Healthcare Environmental Issues and Opportunities

The healthcare industry affects the lives of virtually everyone in the United States. According to the Centers for Medicare and Medicaid Services (CMS), healthcare expenditures will account for approximately 17% of the Gross Domestic Product this year. Many activities in the healthcare industry result in land, water or air pollution. Much of the waste is recyclable and consists of paper, cardboard, glass, plastic and metals. There are two other types of solid waste in healthcare: regulated medical waste and hazardous or chemical waste. Additionally, hospitals discharge large amounts of wastewater and release air emissions from their facility operations.

Oftentimes, hospital services are decentralized, departmentalized, or even managed by contracted services. There may be little or no centralization of efforts. There may be minimal regard, knowledge or control over minimizing waste or environmental impact. If healthcare organizations really want to decrease costs and reduce their carbon footprint, they must embrace sustainability with the full support of top management. They must pay close attention to what they purchase and what they discard.

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There are many variables affecting healthcare waste minimization:

Healthcare Environmental Issues and Opportunities

* The types of products and materials purchased

* The types of waste segregation systems

* The degree to which wastes are identified

* The locations of the waste generation

Healthcare wastes can be categorized as:

* Municipal

* Recycling (Pennsylvania Act 101, for example)

* Regulated medical waste (Bio-hazardous or Red Bag Waste)

* Hazardous waste (listed and characteristic waste, commingled waste, pressurized containers and ignitable gas, and universal waste)

* Universal Waste (Batteries, Fluorescent Bulbs, Electronics, Mercury-containing Equipment)

* Waste water, Storm Water and Air Emissions

Municipal Waste:

The United States healthcare industry generates 6,670 tons of waste per day, most of which is solid or municipal waste. Of this solid waste, more than half is composed of paper and cardboard. Hospitals with excellent recycling programs recycle over 40 percent of their total municipal waste.

Recycling:

Many states mandate commercial and residential recycling of a wide range of materials. For example, Pennsylvania Act 101 mandates recycling in Pennsylvania's larger municipalities and requires counties to develop municipal waste management plans. The goals of the Act are to reduce Pennsylvania's municipal waste generation; recycle at least 25% of waste generated; procure and use recycled and recyclable materials in state governmental agencies; and educate the public as to the benefits of recycling and waste reduction.

Municipalities must collect at least 3 of the following materials: clear glass; colored glass; plastics; aluminum; steel and bimetallic cans; high grade office paper; corrugated paper and newsprint. Commercial, municipal and institutional establishments are required to recycle aluminum, high-grade office paper and corrugated paper in addition to other materials chosen by the municipality. Leaf and composting are required to be separated from municipal waste. Businesses, including hospitals, are encouraged to help reduce waste by purchasing products that are durable, repairable, recycled, recyclable and/or have minimal packaging, and to find other uses for surplus goods instead of throwing them away.

Regulated Medical Waste:

Industry best practices for red bag waste are between one and three pounds of red bag waste per patient day, yet many hospitals still treat 25 to 30% percent of their total waste stream as infectious. Bio-hazardous waste includes sharps, pathological waste, blood and blood products, blood-soaked items, and non-regulated chemotherapy waste. Most patients in medical-surgical rooms generate little, if any, infectious waste, however, there may still be reluctance on the part of hospitals to "source-separate" the bio-hazardous waste at the patient's bedside or at the place of treatment. Some healthcare organizations still consider all waste generated in a patient's room as red bag waste even when the waste contains no visible blood. Hospitals may fear that they will be cited with a violation should an item of trash be discarded improperly.

Progress in pharmaceutical technology has reduced the need for surgical interventions. Changes in healthcare reimbursements have decreased the length of stay in hospitals and increased home care and outpatient healthcare. Healthcare products are being packaged more efficiently and the use of plastics instead of glass has lessened the weight of many products. Despite all these advances, the widespread purchase and use of "disposables" in healthcare has created large amounts of waste that cannot easily be recycled. Many "single-use" medical devices can be safely sterilized and reprocessed and used many times. This can save healthcare organizations significant dollars by minimizing their need to purchase single use items.

Hazardous Chemical Waste:

The healthcare industry generates only small quantities of hazardous chemicals relative to the amount of municipal solid waste or bio-hazardous waste. Hospitals that own research laboratories generate greater volumes and more diverse types of hazardous chemicals. Healthcare laboratories that perform diagnostic testing often use a large volume of a few chemicals such as xylene, alcohol and formalin in their processes. Some labs recycle and reuse chemicals to avoid the cost associated with hazardous waste disposal and repurchase of new materials. Other labs are equipped with chemical analyzer systems with reagent reservoirs that reduce the total amounts of chemicals used and waste generated.

Wastewater Discharge:

Most healthcare facilities discharge wastewater to Publicly Owned Treatment Works (POTW). Dischargers are classified as major based on an assessment of six characteristics: (1) toxic pollutant potential; (2) waste stream flow volume; (3) conventional pollutant loading; (4) public health impact; (5) water quality factors; and (6) proximity to nearby coastal waters.

Healthcare Wastewater Best Practices include:

* Limit the use of water discharged through conservation and reusing water wherever possible.

* Train employees to use water more efficiently.

* Post signs at all floor drains and sinks to discourage employees from using drains to dispose of oil, vehicle fluids, solvents, and paints.

* Use non-toxic floor cleaners or "Green Chemicals."

* Consider capping off unused floor drains.

* Prevent any spills and drips from reaching the drain.

* Know where your floor drains discharge.

* Set up a preventive maintenance program for inspecting and cleaning floor drains, traps and oil/water separators.

Air Emissions:

Hospitals may generate air emissions from boilers, emergency generators, sterilization chemicals (ethylene oxide), air conditioning and refrigeration, paint booths, and laboratory fume hoods.

Boilers: Many hospitals operate industrial boilers, which generate criteria pollutants (NOx, SO2, particulates, CO) as well as hazardous air pollutants. NOx emissions from boilers are the most serious criteria air pollutant generated by the healthcare industry. Click here for information regarding EPA's new HAP regulations for boilers.

Incinerator emissions: As a result of the Medical/Infectious Waste Incinerators HMIWI rule, most facilities no longer have on site-incinerators.

Healthcare Sustainability:

Through training, education, source-separation, environmental purchasing, energy conservation, recycling initiatives and waste minimization, a green initiative will have a major impact on reducing waste and pollution. Healthcare facilities should organize a multi-disciplinary team of healthcare professionals and establish a sustainability program if they haven't already done so. A Green Team will reduce waste from healthcare operations while saving money. Paying attention to the little things pays big dividends. It is also an important component of any organization's public relations and marketing arsenal.

Healthcare Environmental Issues and Opportunities

How EES Can Help:

Environmental and Engineering Solutions, Inc. is the trusted source for environmental compliance for numerous hospitals. Our comprehensive services in sustainability, energy conservation and environmental, health and safety compliance make EES your best choice for sustainable development and cost savings. Call Tom Petersen at 215-881-9401 or email at tom@eesolutions.net for a complimentary site visit to review your current sustainability and compliance practices and to suggest areas for improvement.

Causes of Dog Health Problems Bloody Stool Issues

Melena is the number one cause of dog health problems bloody stool issues. Melena and hematochezia cause the dog to have bloody stool. Melena is blood that the dog digested, and looks dark in color. Hematochezia is considered fresh blood in the stool and is considered minor compared to melena. Many health reasons result in a bloody stool and most tests by a veterinarian will confirm the problem.

This health problem causes a lack of energy and sometimes incontinence, as accidents happen due to the inability to move outdoors quickly. By restricting food, the dog will eventually stop the diarrhea and give the intestines time to heal. If the diarrhea results from infection or parasite, the problem will persist until proper medical is received. This condition affects all sizes and breeds of dogs no matter what you do to prevent it.

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Causes of Dog Health Problems Bloody Stool Issues

Medications, infections, cancer and foreign objects digested by the dog. A metabolic disorder or hemorrhagic gastro enteritis may cause a dog to have a bloody stool. Some heavy metal or blood ingestion and gastrointetestinal ischemia are all causes of melena in dogs. Metabolic diseases cause ulcers of the stomach or intestines and can result from many different causes. If your dog health problems bloody stool issues arise with such signs as pale gums, frequent urination and thirst, lack of appetite and weight loss are all signs of problems along with dark black stools.

If the dog continues to have diarrhea for more than twenty-four hours, medical treatment is required. The first thing you can try is a bland diet of rice and potato instead of their regular food. This may help, but in case it does not, you may need to have a veterinarian determine the cause.

Diagnosis and Treatment of Dog Melena

When you notice black or dark colored stools, you need to contact the vet for further tests. These tests will include urinalysis, a biochemical work up, stool sample diagnosis, blood work up, ultrasound and chest/abdominal x-rays. After these tests are concluded, the vet will determine the exact cause of the dog health problems bloody stool issues and discuss treatment with you.

If the dog does not have a severe health condition, they may be treated at home instead of an overnight stay at an animal clinic. A special diet of a bland diet that is specified by the vet and any medications prescribed by the veterinarian need to be dealt with at home in order to treat the dog health problem bloody stool issues. In most cases, medications are needed to block stomach acids and coat the intestines. If you do not see any improvement, you need to contact the vet for further treatments. .

Get treatment for your dog if this problem persists and stick to a strict diet and medication schedule for proper treatment of a sick dog. The dog will need plenty of rest and a calm environment in order to heal and come back to health.

Causes of Dog Health Problems Bloody Stool Issues

You can also find more information at Boxer dog health and large dog health issues. AboutDogHealth.org is a comprehensive resource to help dog owners identify their dog's illness symptoms and treatment options.

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Ethical Issues in Health Care Management

One of each and every most significant ethical issue in health care management is the security of info about the patient, which is both private and personal. To begin with, patient medical records were widely available to any person and everybody; this nevertheless is no more the situation. Majority of hospitals these days maintain the patient records very secure and private today.

An ethical business organization of more and more health care executives, physicians and nursemaids is to protect themselves from the risk of getting communicable diseases coming from the patients, particularly when the patient records is not available in some manner. And even though, health care professionals do have the right to protect themselves from the several viruses that could be transferred by the patients to them, nevertheless, at the same time they must take care not in order to make the patients miserable by making these protective treatments very apparent.

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While marketing of hospitals, to make the people conscious of the hospital and its services is very essential to advertise any hospital. Attention requires to be taken that the hospital agencies and the vendors follow certain recommendations and moral principles concurrently. To manage the ethical consequences in health care marketing, the hospital agencies should ensure that the info they give through advertisement is completely precise and appropriate. Secondly, marketing in no way entails aggressively promoting and recommending such services to the patients whom they might not even need. So this should be ignored as well. Finally, a marketer or a chief should not forget his main motive, i.e. benefit of the patient. Profit making is important, but is not the be all and end all of health care marketing and management.

Ethical Issues in Health Care Management

Hima Mehta is a business entrepreneur who has great knowledge in software implementation methodology, healthcare consulting, project management and IT solutions.

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Universal Health Care - Ethical Issues in Health Care Reform

Universal health care seems to be a hotly debated topic whenever health care reform in the United States is discussed. 

Those who maintain that health is an individual responsibility do not want a system that requires them to contribute tax dollars to support fellow citizens who do not act responsibly in protecting or promoting their own health. They argue that they want the freedom to choose their own physicians and treatments, and suggest that government cannot know what is best for them.  These people argue that preserving the current system with improvements to provide better insurance coverage for citizens who remain uninsured or under insured for their medical care needs is the only reform that is needed.

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Those who believe health care is an individual right support a universal health care system with the argument that every citizen deserves to have access to the right care at the right time and that a government's responsibility is to protect its citizens, sometimes even from themselves.

Two opposing arguments arising from two opposing ideologies.  Both are good arguments but neither can be the supporting argument for implementing or denying universal health care.  The matter must be resolved through an ethical framework.

Examination of the ethical issues in health care reform would require consideration of much different arguments  than those already presented.   Ethical issues would center on the moral right.  Discussion would begin with not "What is best for me?" but rather  "How should we as a society be acting so that our actions are morally correct?"

Ethics refers to determining right and wrong in how humans relate to one another.  Ethical decision making for health care reform then would require human beings to act in consideration of our relationships to each other not our own individual interests.

Examination of some of the common ethical decision making theories can provide a foundation for a different perspective than one that is solely concerned  with individual rights and freedoms. 

Ethical decision making requires that specific questions be answered in order to decide on whether intended actions are good or morally correct.  Here are some questions that could be used in ethical decision making for health care reform.

• What action will bring the most good to the most people?
• What action in and of itself is a good act and helps us to fulfill our duties, obligations, and responsibilities to each other?
• What action in and of itself shows caring and concern for all citizens?

As the answer to all  these questions, universal health care can always be considered the right thing to do.

The United States is in the most advantageous position there is when it comes to health care reform.  They are the only developed country without a national health care system in place for all citizens.  They have the opportunity to learn from the mistakes that have been made by all the other countries that have already gone down the universal health care road. They have an opportunity to design a system that can shine as a jewel in the crown of universal health care systems everywhere. 

However, all ethical decision making is structured around values.  In order for universal health care to be embraced by all citizens in the United States, they will first have to agree to the collective value of equity and fairness and embrace the goal of meeting their collective responsibility to each other while maintaining individual rights and freedoms. That may prove to be the most difficult obstacle of all.

Universal Health Care - Ethical Issues in Health Care Reform

Beverly Hansen OMalley is a nurse with over 35 years experience in nursing education. She is health promotion specialist and is passionate about the necessity to address social determinants of health as part of overall health promotion strategies. She is the owner of http://www.registered-nurse-canada.com where she provides information on the Canadian health care system, the nursing profession in Canada, and the nursing entrance tests for the US and Canada.

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Current Health Care Issues

There are several health care issues that are in the news and in the minds of many people these days. Perhaps because of the push for universal health care, misuses of the current health care system have come to light. The health care issues that plague Americans need to be addressed with intelligent debate and understanding.

One of the health care issues is the overuse of emergency rooms by the poor. It is not their faults. They are simply responding to a situation in which they have no other recourse. For example, a low-income family may have a child with a cut finger. If they had insurance, the parents would take the child to a doctor's office or an urgent care clinic to get the finger stitched up.

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Since they have no such option, they take the much more costly route of going to the emergency room for the same service. This puts a strain on emergency rooms and costs taxpayers much more than if the poor families were given adequate medical coverage in the first place. Health care issues like this one are difficult to fathom when there are so many sources of cheaper medical care.

Other health care issues involve preventative medicine. Insurance companies do not all support the patient's right to preventative medical screening procedures and treatments. This also makes health care more expensive in the long run.

Many health care issues revolve around the older population. There are so many elderly people who are given little or no help with their prescription medications. Insurance companies make drug coverage available - at a price that is so high that most seniors cannot afford it. This does little to resolve these health care issues.

With all the health care issues that are in the public eye, there needs to be a better system of communication on these subjects. People can have an impact on their health care system if they know where to have their ideas on health care issues heard. It is time for the government and other organizations to give them a voice.

Current Health Care Issues

More Information on Health Care Issues:

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