Ambulatory Care Center Allergy and Immunology Clinic Waste Sustainability Cast Study

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Submitted by mwhite on Thu, 04/24/2025 - 14:29

UCSF Health Office of Sustainability 2023

The Problem

Currently, the Allergy and Immunology unit of the Ambulatory Care Center (ACC) has a few issues when relating to waste sustainability. A lack of compost and recycling bins is causing a low recovery number of recyclables and compostable materials. Additionally, many small bins and no central waste stations contribute to the contamination issues, and cause higher costs related to the number of bin liners used and custodial collection.

Purpose

The purpose of the pilot program is to reduce the contamination of landfill and recycling bins in the Allergy and Immunology unit, and to increase the recoverability of compostable materials. Specifically, the pilot program aims to reduce the contamination of the recycling to below the 10% threshold standard of Recology, landfill to the 25% threshold standard of Recology.

Proposed Solutions

Implementing 3 centralized waste stations (only the breakroom waste station was approved)
1. Waste stations will be implemented in the Breakroom (A2214), Team Work Area (A2211), and the Main Hallway.
2. Centralized waste stations help to fundamentally change the way waste is being collected. Separately colored bins with clear labeling and corresponding colored liners help to keep materials clean and separate.
3. It is imperative that the waste stations stay in the same locations after implementation: allows employees to know exactly where to dispose of waste properly.

Signage by every bin (approved)
1. Signage implemented includes at the waste stations, in the bathrooms, and at the lobby waste stations.
2. Dedicated signage helps staff identify materials that were previously being sorted in the wrong locations, and dispose of materials properly.
3. Signage can be specialized to fit the needs of the work space.
  1. e.g. Simplifying the current recycling sign to only contain images of recyclables produced by the allergy and immunology floor (mask and glove boxes, paper, plastic utensils, wipe containers) instead of including the plastic medical recyclables produced by the Parnassus Medical Center.

Removing individual waste bins (not approved)
1. Switching individual bins to a few centralized waste stations changes staff recycling behavior. Instead of tossing waste below desks without a second thought, waste stations make employees approach bins with proper signage and sorting information. This makes sorting easy, and makes employees think while they are tossing.

Add compost bins to each of the 8 exam rooms and the bathroom (exam rooms not approved: needs to have lid and foot pedal for infection control, bathroom approved)
1. The exam table paper in the exam rooms is currently being disposed of in the landfill bins. This type of paper can be composted. By adding composting bins in the exam rooms, we can greatly increase the diversion of compostable materials from the landfill stream.
2. Paper towels are one of the main contaminants of recycling and landfill streams at UCSF. By adding compost bins to the bathrooms, we can recover a large amount of paper towels from the landfill stream.

Training (approved)
1. After implementing the above changes, hosting a staff training session is essential to ensure the changes generate solutions to the waste sustainability issues. We can schedule staff training for before or after the changes are implemented, as long as it is relatively close to when the changes are made.
2. Training will cover where the waste stations are, which materials belong where, and can inform the custodial team of which liners to use.

Audits (approved)
1. Before and after implementing the above changes, waste audits would be performed to track the effectiveness of the changes.
2. Will coordinate with the A&I unit and the custodial team to determine the best times to do so.

Recycling bin with paper and thin plastic. — Contaminated recycling from a small bin in Procedure Room A2201. The thin plastics are not recyclable and belong in the landfill bin.

Example of waste station in the clinic. — Example of a waste station in the main hallway. If signage cannot be placed on walls, it can also be placed directly onto the bins.

Old recycling signage. — Example of recycling signage.

New recycling signage, with hospital items removed. — Example of ACC recycling signage.

Example of break room compost signage. — Example of exam room compost signage.

Example of a work station small landfill bin that should be removed.

Example of a compost bin in the bathroom.

Example of a compost bin in an exam room.

Constraints

New staff or staff that miss training may not be aware of the new waste sustainability program.

Bins may get moved or go missing.

Objective of Pilot Program

To determine if new bins, signage, and removing small deskside bins helps to reduce the recycling and landfill contamination and increases the recoverability of compostable materials in the A&I unit.

Implementation Process

Reach out to heads of unit, unit staff, and custodial team informing them about the new changes.
1. Ask if they approve the changes.
  1. Approved all besides having 3 waste stations (only want to do a waste station in the breakroom), adding compost bins to the exam rooms, and removing small deskside bins.
2. Ask about when the bins get emptied.
  1. Bins get emptied Monday through Friday 7-10pm.
  2. Preferably complete audits when the bins haven’t recently been emptied.
3. Ask which waste auditing plan works best for them.
  1. Selected 2x a week for 2 weeks.
Complete control waste audits using the Zabble mobile tagging app.
1. Timeline: 2x a week for 2 weeks or 1x a week for 4 weeks, 2 audits to be completed with a trash grabber
  1. 11/21
  2. 11/23
  3. 11/28
  4. 11/29
  5. 12/1 (with grabber)
  6. 12/2 (with grabber)

Train unit staff and custodial team about proper sorting and where new waste stations are located before/shortly after implementing changes.
1. Training completed 12/16/22, 28 participants.

Implement changes: add waste stations and signs, add compost bin to the bathroom.
1. Added 12/27/22

Complete after implementation waste audits with Zabble.
1. Timeline: 2x a week for 2 weeks or 1x a week for 4 weeks
  1. 12/28/22
  2. 1/4/23
  3. 1/5/23
  4. 1/9/23
  5. 1/10/23 (with grabber)
  6. 1/11/23 (with grabber)

Waste station in breakroom after implementation.

Waste station in bathroom after implementation.

Metrics of Success

Audits done at varying times afterwards will help determine if there was a spike in diversion after the pilot program was implemented, and to see if the increase in diversion is retained. If contamination levels of recycling and landfill on average amongst all the bins goes down, and the amount of recovered compost goes up, the pilot program will be considered successful. Details of contamination diversion based on audits are visible on the Zabble dashboard. This includes the average contamination percentage and the diversion amongst all the units audited.

Next Steps

If the pilot program proves to be successful, the waste plan will be proposed to the other floors of the ACC.

Results

The control audits showed a landfill contamination of 71%, a compost contamination of 8%, and an overall contamination of 53%. In the bathroom, the primary landfill contaminant was paper towels, while in the break room it was recyclables. The endline audit results showed a landfill contamination of 6%, a recycling contamination of 3%, a compost contamination of 2%, with an overall contamination of 3%. This pilot program was a huge success, dropping contamination rates well below our initial goals of the 10% recycling and 25% landfill maximums.

Business Unit

Sustainability