Making Medicine Mercury FreeMaking Medicine Mercury FreeImplementing a Mercury-Elimination Plan Implementing a Mercury-Elimination Plan MMMF Award ProcessMMMF Award Process

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Why Bother?Why Bother? AHA/EPA Goal to Eliminate Mercury in

health care. – Goal of 50 MMMF awards in next round!

Ethical responsibility/Mission Statement Environmental/Public Health Regulatory Compliance/Liability Safety Press coverage and awards Community Relations Patient/Employee satisfaction Potential Cost Savings

3

www.h2e-online.orgwww.h2e-online.org

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Obstacles to Mercury EliminationObstacles to Mercury Elimination

Mercury is considered the Gold Standard

Clinicians are trained on mercury devices

Cost of replacements

Old habits

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Be like Mercury – Persistent!Be like Mercury – Persistent! Designate team leader Pilot – Start Small if

you need to Take a team approach

– include multiple departments

Check with your GPO – We’re driving markets!

Educate

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Environmental/Health ImpactEnvironmental/Health Impact

Medical waste incinerators are major source of mercury

AHA-EPA Memorandum of Understanding - 1998

FDA and state fish consumption advisories New York Academy of Sciences Report National Resource Council (NRC) Report AMA, ANA, APHA resolutions

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The Fish ConnectionThe Fish Connection

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Clinical SourcesClinical Sources

Sphygmomanometers Thermometers Barometers Bougies, cantor tubes Pharmaceutical Preservatives

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Facilities ManagementFacilities Management

Light Bulbs

Switches

Thermostats

Batteries, electronics

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Laboratories SourcesLaboratories Sources

Laboratory chemicals

ThermometersCleaning

chemicals

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But First…Manage what you have!But First…Manage what you have!

Education Segregation Labeling Spill Response Monitoring Removal Record keeping

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Shut the Door to MercuryShut the Door to Mercury Identify mercury-containing products

purchased for your facility Prioritize items – Major source is

sphygmomanometers and cantor tubes. Identify/pilot alternatives to mercury-

containing products Develop a policy for mercury elimination

plan Educate department heads and purchasing

agents Monitor and track. Newsletters, education

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H2E National AwardsH2E National Awards Making Medicine Mercury Free Partners for Change Partner Recognition Environmental Leadership Award Champion for Change Internal Awards Process

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MMMF Award FactsMMMF Award Facts

You have to be an H2E partner. You can apply any time during the

year. This is a one-time award. You don’t have to be 100% mercury

free to be eligible. H2E can walk you through the

process. H2E will inform you in 30-60 days.

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MMMF Award ApplicationMMMF Award Application

Click on MMMF form and save as a file. http://www.h2e-online.org/pubs/awards/MmmfForm60.doc.

Click on Annual Summary & Goals Form and save as filewww.h2e-online.org/programs/partner/p_goals.dot

Provide back-up documentation Send in via email wherever possible and

send in mail back-up information. Contact H2E for more information.

1/800-727-2179 or h2e@h2e-online.org

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Facility Information (S&G form)Facility Information (S&G form)

Section 2: Adjusted Patient Days per month

Number of beds

# of Outpatient Visits for Amb. Sites

Long-term Care - # of bedsAdjusted patient days = TTL patient days X (TTL Patient Revenue (Inpatient + outpatient)/Inpatient Revenue # of beds = # of staff beds.

Admitting or finance will have this data

Section 3: Facility Waste Assessment Summary

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Facility Waste Assessment Summary Facility Waste Assessment Summary (S&G Form)(S&G Form) Section 4: Mercury Assessment Section 5: Environmental Policies

Questions regarding formal policies on environmental commitment and environmentally preferable purchasing.

For information on how to evaluate mercury use and implement activities to eliminate mercury from your facility’s waste stream, download the H2E self-Assessment Guide at www.h2e-online.org. See Sections 5A and B in the guide.

Setting new H2E goals.

H2E goals – Finishing off last bits of mercury

Set new goals that may not be related to mercury work.

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MMMF Award ApplicationMMMF Award Application

Award Application Check List

1. Mercury Elimination Policies

2. Mercury Management Policy

3. Environmentally Preferable Purchasing

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MMMF Application – Clinical DevicesMMMF Application – Clinical Devices

Replaced Thermometers Replaced at least 75%

sphygmomanometers Replaced at least 75% clinical

devices

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MMMF Award Application - FacilitiesMMMF Award Application - Facilities

Recycle Bulbs Battery Collection Inventoried and

labeled mercury-containing devices and plan to replace.

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MMMA Application - LabsMMMA Application - Labs

Replaced B5/Zenkers stains Inventoried mercury-containing lab

chemicals with plan to substitute. Inventoried thermometers, replaced

at least 75% and phase-out plan in place

Other chemicals – Pharmacy, dental, cleaning chemicals

Other projects

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MMMF Award Check-ListMMMF Award Check-List

Partner of H2E Annual Summary and Goals Form MMMF Award Application No outstanding OSHA violations 3 copies of everything Back up/Supporting information Email and send in regular mail

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H2E Resources/GuidanceH2E Resources/GuidanceAwards Process: www.h2e-online.org/programs/award/index2004.htmMercury Recyclers – www.h2e-online.org/tools/hg-recy.htm

Consultants – www.h2e-online.org/tools/consult.cfmVendors – www.h2e-online.org/tools/vendors.cfmMercury Backgrounder – www.h2e-online.org/tools/mercury.htmList serve: www.h2e-online.org/programs/list.htmUniversal Waste Guidelines – www.h2e-online.org/tools/univwaste.htm10 steps to bulb recycling – www.h2e-online.org/tools/univwaste.htm#fluMercury Elimination Plan – www.h2e-online.org/pubs/mercurywaste.pdfFish Advisories – www.h2e-online.org/tools/merc-oth.htm#fish

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Other Mercury ResourcesOther Mercury Resources Massachusetts Academic & Scientific Community

Organization – www.masco.org U.S. Food & Drug Administration -

www.cfsan.fda.gov Health Care Without Harm’s Fast Facts -

http://www.noharm.org/library/docs/Going_Green_The_Mercury_Problem_-_Fast_Facts.pdf HCWH Making Medicine Mercury Free Resource Guide -

http://www.noharm.org/library/docs/Going_Green_Making_Medicine_Mercury_Free.pdf Measuring Blood Pressure Accurately –

http://www.noharm.org/mercury/sphygmo American Medical Association – www.ama-assn.org

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Need Help?Need Help? Hospitals for a Healthy

Environment www.h2e-online.org800/727-4179

Partner Coordinator -Janet.brown@h2e-online.org 212/941-2486

Champion Coordinator –Sarah.obrien@h2e-online.org802/479-0317

State Program Coordinator

Cecilia.deloach@h2e-online.org202/234-0091

Director

Laura.brannen@h2e-online.org603/643-6700