Less Waste: Red Bag Reduction Success at Inova Fairfax Hospital


  • 14% red bag reduction
  • 1,000,000 pound reduction
  • Over $200,000 in waste removal fees
  • Cost Reduction
  • Employee Engagement
  • Process Improvement

The Problem

With Regulated Medical Waste removal fees five to ten times more expensive than solid waste, hospitals benefit from reducing the generation rate to 10% of total waste through improved segregation. Hospitals generating more than 10% RMW are throwing dollars in the waste stream.

The Strategy Selected

Red Bag Poster

Creating and sustaining change at Inova Fairfax required:

  • Communication
  • Auditing
  • Monitoring
  • Process improvement
  • Education

As the largest departmental generator of waste overall, Inova first focused on the operating room to assess generation rates and develop an updated process with receptacles, signage and training to improve material segregation. Once big wins were realized in the operating room setting, strategies were expanded across the medical center in patient care areas, laboratories, blood drawing areas and dialysis.

Implementation Process

The Team:

  • Sustainability Coordinator
  • Environmental Services
  • Director of Support Services
  • Materials Management
  • Infection Control
  • Nursing
  • Administration
  • Communications

A regulated medical waste reduction taskforce was at the center of achieving success. The infection control committee was instrumental in reviewing the definition of Regulated Medical Waste and developing an educational protocol for new and existing staff, clinicians, float and temporary staffers. Staff engagement and a diverse approach included piloting in a variety of settings with a variety of receptacles, signage, departmental meetings and standardization, where possible, to ease in the process of both understanding waste regulations and facilitating proper segregation to realize the potential for savings in waste removal fees.

While Inova undertook this process as part of its green team, other facilities may address it within the Joint Commission Environment of Care or as a quality improvement initiative. Ongoing monitoring and education is critical for long-term success and compliance.

Challenges and Lessons Learned

Changing the overall culture of the organization was key to the successful implementation of sustainable practices. The challenges of the waste minimization and segregation project included the consideration of all waste disposal regulations and ensuring that hospital policies were updated and
clarified to outline the new practices.

Demographic Information

Inova Fairfax Hospital is a 900-bed Trauma 1 community hospital located in Falls Church, Virginia. The hospital is part of the Inova Health System, a large integrated delivery network of 5 hospitals with 1,700 beds and 16,000 employees. Located on the Inova Fairfax campus, the Inova Fairfax Hospital for Children offers a level 3 Neonatal Intensive Care Unit and a full range of specialized health services for infants, children, and adolescents. Inova Fairfax has 29 operating rooms. 

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