Eastern Visayas State University

College of Engineering
Industrial Engineering Department

Risk Assessment of Waste Management System in Eastern Visayas Regional

Medical Center (EVRMC); Inputs for Effective Risk Treatment Planning and
Implementation

In partial fulfilment for the Course EL 423(Risk Management)

Submitted to:
Engr. Zaira Marie P. Verunque
Instructor

Submitted by:
Arlene D. Jaca
Nadine E. Roxas

March 29, 2016

 APPROVAL SHEET
In Partial Fulfillment of the Requirement in the subject EL 423 (Elective 2) for
the Degree of Bachelor Of science in Industrial Engineering, this case study entitled
“Risk Assessment of Waste Management in Eastern Visayas Regional Medical
Center (EVRMC): Inputs for Effective Risk Planning and Implementation” has
been prepared and submitted by Buddy Six (6).

Engr. Zaira Marie P. Verunque

Adviser

PANEL OF EXAMINERS
Approved by the Committee on Oral Examination with a grade of

Accepted and approved in partial fulfillment of the requirements for the

course EL 423 (Elective 2).

DANILO B. PULMA, D.M

Dean, College of Engineering

Date of Oral Examination

March 2016

ACKNOWLEDGEMENT
 Studies show hard-work. It will be possible for us to success in writing a study
without the dependence of earlier studies. This work provided as an inspiration,
motivation and opportunity to contribute a broader analysis and ideas regarding the
concept of this work.

I would like to extend our deepest gratitude for the people who patiently
helped and support for the completion of this study:

Engr. Zaira Marie P. Verunque, for the background knowledge about our
topic; for the time and patience during the study development.

Mr. Michael Garin-PCO Chief and Engr. Jose M. Jocano Jr.- Head-Maintenance
& Facility Services.who helped us to answer our question about our topic and tour us in
their waste management plant, specifically the storage room where their equipment
they used is located.

Lorlyn H. Callosa, Rosemarie Yunzon, Anastacio Jasmin, Danica Rose Ocenar,

Michelle Pomasin & Whendelle Ann Talacay for giving us an inspiring words and shared
their ideas about this.

To the 4th year Industrial Engineering Students, for helping us to pray to

accomplish this study.

Jaca and Roxas family, for love, moral and financial support.

And most of all, a big thanks to our Almighty God, for knowledge and
strength, for the wisdom, the blessings and patience and hope showered to us, in
conceptualizing this work, and lastly, for the guidance and protection during our
undesirable moments.

TABLE OF CONTENTS
Title page page

Approval Sheet . . . . . . . . . i

Acknowledgement . . . . . . . . . ii

Table of Contents . . . . . . . . . iii

List of Tables . . . . . . . . . iv

List of Figures . . . . . . . . . v

Chapter

I. Abstract . . . . . . . . . 1

II. Introduction

Background of the Study . . . . . . . 2

Objective of the Study . . . . . . . 3

Scope of the Study . . . . . . . 4

Hypotheses . . . . . . . 4

Significance of the Study . . . . . . . 4-5

Definition of terms . . . . . . . 5

III. Methodology

Research Design . . . . . . . . 6

Research Locale . . . . . . . . 6

Research Instrument . . . . . . . 6
 Conceptual Framework . . . . . . . 7

Data gathering Procedure . . . . . . . 8

Risk Management Process . . . . . . . 8-13

IV. Result and Discussion

Waste Management System . . . . . . 14-16

Color Coding Container Scheme . . . . . . 16-17

Water Waste Dispose System . . . . . . 17-18

Risk Management System . . . . . . 18-28

Analysis . . . . . . . . . 29

References . . . . . . . . . 30

Appendices . . . . . . . . . 31

List of Tables
Figures page

3.1 Severity of Consequence Criteria . . . . . 10

3.2 Likelihood of Occurrence . . . . . . 10

3.3 Detection . . . . . . . . 10

3.4 Formula of the Risk Priority Number (RPN) . . 11

3.5 FMEA Sheet . . . . . . . 11

3.6 Risk Matrix . . . . . . . . 12

3.7 Risk Treatment Plan . . . . . . 13

4.1 Color Coding Scheme . . . . . . 15

4.2 FMEA Sheet

Risk Assessing . . . . . . 19-22

4.3 Risk Matrix . . . . . . . . 23

4.4 Risk Treatment Plan . . . . . . 27

List of Figures
Figures page

3.1 Conceptual Framework . . . . . . 7

3.2 Fishbone Diagram . . . . . . . 9

3.3 Area Chart . . . . . . . . 13

4.1 Waste Management System . . . . . 14

4.2 Water Waste System . . . . . . 17

4.3 Fishbone Diagram

Risk Identification . . . . . . 18

4.4 Area Chart

Identifying High, Moderate and Low . . . 24

CHAPTER I

ABSTRACT
 Inadequate waste management is a serious concern in many countries due to
the risks posed to human health and environment. Poor management of waste exposes
health care workers, waste handlers and the community to different risks: infectious,
toxic effects and injuries. Risk Management is the identification, assessment and
prioritization of risks.

Hospital like Eastern Visayas Regional Medical Center (EVRMC) has a big
responsibilities to accommodate different people, patients with a good facilities and
ongoing transactions with doctors and nurses. It is very important to them to formulate
a well function system, where in the personnel even more convenient. Figures were
shown to merely understand the process of Waste Management System in EVRMC, flow
charts. Words was intentionally defined. The researchers were able to identify the
possible risk under the Waste Management System, how risks does affects, gives
impact to the flow of managing the hospital. If the system is still working, if there at
least move to be done by the staff to implement on improve the way of seeking the
system. The researchers discussed the following data (1) Waste Management System
(2) Color Coding Container (3) Waste Water Disposal System (4) Risk Identified in the
System (5) Planning and Treatment of Risk (6) Implementation/Inputs.

CHAPTER II

INTRODUCTION
Background of study

The idea of management system is an integral part of a process. It is a

documented and tested step-by-step method aimed at smooth functioning through
standard practices, it includes detail information on topics about, setting and
implementing corporate policies, establishing accounting, monitoring and quality control
procedures.

The researchers tackled the involvement of Risk Assessment of Waste

Management System in EVRMC. Eastern Visayas Regional Medical Center is highly
recommended public hospital in the region.

The Eastern Visayas Regional Medical Center (EVRMC), then known as the Leyte
Provincial Hospital, first opened doors to the public in July 16, 1916 at Jones Street with
an authorized bed capacity of 14. With increasing demand, the hospital was relocated
(to its present site) and a new building was constructed in 1925. In 1936, the hospital
was further expanded to 40 beds and the new building was inaugurated by President
Manuel L. Quezon.  In 1952, the bed capacity of the hospital was further increased to
100 in order to cope with the rising health needs of the growing population. On July 6,
1970, the hospital expanded its role in the region by formally opening the Leyte
Provincial Hospital School of Nursing, the 7th School of Nursing under the Department
of Health. It was then the only school of Nursing in Leyte and Samar.

The EVRMC today is a modern, tertiary level four (4) teaching and training
hospital conveniently located along Magsaysay Boulevard, Tacloban City. Its 15
buildings occupy a total land area of 25, 639.36 square meters on land owned by the
Provincial Government of Leyte. Its present location is conducive for prompt medical
assistance to the people of Region VIII since it is accessible and strategically located
midway between Samar and Leyte.
The purpose of the study is to know how the waste properly disposed, and to be
able to see if the management is following the duties and responsibilities according to
the noted act. Also, if the said system has a risk assessment, and if they have actions to
reduce it, then what or how will be the steps they make to be able to control those
risks.
Through researchers curiosity is to gather information in risks and
implementation treatment. On how these risks can be controlled and reduced for the
sake of securing the people and environment’s safety in the facility.

Objectives of the Study

The researchers want to achieve this following objective;

1. To identify the impact of improper waste management.

2. Be able to equip the participant with the general knowledge in managing waste
safely and wisely.

3. To determine the possible risks in the Waste Management System of EVRMC, as it’s
implemented and improve.
Scope of the Study

This study was only limits beyond the sufficiency of the researchers about how
Eastern Visayas Regional Medical Center (EVRMC) operates their waste management
and how does the risk affect the system. If possible what are the inputs will be used in
planning and implementing the treatment.

Hypothesis

Hospitals are assumed to have risk management under the waste management
system, so that, the selective hazardous waste can affect subjects to be able to control
or to limit.

Significance of the Study

This study is significant to the following:

To the Researchers: It is hoped that other researchers will find the present
study a ready source of information. The present study may serve as spring board for
other similar researches in the future.

To the Students: The study may help to the students specifically IE students to
understand more on Risk Management System, especially how a system or a certain
scenario identified each of the risks in terms of materials, equipment or even in
yourself.
 To the Management (EVRMC): The study may help them to promote and
sustain the need of their operation. It also give them additional information about this
study and will serve them as a guide to operate their operation by reducing the risks
and if possible to treat and implement.

To the Teachers: The findings of this study would help them in practicing the
upcoming researchers as well as the students on how they could formulate a globally
competitive study.

Definition of Terms

The researchers defined the following terms:

Risk- potential future harm that may arise from some present actions

Waste- material discharged to, deposited in, or emitted to an environment in

such amount or manner that causes a harmful change.

Risk Management- series of steps whose objectives are to identify, address,

and eliminate software risk items before they become either threats to successful
software operation or a major source of expensive rework.
Waste Management- the collection, transportation, and disposal of garbage,
sewage, and other waste products.
Waste Disposal- proper disposition of a discarded or discharged material in
accordance with local environmental guidelines or laws.
Segregation- is the process of separating different types of waste at the point
of generation and keeping them isolated from each other.
 CHAPTER III

METHODOLOGY

Research Design

In preparation of this study, narrative, descriptive and statistical methods were

used. Narrative since most of the ideas are meaningly defined, descriptive because
system was described intentionally, statistical because charts and figures helped to
understand the procedures that this report fade to impart.

Research Locale

Location of the study was conducted in Eastern Visayas Regional Medical Center
(EVRMC) at Senator Inahes St. Tacloban City, Leyte. The outcome of this study is
considered as a big help to the management in classifying the waste and operation
system that needs an improvement.

Research Instrument

In conducting the study, camera, cellphone, and questionnaire were used. The
camera was used in documenting the conditions of the aspects to be given focus. The
cellphone was used to record during interview. The researcher utilized a self-structured
questionnaire to focus on the study.

Conceptual Framework

Improving an existing system requires many activities and involves people. One
of the most important activities in determining the root cause of a certain problem that
causes interference in an operation is to review and assess every system component to
determine whether alterations are needed or totally change the existing system to solve
the problems by proposing a possible solution in a system requirement. The proposed
system must be easy to use, whether if the system has an existing risk system over on
the waste management system.

The most important concept in conducting a system study is to determine the

process. The process where it is an interaction between people, materials, method and
environment to produce an outcome such as service or input to another process.

Figure 3.1 Conceptual Framework

EVRMC

Waste
Management
System
Is there a risk management
system over waste
management?
YES Is the system
still effective?
No
Design a new system
Improve the existing
system IMPLEMENT
YES

Data gathering Procedure

The researchers first asked for permission from the EVRMC who’s in charge of
the Repair and Maintenance, the OIC and from the PCO in waste management in
EVRMC, and to the Respondents through a communication letter. After permitted our
communication letter we undergo a brainstorming to come up a questionnaire that we
are going the discussed in our study. This study used an Interview guide to gather
some important data regarding the Risk Assessment and Implementation of Waste
Management in EVRMC. Also, a personal visit was conducted personally interview the
OIC of the Department and inspected the place.

The data gathered were based from the quarterly discussed the following;

1. Waste Management System

2. Color Coding Container Scheme

3. Waste Water Disposal System

Risks Management Process

The researchers seek to discuss the following steps that helps their system to
assess and analyze the risks they identified. Using the different tools to come up an
output in regards to the Waste Management System.
1. Context Definition

2. Risk Identification

- Brainstorming and Ishikawa/Fishbone

3. Risks Analysis and Evaluation

- FMEA

- Risks Matrix

4. Risks Treatment

- Area Chart and Risk Treatment Plan (Risk Register)

5. Implementation

Ishikawa/Fishbone

Cause 1 Cause 2 Cause 3 Cause 4 Cause 5

Effect
Cause 6 Cause 7 Cause 8 Cause 9 Cause 10

POTENTIAL CAUSES EFFECT

Figure 3.2 Fishbone diagram

FMEA

Severity
No Effect (1) Has no Effect on Health
Minor (2) Minor infection
Major (3) Infection
Hazardous (4) Serious or fatal infection
Catastrophic (5) Death
Table 3.1 Severity of Consequence Criteria

Occurrence
Very Unlikely 1
Unlikely 2
Possible 3
Likely 4
Very likely 5

Table 3.2 Likelihood of Occurrence

Detection
Can be detected 1
Possible to detect 2
Moderately detectable 3
Impossible to detect 4
Very Impossible to detect 5
Table 3.3 Detection

To compute for the RPN (Risk Priority Number),

Formula:
S (severity) x O (occurrence) x D (Detection) = RPN
Table 3.4 Formula of the RPN (Risk Priority Number)

Risks Probable Preven Occu- Severi Detec- RPN

Identifie Cause Events -tion rrence -ty tion
d

Table 3.5 FMEA Sheet

Methods of Scoring

To make sure that the scoring and interpretation of the data gathered in the
study can be readily given their meaning; the following arbitrary scales, rate and their
corresponding color.

Rate Color Description

4-5 Red High

 3-2 Yellow Medium

1 Green Low

Hazard Severity
No effect Minor Major Hazardous Catastrophic
(1) (2) (3) (4) (5)
Very
Unlikely Low Low Low Medium Medium
(1)
Likelihood Unlikely
Of (2) Low Low Medium Medium High
Occurrence
Possible
(3) Low Medium Medium High High
Likely
(4) Medium Medium High High High
Very
Likely Medium High High High High
(5)

LOW MEDIUM HIGH

Table 3.6 Risks Matrix
 Fi
gur
e
3.3

Area Chart

Risk
Identification Risk Treatment
Event Action Plan Risk Owner

Table 3.7 Risk Treatment Plan

 CHAPTER IV

RESULT AND DISCUSSION

Figure 4.1 Waste Management System

SOURCE

Segregation

General Infectious
Waste Waste

Wet Dry Vials Sharps Pathological Plastics

Distilled Left Empty Human Contami-

Needles,
Water overs bottles tissues, nated
syringes,
(left usually /glass blood, items
blades
over) don’t bandages include
contain urine bags
Any
These maybe Shredded Autoclaved
Hazardous
recyclable
when they Autoclaved
are properly
treated

Converted
 DISPOSED
Waste Management System

The flow chart shows in Figure 4.1 is the process of Waste Management in
EVRMC, executed from above figure. From the top is the source, it is the main course
where the waste came from (usually form the rooms or wards).

There are two types of segregating waste in the system. First, of that is the
General Waste, this type does not post specified handling problem or hazard to human
health also in environment. General waste is divided into three (3) categories, the wet,
dry, and the vials. In the row of dry waste, are those recyclable things, such as left over
foods, disposable utensils, Styrofoam, tissues where does not contain any hazard.
Under the waste are those liquids does not contaminated. Lastly the vials, these are the
empty glass bottles where the chemicals specified as non-hazardous is put. Liquids are
said to be drop at the septic tanks, the dry waste particularly the solid one or recyclable
materials are put in an empty container. It is separated by the other garbage’s, it is
implemented also to the vials, and it is collected and saved to an empty drum.

Continuing the 2nd type of waste which is the Infectious Waste, this type is
suspected to contain hazardous chemicals. It is separated from the general waste, below the
infectious waste is the pathological waste, consists of tissues, organs, body parts, human fetus
and animal carcasses, also an infectious waste is Sharps, include needles, syringe, scalpers,
saws, blades, broken glass, infusion sets, knives, nails and any other items that can cause a cut
or puncture wounds. Whether or not the infected, such items are usually considered as highly
hazardous care waste. These are stock at the storage area, last branch of infectious waste are
the plastics contaminated items include syringes, blood and urine bags, it will be put to an empty
mineral bottle.
 At the Waste Disposal Area, they have this kind of device used in cooking the
infectious waste, specifically the pathological, it is called autoclaved. Sharps are sealed
in the grinder and let scattered into pieces. The management build a method which is
the scattered pieces were able to mix together with the cement. As their view, this is an
effective step, in regards to the safety of personnel. Vials are supposed be in the
grinder. After the process of cooking, grinding mixing. The result of all methods, now
the infectious waste were converted into general waste. In this case, waste is now
ready to disposed, but EVRMC don’t have their own landfill. So, it is collected by the
City of the ordinance.

Color Coding Container Scheme

Color of Container/ Bag Type of Waste

BLACK Non-Infectious Dry Waste
YELLOW Infectious and Pathological Waste
GREEN Non-Infectious Wet Waste
Table 4.1 Color Coding Scheme

In Table 4.1 shows the color coding container where the segregation of waste
will be categorized. The black container is support for the non-infectious dry waste like
(plastic bottles, paper, etc.), the yellow container is for the infectious and pathological
waste are being segregate. This container is the hazardous one because all waste which
are infectious are being put like blood, removed organs, tissue waste, etc., the green
container symbolized or labelled those non-infectious waste like left over food from the
patients, left over of water, etc. Those color container helps to the patient, nurses,
doctor or even the family of the patient to segregate those waste in a proper color
container. But, there is a problem that EVRMC encounter on this. The government did
not supply for this kind of most needed in a hospital. The researchers view about this,
that those container they used are lack of supply. The management, trying to give a
treatment in regards of this problem, those black bags or cellophane are being put in
every ward and they only put a straw of different color which are yellow and green to
labelled that those black bags who have a color yellow and green straw are not the dry
waste. Basically, the EVRMC are in need of supply and need an immediate attention and
improvement by the government.

Figure 4.2 Water Waste System

Storage Tank
WARDS Roto Sieve
(Solid and Liquid waste)

Micro Strainer 6 Reactor Storage Tank (Strained water)

UV Light 2 Clean Water 3 Aerated Sludge

Sludge Press Polymer Sludge Tank

 DISPOSED (Ocean)

Water Waste Dispose System

Contaminated Waters is considered as waste. Respectively in Figure 4.2 they have

their water system, from the wards, water will be sipped through the storage tank, the
water sipped from the ward are full of solid particles (cellophane, leaves), then from
storage tank it undergo filtration. First, the roto sieve, it is a machine where all big solid
particles like cellophane will be separated or it undergo strained. After the water
strained in the roto sieve, the water from there will go to the storage tank where in a
water don’t have a solid particles and it is now ready to go in a reactor. The water
house consist of 6 reactor tanks where in the water undergo a process which is to keep
the good bacteria active just to kill those bad bacteria, after the processing of reactor it
goes down to the micro strainer, through this the small particles will be strained and
goes to UV Light to kill the other particles. Meanwhile, it is now ready to store in the 2
Clean Water Tank, and after that it undergo a process where in, the 3 aerated sludge
will sipped the water from CW tank. In addition, the water will go to the sludge tank
and polymer, it is a mix tank where the water will be ready to go to sludge press, by
that it is now ready to release or disposed to the ocean, the water will be already
filtered.
 Risks Management System

Improper Improper
Lack of
Sharp waste collection Segregation
space

Infection

Lack of PPE Infectious Machine No transportation

waste Failure vehicle

Figure 4.3 Fishbone Diagram (Risk Identified)

From the figure shown above, risks was identified by the use of Cause and Effect
Diagram or Fishbone Diagram. The abovementioned risks, was observed by the
researchers and if possible the risks will be going to treat in the following chapter.
Through this, the researchers come up an analysis and assess different risks on waste
management in EVRMC.
Table 4.2 FMEAA Sheet

Risks Probable Events Preven- Occu- Seve- Detec- RPN

Identified Causes tion rrence rity tion

1. Improper - - - Use of
appropriate
segregation Inadequate Infection 4 5 1 20
Personnel
of waste of bags. protective
-Lack of equipment
information
2. - -Higher -Use or
Inappropriate Inadequate exposition implement a
Collection
of PPE of daily 5 4 3 60
-the contamin schedule of
schedule of ated properly
collection of waste collection of
waste is it - waste from
takes too the ward.
long, they
wait until
their trash
can is full
3. Sharps - Lack of -Injury -Proper
waste information -Infection segregation
(needles, ( from the of waste
vials source they -Develop a 5 5 5 125
without don’t follow written work
content, the proper and
broken segregation emergency
glass, etc.) of waste) procedures.
4. Lack of - Lack of - Expose -Use the
visitors
space space space where
and
(storage patients the unused 4 2 1 8
to
area) machine is
possible
located
contamin
ation
5. - lack of - - Collected
Infection in containers
Infectious material or
( HIV, for
Waste equipment cholera, infectious
TB, waste and
(trash bin 5 5 3 75
rabies, should be
or can) etc.,) marked with
the
Infectious
substance
symbols.
6.Machine - They only - machine - make sure
failure
Failure put the the proper
infectious infectious
waste from waste they 3 2 4 24
the need to cook
 autoclaved to the
without autoclaved
looking the are the
proper exact
gram that minimum or
need to maximum
convert into gram of
general waste so
waste. that it can
prevent
machine
failure
7.No - They - It may - Have a
result to
transporta- don’t have proper
inventory
tion vehicle an exact of those transportatio 4 2 4 32
used
person or n where all
syringes
the person and waste are
exposition
who are being
to the
going to visitors or disposed
patients
collect is specifically
also, the
not from employee those sharps
who are
our City waste need
going to
specifically pass in to transport
their
those in Cebu.
facilities.
syringes.
8. Lack of - The -Infection - Assess and
- Injury
PPE government take an
did not actions to 4 3 48
4
provide for the
their safety government
tools for the
lacking of
equipment.

From the above sheets the RPN solved by the use of the formula shown in
Table 3.4 where the severity, the occurrence and detection was multiply to get an
answer for the Risk Priority Number (RPN= S x O x D). From the above identified risks
the RPN was solve by multiplying the 4 x 5 x 1 in risks number (1), and also for the
next number.

Hazard Severity
No effect Minor Major Hazardous Catastrophic
(1) (2) (3) (4) (5)
Very
Unlikely Low Low Low Medium Medium
(1)
Likelihood Unlikely
Of (2) Low Low Medium Medium Medium
Occurrence
Possible
(3) Low Medium Medium Medium High
 Likely
(4) Medium Medium Medium High High

Very
Likely Medium Medium High High High
(5)

LOW MEDIUM HIGH

Table 4.3 Risk Assessment Matrix

In Table 3.1 shows the severity of consequences where to analyse and assess
the criteria as well as the Figure 3.2 above shows in methodology. The Table 4.2 shows
the risks identified by the researchers to come up on this study. The identified risks
there is a probable cause, events and preventive measures, also, each risks had been
scored based on their criteria of likelihood, severity, detection and the RPN.

The Risk Priority Number serves us to analyse what are the risks that are
acceptable and nonacceptable. Risks with RPN of 30 or less than is acceptable.
Anything more than that is unacceptable. The findings of the unacceptable risks are
the risks that are need to treatment.

From the above matrix (Table 4.3) shows how we categorized of each risks by
low, medium and high. The low risks was not identified based on the matrix, second the
medium was detected in numbers (1) the separation of waste is not properly
segregated (4) the storage area are not properly arranged (6) Machine (autoclaved) (7)
transportation of waste specifically the infectious waste (sharps) and (8) lack of PPE.
Lastly, the high risks was detected (2) the collection of waste are not properly collected
to storage area (3) the sharps (needles, vials without content, broken glass, etc.) (5)
Infectious Waste where they only put or stock the blood in a blood bag.

12

10
Occurrence

0
0 2 4 Severity
6 8 10 12

Figure 4.4 Area Chart

From the Table in 4.4 Area Chart was used in the above chart that shows the
risks where all are plotted based on the occurrence and severity that are shown in the
FMEA Sheet (Table 4.2). The risks that are plotted in an Area Chart are the findings of
the high risks as well as the medium and the low risk.

The result of plotting the risks in an Area Chart are the following:

High Risks
 1. Improper segregation.

2. Inappropriate collection.

3. Sharps waste (needles, vials without content, broken glass, etc.)

5. Infectious Waste

8. Lack of PPE

Moderate/Medium Risks

4. Lack of space (storage area).

6. Machine failure (autoclaved).

7. No transportation vehicle (sharps).

After assessing, risks are need to be treated. This is a decision means to (1)
accept the risks,(2) avoiding the risk to make the risks disappear, (3) reducing and (4)
transferring or sharing to the third party. To develop an effective risk treatment, the
researchers must develop a treatment plan, a treatment option agreed, forecast its risk
analysis and monitor risk treatment plans.

Risk
Identification Risk Treatment
Event Action Plan Risk Owner

Improper - Conduct a seminar or -Waste

orientation regarding management staff
segregation of
Reduced proper waste segregation.
waste - Monitor each ward every -Nurses, employee
 day.
Inappropriate - Must have a specific -Waste
schedule in collecting of management staff
collection
Reduced waste.
-
Sharps waste - Have a machine where in - Waste
the needles are ready to management staff
dissolve to avoid infection.
Reduced
Infectious - Collected in bags or - Doctors and
Reduced containers for infectious waste Nurses
Waste and should be marked with the
international
infectious substance symbol
- Develop written work and
emergency procedures.
- Use an appropriate PPE
Lack of PPE - Ask support from the -Housekeeper
Reduced government to supply the - garbage
protection equipment collector
needed.
Lack of Space - Must have a designated -Waste
Reduced area where general, management staff
(storage area) infectious waste are place.
Machine - Waste must undergo first, - Waste
in weighing the right management
failure.
Reduced number of gram before staff
(Autoclave). place in the autoclave.
- Monitor always the
autoclave after using.
No - Have an own - Pollution
transportation vehicle to Control
Transportation Reduced avoid overload of waste Officer
Vehicle specifically those
infectious waste.

Table 4.4 Risk Treatment Plan

Implementation

Based on the identified risks by assessing and evaluating using FMEA Sheet
and Risks Assessment Matrix, the researchers come up an implementation in regards to
the above discussion.

1. Conduct an orientation on segregation of waste on how it affects to the people who

are responsive in waste management.

2. Should have a regular monitoring of waste in each ward.

3. Those sharps must undergo a process to reduce the impact of waste before
disposing it.

4. Should have a proper arrangement of waste, and if it possible expansion of their

area.

5. Use a better container and this container should be puncture-proof and fitted with
covers.

6. Always monitor the machine and make sure the waste, particularly the blood that are
ready to cook in an autoclaved have a right number of gram to avoid machine failure.

7. Have a regular schedule for transporting waste (general, infectious waste) to avoid
waste inventory in the site and also, to avoid higher contaminated of waste.

8. Provide more safety tools and equipment that are needed in processing their waste.
 ANALYSIS

A comprehensive waste management plan is the key ingredient to a successful

waste management within a facility. In regards to the Waste Management System in
Eastern Visayas Medical Center (EVRMC), the waste are not properly segregated,
collected and disposed, this may lead to a negative impact in public health and
environment. Despite of the efforts of the management of waste, the current system of
waste management in the EVRMC is under development and it is in need an immediate
attention and improvement.

The researchers view, the existing system is so understandable, they don’t

show any illustration of the system and it makes the researchers having a difficulties
about the said system. The facility or the plant of the waste in EVRMC our not properly
arranged, it is an untidy and the surrounding is smelly. Also, the trash bin or the trash
cart are not easy to determine whether it is a general or an infectious waste since they
don’t have an specific container of each type of waste, lacking of equipment is one of
the problem that the management encounter. From the source of waste down to or
going to the storage area there are waste that are mix from different categories of
waste, because of lacking of the supply where in the government did not supply the
needs of the Hospital specifically in disposing of waste, on this it may can affect to the
housekeeper or the person who actually done the last procedures where all infectious
waste are need to undergo cooking so that all waste are considered general waste
before the City collected the waste. Additionally, the color coding of container in EVRMC
have a problem of their management, since the government did not supply this kind of
situation. Lastly, the study would benefit to the management who aim to improve the
said system and managed the right segregation of waste.

References

Internet Sources:

www.evrmctacloban.com.ph

www.bingsearch.com
 www.wikisearch.com

www.ico.com.au

Resource Person:

Engr. Nestor Guy Alcantara - OIC~Chief Admin. Officer

Engr. Jose M. Jocano Jr.- Head-Maintenance & Facility Services.

Mr. Michael Y. Garin – PCO Head, Housekeeping Linen & Laundry Section

Mr. Rowel Agustin – Secretary of the PCO

Appendix

The researchers come up a questionnaire in regards to the Waste

Management System in Eastern Visayas Regional Medical Center (EVRMC) about their
improper segregation as well as the possible risks that they going through.
 This questionnaire help the researchers to get an information, analyse the
situation and serve them as a guide to conduct this study. The following questions are
answered by interviewing the research person.

1. Is there a Waste Management implemented in the said agency? Is there an existing

Risk Management System over the Waste Management?

2. Is the risk management system is effective?

3. How did your risk management help and affect in the waste management?

4. How this Waste Management work in the EVRMC?

5. What are the objectives of this system?

6. What are the types of waste does EVRMC have? How they classified those waste?

7. Where did they store their collected waste?

8. When is the schedule of collecting the waste from the ward? Storage? And
transporting it to the dumpsite?

9. What are their tools they used?

10. How many personnel maintaining and operating the waste management?