DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

1. DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

2. How the business consultant described it How the customer explained it How the project leader understood it How the analyst designed it How the programmer wrote it What the customer really needed What operations installed How the customer was billed How the project was documented How it was supported experiential and picture based learning

3. Project Leader Linda Godfrey - CSIR Division of Water, Environment and Forestry Technology Co-Authors Eric Nørby - Rambøll Andrew Smith - CSIR Division of Information and Communication Technology Paul Furniss - Gauteng Department of Agriculture, Conservation, Environment and Land Affairs Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

4. Presentation Outline • Introduction • Background to Health Care Risk Waste Information System (HCWIS) • Approach to Development: • Pre-Development • Development • Piloting • Implementation • Future Development • Lessons Learnt • Conclusions Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

5. Background to Health Care Risk Waste Information System(1) • A component of a broader strategy: Strategy for the Sustainable Management of HCRW in Gauteng • Overall objective: Sustainable Health Care Waste Management in Gauteng, established within the frames and principles of the National Waste Management strategy, covering the full health care waste stream from “cradle-to-grave”. Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

6. Background to Health Care Risk Waste Information System(2) • Executed by the CSIR and Danish-based company Rambøll • Funded by DANIDA • Consultation with all relevant government departments during development • Initiated in the Gauteng Province in September 2001 • Reporting to system voluntary until promulgation of regulations in September 2003 Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

7. Approach to Development: Pre-Development Establishing a conceptual model: • Aims and objectives of the system • what was required from the system? • who will be required to report to the system? • what data and how often the data would need to be submitted to the system? • Assumptions made in order to be able to address aims and objectives of system • Limitations • Information needs Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

8. Approach to Development: Pre-Development • Aims and objectives: • Developed through consultation with GDACEL, DEAT, DWAF, DoH • Two primary aims: • Monitor trends in monthly amount of HCRW transported and treated in the Province • Assess available treatment capacity in the Province Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

9. Approach to Development: Pre-Development • Assumptions (1) • HCRW is weighed within the Province • HCRW treatment facilities report waste tonnages received per generator and identify relevant transporter • HCRW transporters report waste tonnages removed from Province for treatment in another Province • Only major generators (> 10 kg per day) to be identified. Minor generators to be grouped together as “small generators” Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

10. Approach to Development: Pre-Development • Assumptions(2) • Measures are defined to enforce reporting. • All HCRW containers are clearly marked with generator name and registered unique number. • Data is submitted to GDACEL electronically in a pre-determined format. • The HCWIS is managed and operated by suitably qualified GDACEL personnel. Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

11. Approach to Development: Pre-Development • Limitations • Not a tracking system • Does not incorporate a hazardous waste manifest system • Verification of data limited to a cross-check between serviced generators and list of generators • Only health care risk waste tonnage data captured on system Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

12. Approach to Development: Pre-Development • Information needs • Collect only urgently needed data • From fewest role players in HCRW generation, transportation, treatment chain • Use collected data effectively Output: framework document outlining objectives of system, data requirements for system and role players. Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

13. Registration Data Capture Data Submission Data Entry Verification Reporting Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

14. Approach to Development: Development Design of the system 1) Registration • All HCRW generators, transporters and treatment facilities • Initially only medium – large generators to register (>10 kg generated per day). • 80/20 principle 2) Reporting • Generators - none • Transporters - tonnage removed from province • Treatment facilities - tonnage received for treatment in province Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

15. Approach to Development: Development 1) Registration Process • Generator, transporter or treatment facility submits details to GDACEL on a registration form • Unique identifier assigned to generator, transporter and treatment facility. Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

16. Waste Generator ID Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

17. Approach to Development: Development 2) Reporting Process (1) • Static data and dynamic data • Reporting options: • On-line (internet reporting) • Electronic data capture • Paper data capture • Reporting frequency– monthly/quarterly • Data committed to system after verification by WIS Officer • Cannot be deleted or altered • Transparency of data Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

18. Data Upload Page Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

19. Approach to Development: Development 2) Reporting Process (2) • Waste Information System (WIS) Officer: • Monitoring reporting • Verification and committing of data • Extraction of reports • Verification of data • Information from previous years • Knowledge of the reporter • Experience • Comparison with other reporters • Common sense • Generator information Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

20. Reporting cycle Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

21. Pre-defined Reports: Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

22. Example of Pre-defined Report: Comparison Between HCW Tonnage Generated and HCW Tonnage Treated in Gauteng (Pilot) in 2002 Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

23. Example of Pre-Defined Report: Waste Generation and Treatment per Metropolitan Municipality (Pilot) Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

24. Example of Derived Report: Monthly Provincial Treatment Capacity Vs. Monthly Provincial Generation Rate Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

25. Approach to Development: Development 2) Reporting Process (3) • System data verification • Mass balance not possible because generators do not report Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

26. Approach to Development: Piloting • August 2002 – August 2003 • Involved four treatment facilities, one transport company and waste information officer • User’s manual and training programmes • Provision of support materials Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

27. Approach to Development: Implementation • During piloting, all “bugs” and problems were noted • Version 2 launched in June 2003 – minor changes • All reporters visited again and introduced to new version Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

28. Future Development • Enforcement of reporting – September 2003 • WIS Legislation: • Objectives of the WIS • Identification of persons required to report • Registration of persons required to report • Reporting requirements • Access to information • Penalties • HCWIS is a platform • Waste stream schedules eg. Hazardous waste Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

29. Lessons Learnt • Some problems and challenges: • Confidentiality of information and disclosure of information to competitors • Poor understanding of information requirements eg. mixed loads • Reporting of information voluntary • Poor computer literacy • Access to and maintenance of resources (Internet, hardware) etc. hindered reporting Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

30. Conclusions • HCWIS component of HCWM strategy and platform for broader waste information system • Simplicity is key • Initial aims and objectives have been met Gauteng Department of Agriculture, Conservation, Environment and Land Affairs

31. Thank YouAll documents available at the following url: http://www.csir.co.za/ciwm/hcrw Gauteng Department of Agriculture, Conservation, Environment and Land Affairs