Successful Performance Improvement Project Results in Significant Reduction in Regulated Medical Waste Disposal Expense

Wake Robin, a privately-owned nursing home in rural Vermont with less than 50 skilled residents, has been actively engaged with the New England QIN-QIO since 2014 to create and implement their Quality Assessment and Performance and Improvement Program (QAPI). Using these tools from their QAPI program, the leadership at Wake Robin initiated a Performance Improvement Project (PIP) and Root Cause Analysis to address challenges related to managing the disposal of Regulated Medical Waste. (RMW).

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Wake RobinThe leadership team reviewed the fees they were paying to dispose RMW, also known as “biohazardous waste.” They concluded that the $20,000 per month expense seemed extraordinary for their population of residents. They initiated a PIP to further investigate the situation.

The PIP team was led by the QI Nurse and included the Environmental Service Supervisor, the Nurse Educator, LNAs, and housekeeping staff. The team met regularly and reviewed the baseline costs and pricing structure of the company they used for RMW disposal. They conducted interviews with housekeeping and nursing staff to assess baseline knowledge on the definition and proper disposal of biohazardous waste; and review the current disposal practices.

Wake Robin's interventions
  1. Devised and provided a relevant training program for the nursing and housekeeping staff with emphasis on use of the red bags for true “biohazard waste” only
  2. Provided surveillance on the units and coaching of the staff as needed
  3. Removed the red bags from the rooms where they were not required
  4. Investigated disposal vendor where they learned that company was involved in a class action suit over fraudulent charges. The committee was able to renegotiate the original contract

The continued monitoring of costs over a 6-month period after staff education revealed a savings of $8,000 per month. Renegotiation of the contract resulted in a new monthly charge of $158. Cost were reduced from the 2017 average of $8,131 per month by 98% in 2018 ($113, 839 in 2017 to a projected $1,896 in 2018).

Wake Robin is grateful for the help of the New England QIN-QIO and its steady support through their successful QAPI program. This is a significant cost benefit to their home and can be duplicated in other nursing homes with similar circumstances.