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Case Study

Pharmaceutical Program Development

Situation

A healthcare network consisting of two hospitals was struggling to build internal pharmaceutical waste programs. Its current provider didn't have the attention of the nursing staff which is fundamental to the success and sustainability of these programs.

Additionally, the healthcare network had two different vendors for hazardous and universal waste disposal, and both were controlled by different departments within the hospital. Management was frayed on both the front and back end. The network wanted to consolidate outsourced services to one provider with the authority to dispose of pharmaceutical, hazardous, and universal waste as well as to manage onsite generation.

The healthcare network chose Triumvirate Environmental, one of the pre-existing providers of hazardous waste management and disposal, to oversee the program’s implementation and ongoing success.

Action Triumvirate’s main focus when taking over management of the network’s waste was the development and installation of a pharmaceutical waste program to compliment routine waste services.

Action

Here's what Triumvirate did: 
  • The account management and operations team worked with the pharmacy director at each hospital to first characterize respective formularies.
  • Data was keyed into Triumvirate’s proprietary software program, ADVISE.
  • The team used the software’s formulary module to export a list of hazardous waste pharmaceuticals that each hospital would be required to collect and dispose of to have a compliant program.
  • Triumvirate then conducted an onsite objective assessment of each hospital’s waste generation process to put together customized profiles and satellite accumulation areas (SAAs).
  • Triumvirate compiled all of this information to develop a specialized program that would bring each hospital into full compliance with federal, state, and local regulations. 
  • Triumvirate’s operations team implemented this program by setting up containers and training pharmacy and nursing staff on the new procedure for pharmaceutical waste. This educational phase was crucial to the execution and sustainability of this program.
  • Floor by floor, Triumvirate trained hundreds of employees to start utilizing the new pharmaceutical program. This personal training forged a relationship between Triumvirate and the nurses, giving internal staff members a point-person to direct questions to. 
  • Triumvirate recognized the nursing staff’s focus on patient safety, and, as a result, brought the training process to them in order to maintain operational efficiency and avoid confusion and any potential breakdown in communication. 

Result

Triumvirate’s implementation of the new pharmaceutical waste program brought both of the network’s hospitals to EPA, OSHA, DOT, NFPA, Joint Commission, and state compliance. In addition to this, the hospital’s consolidation of all waste under the management of Triumvirate cut disposal and transportation costs and simplified the training and oversight of compliance programs. This clarified program requirements and resources for the key personnel at both of the hospitals.  

Other enhancements include pharmacy formulary characterization, reverse distribution review, waste stream profiling, satellite accumulation area setup and collection, training program, consolidation and disposal, site specific education opportunitie, and ADVISE - Enterprise-wide EH&S Management Platform. 

Today, Triumvirate continues to provide onsite support and disposal services for hazardous, universal, and pharmaceutical waste streams. While other vendors would have completed onsite services and disposal of these waste streams in three days per week, Triumvirate completes all services and conducts compliance inspections within one day. Additionally, Triumvirate has implemented waste diversion initiatives at both hospitals to reduce costs by pushing to waste into lower-cost waste streams while maintaining compliance. 

Our account management and operations teams now attend monthly Environment of Care meetings, where they use ADVISE to present compliance data and analytics. They also perform quarterly audits of the program to ensure that goals are being met. Triumvirate maintains constant communication with the healthcare network’s director of materials management and continues to customize the program for each hospital as it grows over the years. 
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