Evaluating the waste management system of new hip joints at NorthwickParkHospital, Watford Road, Harrow.

AS and A Level Business Studies

Sham Bakrania 07/05/2007

System Case Study.

Recycling and Waste Management.

Evaluating the waste management system of new hip joints at Northwick Park Hospital, Watford Road, Harrow.

System choice, objectives and Research Plan.

I have decided to investigate the waste management system of new hip joints used in at Northwick Park Hospital, Harrow.

Northwick Park Hospital is situated in North West London, (figure 1).

The hospital was opened in 1972 by Her Royal Majesty the Queen. The hospital was designed and drawn up in 1956 using American based layouts. The final design was made so the whole hospital could be accessed from the inside, like a small village.

The hospital has 1,400 rooms for doctors and nurses.

There are over 1000 beds available to the public.

Now the hospital has many facilities available to patients, like a shopping square, hairdressers, computer suits, large swimming pools, a famous Olympic medical centre, social club and it’s very own train station.

One of the most recent events was in 1994 when Diana Princess of Wales opened the children’s A & E department.

Surgery of Hip Joints:

When the hip joint surgery takes place, it is normally done on older women aged between 70 to 90. The surgery means the patients stays up to on average of 8 days in hospital.

The procedure needs a 30cm incision, and extensive cutting of the leg and hip muscles, which can scar and can lead to dramatic blood loss.

At Northwick Park they dispose of new hip joints because after a year of storage they are expired, as said by doctors. The joints don’t actually have expiry dates, but they do need to be replaced every year for hygiene reasons. The brand new stainless steel joints are exposed of every year. Each joint is packed in foam and costs about £3,000 each (£6,000 a pair). In total it would cost about £10,000 to order and have the operation.

This system is appropriate to investigate because at Northwick Park, they get rid of hundreds of millions of tonnes of waste a year. Some of the standard waste includes paper and standard medical waste, as syringes and gloves. These are put into yellow bags and then taken away to get burnt. My waste, which I have chosen to investigate, is interesting because hip joints are made of a special alloy which can be interesting to investigate how it could be disposed of. Also it is normally unknown what happens to expensive medical parts, like the environmental and social effect it could have by simply throwing it away, as the material seems that it could take billions of years to decompose.

So to investigate it will unlock interesting information. Furthermore, the NHS is always loosing millions of pounds a year; this could be one of the reasons why, but my research will give me a better understanding whether I am correct.

When the unused hip joints have expired, a member of the department which stocks them calls the maintenance department to ask them to hire a skip and to call a porter to take the unwanted hip joint away.

Once this is done the maintenance department charges the department which called for the skip and labour.

When the skip is hired a porter goes up and down the building taking the hip joints away. Once the skip is filled it is taken away to be dumped in a landfill.

This flow chart shows the waste management process of the hip joints:

The costs which is needed every year is about 120 pounds to hire the skip as the labour to taken them down is free. Not only is this there the amount that each hip joint costs £3,000.

In total there are about 200 types of hip joint in stock and the same amount thrown away. As 4 to 8 of these joints are used every week, and new ones ordered when the stock is low.

Objectives:

To complete this study I will need to:

Obtain a map of the hospital to research the location of the stock. Also I can obtain any books which have plans of the original building, so I can see the stock room more clearly.
Conduct interviews with staff regarding their role within the system.
Photograph the system areas of interest and record observations.
To investigate the area the waste is kept and stored when in use, also see whether the security within the system is of high standard. This can be done by observing the security guards ...

This is a preview of the whole essay

To complete this study I will need to:

Obtain a map of the hospital to research the location of the stock. Also I can obtain any books which have plans of the original building, so I can see the stock room more clearly.
Conduct interviews with staff regarding their role within the system.
Photograph the system areas of interest and record observations.
To investigate the area the waste is kept and stored when in use, also see whether the security within the system is of high standard. This can be done by observing the security guards actions and/or looking at the NHS website for further details.
Research on new medical technology in this area of medical stock by searching for the information on , in order to get research which is related to the United Kingdom.

From the objectives I will need to:

Interview the maintenance supervisor as he is in charge of all the actions in the hospital. The information which he can provide can answer most of my questions and he can locate me to others is he does no know the answer. (Mr. Shoo Bakrania)
Interview a porter who empties the waste into the skip. This person would give me suggestions on improvements and would provide inside information on what actually happens to the waste. (Mr.Gary Smith)
Photograph areas of the system which are of interest. This will help me analyse the areas and situations. Also it will provide me with visual information.
Research into the hospitals areas of stock and the company who disposes it. This information will give me background knowledge.

All the people and places which I need to see and speak to are all situated inside the hospital, and can be located easily through the maintain supervisor.

To contact them I will use the hospitals address and simply add the name and department before it:

------------------------------ NAME

----------------------------- DEPARTMENT

Northwick Park Hospital

Watford Road

Harrow

Middlesex

HA1 3UJ

By calling the hospital I can be put automatically through to the people I want to speak to:

Tel: 020 8864 3232

Research Plan:

(Figures to refer to are allocated at the end of this section)

The first piece of information I collected was from the internet. I looked at the new types of medical hip technology to see if there are any new designs. Figure 2 shows what I found out on U.K websites, that there is a new easy method of inserting the new joint. The pervious information gives me some background information and shows me if there are any new types of hip joint replacements available.

Also I did some background research on one of the skip companies which they use at Northwick Park. When I spoke to the maintenance supervisor he gave me details on the company and where to look. Figure 3 shows what I have found out.

The second piece of information which I collected was the questionnaire. I created a questionnaire which covers some of the points which I mentioned in my research plan. Figure 4 shows the questions which I used. In total there are 16 complete questionnaires, shown after the blank one.

When I visited Northwick Park hospitals maintenance department I received a copy of the hospitals map and asked the maintenance supervisor to highlight the area where the hip joint stock room is and the area the skip is placed. This map shows me the distance between the waste and skip and I can see how far a porter needs to travel every year. Figure 5 shows the map which I collected.

Also when I visited the hospital I took as many photographs that I can, as some areas could not be photographed. This piece of information gives me visual proof that the waste enters these areas. Figure 6 shows the photographs that I took.

When I visited I interviewed the maintenance supervisor and a porter. This information gives me one to one information about the areas the questionnaire did not answer. Figure 7 shows the questions I asked, and then it’s followed by the two I took.

During the research I wrote a letter explaining what I am doing to the maintenance boss and to a nurse from the stock room area. This information was sent with a copy of my questionnaire. What I received shows me what individuals think about the system. Figure 8 shows the letter I sent off and the replies I revived.

The final piece of information I collected was two sketches, which I took in the hospital. I had to sketch these areas as, cameras where not allowed, due to medical equipment. The information I have gives me visual proof of the areas that the waste is kept in. Figure 9 shows the sketches I took.

Analysis of Information and Conclusions.

From my research I can conclude the following points about the disposal of new hip joints at Northwick Park Hospital:

Management:

I have discovered that the way the management works keeps the system working well each year. The system relies on the Maintenance Supervisor to have organised the skip, the porter and the time. Without this the system will not work well.

Another good point about the management is that the nurses are well up to date in reminding and arranging the disposal with the Maintenance department.

From my research I can conclude that most members of staff are responsible for the handling of waste. This shows that the management of the waste is well structured as the waste is constantly being guarded. This proves that security is well organised and that it is virtually impossible to get to see the stock and waste without a member of staff who deals with it.

Safety:

A great deal of safety is used when the system is in use. The issues which are looked at are:

Maintaining no contact of solid sterilized material from staff and the public, so germs are not spread through infection.
Preventing germs from accumulating in stock, by removing waste swiftly.
Helping keep the disposal of the stock constant, every year so germs don’t accumulate.

From my research I can see that the distance which needs to be travelled in order to completely dispose of the stock, is very short, this means that the stock can be swiftly deposed of, without causing problems and spreading germs into the environment.

Quality Assurance:

When the new hip joints are re-ordered it arrives in sterilized vans. The stock is taken immediately to the stock room. The stock room is also sterilized.

This rapid process insures the stock does not become infected with foreign objects. As the safety of the patient is important.

From my research I can see that the main problems which are identified by staff are the amounts of waste, this shows that care and attention is taken when disposing of the hip joints takes place.

So that each new hip joint being disposed of is being appreciated, that a large number of them means the quality will not be as good when handing them from A to B.

Sub System:

The whole disposal is a small sub system itself, as the whole disposal of waste at Northwick Park is mainly the same process, and is done for many materials.

A sub system which is an important part of the waste disposal is the re-ordering of the new hip joints. When the old stock has been taken away, a nurse arranges the new stock to be ordered, the payments for the new stock is sent to the Accounts department which records and accepts the purchase which lets the company deliver and re stock.

From my research I can conclude that this process takes place, as proof of the hip joints are photographed and shown. Also from my research it shows that a large amount of waste is being disposed of every year, this means a large amount has been ordered, if it is not being used through the year.

Weaknesses:

From my research there are a few weaknesses in the system that has shown up, which are:

That there is a lack of communication within the system, between staff, which dispose of the waste and which order and organise the re stocking, this is because the system is very basic, and communication is not needed too much, but if it was improved then the system could become better by being more efficient so less time and money is spent on the disposal.
That there is a too large amount of waste being ordered and therefore being thrown away, this is because the hospital normally does not know how much they will be needed for each year, so they over order, which is normally a waste.
That the waste being thrown away is not useless and can be used for other uses, as it’s a waste of trained staffs time for organising the disposure and re ordering the stock, this is because instead of throwing the joints away the stock could be sent off, to other countries or hospitals in the area, so it’s not a problem for other staff each year.

Overall the system works well without too many problems, expect of the fact that the waste can be used for other uses, instead of adding to pollution.

The next page shows the graphs from my questionnaire results which also show weaknesses:

Proposals & Personal Evaluation.

From my analysis and research I have proposed that the system is successfully operating every year. The process of arranging the disposal to re-ordering the stock runs almost smoothly. But a main problem has come up, that the deposal itself is a waste of time and money.

A solution to this problem is to re-use the hip joints elsewhere. This suggestion is a common idea among the staff and in my thought.

12/16 members of staff I gave the questionnaire to recommended the waste to be used elsewhere or recycled.

Others recommended making the product packaging smaller or selling them in smaller packs, so there will be less to throw away each year.

In my opinion using the hip joints elsewhere in the U.K or in other countries will be a better use of taxpayer’s money.

This idea of sending the waste to a third world county was inspired by the maintenance supervisor. When I interviewed him he had suggested it and said that the waste has no problems with it and sending it off would be more affective than throwing it away, to some landfill.

If the hip joints were recycled or sent to another country it would cost a bit more, but it’s worth it. The costs which needs to be thought of is the shipping costs, melting down, re-forming and also packing is needed. The overall costs can be from £500 to £1000, depending on the amount of waste. The prices are high as the materials are expensive and quite heavy.

To send it off to be recycled or sent to another country would be done by a specialist. From a lot of research I can’t find much on the internet, but the maintenance department says “we have links to industrial companies and other hospitals abroad”

The total recycling or sending off process will save money physically, in other words the money spent on the hip joints is still going to be used and not just thrown away. This means that there is less impact on the environment as there can be less waste in landfills, which take billions of years to decompose.

Overall from my case study the system has been affective, that it successfully does its job by disposing of the waste. The system has a smooth process of throwing away the waste.

My case study meets the following objectives, which I set:

As the system does dispose of the waste successfully, the improvements which have been thought off and the ones which are obvious, have not been put to work, this could be because the hospital throws away so much waste, so why should they care about one type of waste.

Another reason could be that it costs to much, as the hospital already uses to much money for medical equipment and repairs, they sometimes can’t afford to pay for other services and machines.

If I had more time to look at this case study I would look and ask more people within the system, about what happens. This would give me a wide and varied range of results meaning that my research would be more precise.

Also I would put my proposal to practice by asking the staff about what they think of the idea. Maybe it could lead to my proposal becoming a real situation.

By doing these changes this I would make my case study better and more detailed and successfully, than it already is.