A safety net for medical waste management

It is vital for healthcare waste service providers to have a contingency plan for unexpected challenges, which could lead to a build-up of dangerous medical waste. Samantha Immelman, national sales manager for Compass Medical Waste Services, explains

Generators of medical waste – such as hospitals, clinics, laboratories, pharmacies and veterinarians – must ensure that the service provider that collects, contains, treats and disposes of their healthcare risk waste (HCRW) has a contingency plan in place to cater for unforeseen circumstances which may arise.

The service provider must be able to continue providing products and services without interruption and inconvenience, while at the same time ensuring compliance.

Here are some of the important factors HCRW generators and service providers should consider when drawing up or reviewing a contingency plan:

Containers

These have to be approved by the South African Bureau of Standards (SABS) and aligned to the South African National Standards (SANS) to ensure the safe containment of medical waste. Ideally, a service provider should have more than one supplier, so that containers can be sourced from other approved suppliers in the event that a supplier can no longer deliver or produce SABS-approved containers.

Transportation

The service provider should deliver clean containers and collect the containers filled with waste for treatment and/or disposal. It is important to consider whether the particular service provider has its own fleet, or whether it relies on a third party.

When a service provider makes use of a third party, it is important to be aware of how the medical waste generator will be impacted if there is a breakdown in the relationship between the service provider and transporter.

If the service provider owns its fleet, there should be a comprehensive maintenance programme in place to ensure the vehicles are fully operational at all times and properly maintained.

Treatment

HCRW should be treated in accordance with the provisions of an issued waste-management licence. The service provider should have sufficient capacity to deal with a significant increase in medical waste volumes.

If the treatment plant breaks down, the service provider should have a contingency plan in place to ensure the waste is treated and not stored outside the time-span parameters of the waste-management licence.

The contingency plan could include having an agreement in place with other permitted treatment facilities to assist with breakdowns, or unscheduled maintenance. Another option for the service provider is to have multiple treatment units, so that a second unit could assist in the treatment of waste if the first unit breaks down.

If treatment facilities in an entire region are down, the service provider should have the resources to transport waste to facilities in other regions. A waste generator should be concerned when a service provider requests it to hold waste until the service provider can overcome any challenges at the treatment facility.

Disposal

After waste has been correctly treated, it must be disposed in a permitted landfill. HCRW service providers should be aware of the holding capacity of the landfill being used and when the landfill is due to be closed. Once again, it is important to know whether the service provider has any agreements in place with other permitted sites.

Employees

An HCRW service provider should have contingency plans in the event of labour unrest and strikes to ensure medical waste generators are not inconvenienced in terms of service delivery. Ideally, they should have an agreement in place with a reputable labour broker to fill the gap left by a possible strike.

It is also important that the replacement staff be appropriately trained and available within a guaranteed period, for example 24 hours. A delay in HCRW management services could result in a build up of medical waste at the generator, which could cause a health risk to employees at the generator and surrounding communities.

Electricity outages

As power outages do occur (sometimes frequently) in South Africa, it is important for the service provider to be prepared and able to continue with normal services despite an electricity outage. An on-site electricity generator is an excellent backup to ensure business continuity without interruption.

Data

In terms of quality management standard ISO 9001, certain documentation is required to be stored for a specified period of time, which should be noted on the document itself. It is important for the service provider to keep these documents off site and in accordance with the standard requirements.

If an HCRW generator misplaces its Safe Disposal Certificate, or agreement with a service provider, the service provider should have a copy available. Copies of all documents should be kept in an off-site location to ensure that they are secure in the event of a fire.

Most healthcare risk waste generators, such as hospitals, cannot afford delays or inconveniences. It is important for service providers to work efficiently, but it is also the responsibility of the waste generator to ensure that the service provider is competent and has a backup plan for any unforeseen obstacles. It is always better to be safe than to resort to hoarding healthcare risk waste.