region 2 Healthcare Compliance Initiative

  19. Top 15 Violations From 68 Resolved Voluntary Disclosures Region 2 Healthcare Compliance Initiative

  20. Survey Overview • 38 hospitals completed and returned the audit survey • 65,279 staff are reported to be working at these 38 hospitals • 10,691 beds are reported to be within these 38 hospitals • 282 facilities are reported to compose these 38 hospitals Region 2 Healthcare Compliance Initiative

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  26. Understanding Of Waste Management Regulations Before And After Compliance Initiative (24% - 92%) Region 2 Healthcare Compliance Initiative

  27. Understanding Of Above Ground Storage Tank Regulations Before And After Compliance Initiative (9% - 75%) Region 2 Healthcare Compliance Initiative

  28. Understanding Of Under Ground Storage Tank Regulations Before And After Compliance Initiative (34% - 88%) Region 2 Healthcare Compliance Initiative

  29. Understanding Of Clean Air Act Regulations Before And AfterCompliance Initiative (27% - 76%) Region 2 Healthcare Compliance Initiative

  30. Understanding Of Wastewater Discharge Regulations Before And After Compliance Initiative (24% - 70%) Region 2 Healthcare Compliance Initiative

  31. Understanding Of Spill Prevention Control Countermeasure Plans Before And AfterCompliance Initiative (14% - 83%) Region 2 Healthcare Compliance Initiative

  32. Understanding Of Toxic Substances Control Act Before And AfterCompliance Initiative (14% - 61) Region 2 Healthcare Compliance Initiative

  33. Understanding Of Pesticide Regulations Before And AfterCompliance Initiative (36% - 76%) Region 2 Healthcare Compliance Initiative

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  36. Top Five $ Saving Activities Region 2 Healthcare Compliance Initiative

  37. Top Five Pollutant Reductions Region 2 Healthcare Compliance Initiative

  38. Five Simple Waste Reduction Activities • Install automatic light sensors • Install water saver plumbing fixtures • Send kitchen grease to a reclamation facility • Switch from disposable to reusable plates, eating utensils, and cups for cafeteria services • Reduce the use of disposable cleaning materials Region 2 Healthcare Compliance Initiative

  39. Most Common Mercury Reduction Activities • Upgraded light fixtures to t-8’s and installed new electronic ballasts • Replaced mercury monometers & thermometers • Implemented computer monitor and electronics recycling program • Collected and recycled amalgam at dentist and silver reclaimer installed at cancer treatment center • Initiated a hospital-wide mercury reduction and recycling program Region 2 Healthcare Compliance Initiative

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