By including Advocate-branded signage on waste containers and posters along with images and keywords describing recyclable materials, the health system is underscoring the program’s importance.
Photo courtesy of Advocate Health Care

The design of a health care provider's recycling program serves as the face of the organization's commitment to sustainability, says Laura Brannen, senior environmental performance consultant for Mazzetti and project coordinator for the American Hospital Association's Sustainability Roadmap for Hospitals (, an online tool designed to help health care organizations chart a course to sustainability.

Appropriate containers and associated messages tell the public, "We're proud of our sustainability program," Brannen says. She adds that a well-designed recycling effort, with properly placed and identified receptacles, can absolutely improve compliance, but without these things, public area recycling often becomes too contaminated to actually recycle.

Visual cues

According to Brannen, a receptacle system for a public area must be attractive. The recycling container should be located next to the trash container but clearly differentiated by size, color, labeling or a combination of these attributes. Janet Howard, director of facility engagement for Practice Greenhealth, a nonprofit membership and networking organization for health care organizations committed to sustainability, notes that the shape of the opening at the top of the container, such as a slit for paper or a round hole for cans, also can be helpful in denoting proper usage. Visual cues are beneficial to people who are distracted, in a hurry or don't read English. Attention-getting labels, such as those identifying a container's contents as "landfill" or "recycling," can be effective, too.

"One of the most challenging concerns in a public space, especially in health care, is that preoccupied people often do not notice the difference between waste and recycling containers," says Mary J. Larsen, environmental stewardship manager, Advocate Health Care. "Our aim at Advocate is to create the safest, most welcoming healing environment. So we try to make it as convenient as possible for people to recycle." To do this takes no real magic, she says, just the right containers in the right locations with the right signage.

Advocate has developed a comprehensive communications strategy to motivate staff and visitors to reduce or recycle waste at the health system's facilities. By including Advocate-branded signage on waste containers and posters, along with images and key words describing accepted recyclable materials, the health system is underscoring the fact that this program is important to the organization, Larsen says. According to Advocate's annual environmental stewardship report, the system reduced its total amount of solid and medical waste, adjusted for patient volume, in the period between 2008 and 2013, even while adding four hospitals during that time.

Jeff Amrein, senior manager, product marketing, Rubbermaid Commercial Products (, Winchester, Va., says it's important to understand the aesthetic needs of a facility when selecting trash and recycling containers that complement, rather than overpower, the interior design. He says Rubbermaid offers customized products in a variety of finishes and colors to enhance interiors. From a decorative standpoint, containers shouldn't stand out, but they should blend in with the overall design concept, Amrein says.

Sam Glover, senior product manager, recycling, Rubbermaid Commercial Products, adds that consistent, universal labels that combine words, colors and icons are the best way to communicate how to dispose of and separate different waste streams properly. "A successful recycling program is a combination of education and the right product offering. If you offer a complete system, you've eliminated the guesswork — making it easier for people to recycle," he says.

Glover recommends that facilities perform a waste audit to assess their material streams and determine the number and location of containers needed; Rubbermaid Commercial Products has a variety of tools that can help with this. He also encourages health providers to develop a relationship with their waste haulers, to fully understand what recyclables the haulers will collect and whether the materials need to be separated, as this information will affect container selection.

Automated solutions

Tim Eng, project manager, regional support services, Kaiser Permanente, says the public is starting to expect recycling containers as part of an aesthetically pleasing, well-maintained and environmentally responsible facility. At Kaiser Permanente's Baldwin Park (Calif.) Medical Center, the organization recently installed solar-powered compactors manufactured by BigBelly Solar (, Newton, Mass.

BigBelly's CLEAN management console alerts users when the containers have reached a predetermined capacity. "The notification feature is amazing," says Laurin DeVine, director, environmental services, Baldwin Park Medical Center. He anticipates the system will improve staff efficiency and safety, by signaling the optimal time to empty containers. Environmental services staff won't waste time checking receptacles that aren't full, or risk injury when lifting bags that are too heavy.

Kaiser Permanente plans to add a custom wrap to the containers to promote recycling and communicate the organization's dedication to sustainability. "The compactors are a visible demonstration of our commitment to reducing waste," Eng says.

Mitchell Nollman, vice president, marketing, BigBelly Solar, notes that the laminate container wrap is one of several customization options the company offers for its products, to provide messaging or help to blend units into a décor. The containers are available in compacting or non-compacting versions, with an adaptor for indoor use.

TransVac Solutions (, Denver, designs and engineers automated collection and transport systems for hospital waste, recycling and soiled linen. A computer-controlled network of sealed pipes creates a dedicated pathway for dirty materials, reducing the amount of space needed on each floor for the collection and storage of soiled linen, waste or recyclable materials. This contributes to a cleaner, more aesthetically pleasing environment, says Harry Pliskin, president, TransVac.

Pliskin explains that the company's linen and waste systems typically are designed and installed in parallel at health facilities; the waste system handles both trash and recyclables. Users swipe their access cards to open an outer and inner door to the system, which whisks material away to the loading dock along a sealed path at up to 60 miles per hour. "You never touch or see it again," Pliskin says. The system can transport items vertically or horizontally, up to more than a mile away.

Swedish Medical Center's Issaquah, Wash., hospital campus is among the health facilities using TransVac as part of a waste management program. David Holmes, project manager of architecture, design and planning firm CollinsWoerman that designed the hospital, says the system was coordinated early in the project so that it could be integrated with ductwork and other infrastructure. He says it provides a benefit to the design by being concealed within the walls.

Employee engagement

Kelli Pettigrew, president of Witt Industries (, Mason, Ohio, notes that her company's founder, George Witt, patented its first trash can in 1889; the organization has nearly 125 years of experience in waste management. Witt is highly focused on sustainability, she says, with more than 100 items, or about 20 percent of the product line, related to sustainability or recycling.

Pettigrew advises organizations that are developing a recycling program to start small, increase awareness and engage people. "Our product line covers the gamut. We'll try to recommend the best solution based on where you are on the continuum," she says.

Providers can learn more about designing for sustainable operations by exploring Practice Greenhealth's Sustainability Benchmark Report at or the Sustainability Roadmap for Hospitals.