By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs
BREMERTON, Wash. (NNS) -- Naval Hospital Bremerton (NHB) was honored with a "Partner Recognition" award by Practice Greenhealth, the national membership organization for health care facilities committed to environmentally responsible stewardship, June 14.
The award was presented to Capt. Christopher Culp, NHB commanding officer, and recognized NHB for making significant progress toward environmental performance goals.
The honor is one of the organization's Environmental Excellence Awards given annually to honor environmental achievements in the health care sector.
"This award demonstrates our commitment to beneficiaries, staff and visitors in protecting and preserving our environment. I am honored to accept it on behalf of our command," said Culp.
As was the case last year, NHB's environmental stewardship at home also continues to impact communities overseas. By receiving this award, a full set of mercury-free digital thermometers and sphygmomanometers have been donated to seven hospitals in Bali, Indonesia in honor of the 2012 Environmental Excellence Award winners. Previously, 100 trees were planted in Tanzania on behalf of NHB which received the 'Making Medicine Mercury Free' award as part of Practice Greenhealth's 2011 Environmental Excellence Awards.
The Partner Recognition Award is for health care facilities that have begun to work on environmental improvements, achieved some progress, and have at least a ten percent recycling rate for the total waste stream.
Naval Hospital Bremerton is recognized not only for its 30 percent recycling rate, but also for the successful completion in expanding the pharmaceutical waste program to outlying clinics, training staff members in the Green Purchasing Program and for improving the dental mercury recovery operations.
According to complied figures by NHB's Environmental department, the main operating room (OR) is a prime example in recycling efforts at the command. Their surgical savings from recycling efforts for just three weeks in late 2011 was $11,508. Projected 2012 savings for the entire year in the main OR by recycling and usage of remanufactured items is estimated to be at $172,614.
The main OR used to throw away three, 30-gallon bags of garbage per total joint surgery case. Now they recycle three, 30-gallon bags of plastic and have just one 15-gallon bag that is now thrown away.
"It's a significant reduction in waste stream to the landfill. It's really an incremental amount of waste product, and we're staying on top of the process because it's easy to take for granted. We even recycle the instrument wrappings to use again," said Kevin Stevenson main OR nurse.
Compiled statistics at NHB show that the ongoing environmental awareness campaign of recycling is working. Recycled material (in tons) of paper and paperboard went from 52.25 in 2010 to 55 in 2011; plastic went from 15.53 in 2010 to 15.75; construction debris went from 2.55 in 2010 to 3.66 in 2011; metals and aluminum cans went from 1.90 in 2010 to 2.12 and batteries showed an increase from 0.43 in 2010 to 0.88 in 2011.
Concurrently, and as a direct result of the command's overall recycle efforts, trash disposed (in tons) fell from 198.50 in 2010 to 190.19 in 2011. Overall, average solid waste disposed by hospital staff per day fell from 1.18 pounds to 1.12 pounds per day.
"Our goal for 2012 solid waste disposal per person, per day, is one pound or under. We think that by continually being actively aware and getting as many people involved as we can, that we can achieve that," said Ramon Calantas, NHB environmental technician.
According to Calantas, the pharmaceutical waste program was implemented at the branch clinic level in 2011 after training clinic staff and coordinating the disposal of pharmaceutical waste with the area base (Naval Base Kitsap, Puget Sound Naval Shipyard, and Naval Station Everett) Hazardous Waste (HW) departments. This process took several months. Base HW staff had to review clinic processes and Wash. State Department of Ecology policy and regulations on pharmaceutical waste disposal prior to approving several areas in the clinics as satellite accumulation areas for hazardous waste. Collection areas in the clinics were added a few months after implementation as clinic staff identified additional areas were pharmaceutical waste was generated.
Pharmaceutical waste is defined as pharmaceuticals that cannot be used for their intended purpose or returned to the distributor for credit; expired/outdated repackaged medications; dropped pills, tablets, capsules; empty vials/carpules; partially used IV bags with medication; creams, lotions; and medicines left at the clinic by discharged patients. The patient info is removed prior to disposal and the clinic will attempt to contact patient prior to disposal.
"Empty plastic medication containers from the pharmacy are [also] recycled and the expired, unused medications are first presented to the Guaranteed Returns Vendor. If the vendor accepts them, we are given monetary credit. If they are rejected, we dispose them as pharmaceutical waste," added Calantas.
NHB's involvement in the Green Purchasing program has led to an increase in the command's efficiency in green procurement by using100 percent recycled content paper by deleting all other options from the supply catalog.
"Cindy Carlson, Material Management Department, sent some of her staff (her buyers) to the Department of Defense Course "Buying Green: A Multifunctional Approach to Pollution Prevention" training in early 2011. The course is about purchasing recycled content materials, energy and water efficient products, alternative fuel vehicles, biobased products, and environmental preferred products," Calantas said, noting that the staff check for green alternatives prior to buying requested material when any non-clinical supplies have to be ordered.
NHB's "Mercury Elimination Plan" started with an inventory of supplies, materials and equipment containing mercury; their locations, manufacturer and quantity, and an assessment of the feasibility of replacing with mercury-free alternatives as practicable. The plan also included requirements to ensure mercury free products are purchased, as well as involvement with maintenance and construction staff to ensure no mercury items are introduced during repairs or projects. Much of the progress made in the plan has been the focus on dental amalgams used in dental procedures now being captured and recycled.
"We have installed a combination of dental amalgam filter in tandem with mercury removal filters to exceed federal regulation for mercury in our wastewater," said Calantas. "We installed the same units in our newly deployed Mobile Dental Van currently at Everett. We invited Environmental Staff at Everett to showcase what we have installed in the van to comply with federal, state, and county regulations for wastewater disposal in the sewer systems. We continue to collect scrap amalgam from the dental clinics including the empty amalgam capsules. These are sent to a recycling company instead of disposing as hazardous waste."
The Mercury Elimination Plan has included having fluorescent lamps being replaced with green tipped, energy efficient, low mercury lamps; using digital radiology machines that eliminate any mercury products needed for wet X-ray processing
"Our goal is to eliminate all mercury from NHB as new alternatives become available." said Robert Mitchell, NHB environmental manager. "Fortunately, our industry and manufacturers have responded to this issue, and it's becoming easier to find safer, cost-effective alternatives. But to further minimize mercury's effect, Naval Hospital Bremerton has set standards that go beyond regulatory reductions."