Who provides advice and support to producers for aspects of clinical waste management? There are always many questions, and access to information can be troublesome.
Who to ask? A waste manager, who may have knowledge of waste collection and storage, as well as associated administrative issues but who will be inexperienced in matters of healthcare and biological risks, and in all probability will need to refer to a waste contractor for advice about most other issues? In their turn, the contractor may offer guidance that relates to their own services but these may not be fully accurate and reflect only the range of services provided and inadequate for those occasional problem issues that crop up.
Perhaps it would be appropriate to seek advice and guidance from the regulator, but don’t hold your breath. Of course, it is not entirely their role to provide practical guidance on a day-to-day basis and though advice may be given this is likely to be generic in nature and refer the questioner to the most recent published guidance. Therein lies the problem, as these often need careful interpretation prior to implementation.
How about asking the front line waste producers, where we should expect to find the necessary experience? But of course that too is inappropriate as so few are aware of the fine detail of waste management and related safety and often completely unaware of what happens from the moment waste leaves the ward.
Perhaps the onus to provide confident and comprehensive guidance of all aspects of clinical waste management should lay with the various professional and trade bodies, in consort with the regulators.
Is that what we have in HTM 07-01? No, it is not, but HTM 07-01 despite its many shortcomings is a start. A simple but nonetheless authoritative translational working guide is needed, covering all aspects of the process, from cradle to grave and for all types of waste. It need not be complex, just sufficient to point the uncertain in the right direction and prevent errors.
Who should author this guide? Many waste management companies have done just this, with simple guides that incorporate additional training materials but t is noticeable that, though all of these are correct they each differ from one another and concern themselves with the particular market sector of the sponsor. Perhaps therefore it is necessary to view this from a broader perspective and consider the role of trade associations, perhaps SMDSA, in authoring such ‘user guides’. There is also scope for the involvement of the professional bodies, CIWM perhaps and those bodies representing healthcare professionals but each would want to see another make the effort.
In the US, the playing field is much greater and these professional bodies, with many more members, can direct far more resources at tasks such as this. A good example is the guide produced by the American Veterinary Medical Association. This identifies a target audience and supports its members with clear and concise information that does not suffer the bloating of HTM 07-01 but cuts straight to the chase, combining practical waste classification matters with waste segregation and packaging, admin, storage and transport, and disposal options, while keeping abreast of current legislation and the variations between States.