The first comprehensive recycling program in British Columbia health care

The Lower Mainland Recycling Renewal project is the first of its kind for BC health authorities. Previous recycling efforts at most of our hospitals have been uncoordinated and largely lacked appropriate support. To date, any recycling that exists in the health authorities is due to dedicated staff that spearheaded efforts for their own departments or sites. As environmental and waste reduction practices advance at provincial and municipal levels, health authorities are aligning their operations to ensure compliance.

Understanding behaviour and best practice

In order to design the most effective system possible, we attempted to understand recycling behaviour and what drives it. Of interest, results from a literature review by Meredith Hunt, Lower Mainland Health Authorities Green+Leaders Coordinator, found there is no conclusive evidence on what drives recycling behaviour. Rather drivers seem to differ between individual settings. For example, people may actively recycle at home, yet they may recycle less in a public space or at work. Although we may not yet be able to pin-point the rationale behind recycling behaviour in hospitals, from research review and experience, we do know:
•    Convenience and knowledge are influencing factors
•    Past behaviour is a predictor of future behaviour
•    The societal norm is an influencing factor
•    Others’ behaviour is a stronger influence than
•    Reporting back encourages and improves recycling
•    Signs with persuasive messages are more effective than single prompts

We have identified the barriers and benefits to recycling allowing behaviour change tools to be designed with these in mind; employ as much face to face communication as possible; used incentives to reward recycling behaviour; focused on social norms and inclusive language in our marketing materials; reported back on progress of the program.

Program overview

The Recycling Renewal Program provides health authority-wide recycling of refundable beverage containers; rigid plastic and tin; soft plastic; mixed paper and batteries.

To engage staff at the site level, administration is required to approve suggested implementation tasks and timelines. From here, each department/unit is consulted for feedback on recycling bin type, location and quantity. At the lab in Royal Columbian Hospital, department champions have gone above and beyond to make sure their department is recycling as much material as possible –they have even set up a styrofoam re-use program!

Getting the recycling bins out on the floor (bin roll-out) is accompanied by distribution of awareness and instructional posters, email and newsletter announcements, training for recruited ‘Recycling Champions’, recycling display days, department in-service training and on-line resources.

Indicators tracked by the recycling team measure program success and effectiveness. Data for these indicators are obtained through the following:
•    Pre and post waste audits to determine the composition of the waste and recycling streams
•    Pre and post surveys to measure staff awareness and satisfaction
•    Post implementation visual audits to measure contamination, identify possible bin re-allocation and flag areas that may need further education
•    Diversion rates calculated from vendor invoices using waste and recycling volumes to identify change in volumes and rates

The Lower Mainland Health Authorities commit to achieving diversion rate targets of 35 per cent in 2011/12, 50 per cent in 2013/14 and 70 per cent in 2014/15.  These progressive targets align with the Metro Vancouver goal of 70 per cent diversion in 2015.

Challenges and solutions

In addition to the common recycling challenges of placement, contamination, a constantly changing recycling market, communication and education, healthcare faces a unique set of recycling challenges.  The table below outlines both common and healthcare specific challenges and details the recycling team’s solutions.

Challenge Solution(s)
Competition for space within and outside of the hospital Within – option for single bin placement, working with staff to identify most appropriate bin locations

Outside – ability to place all recycling streams in one container

Getting the recycling message across – staff experience information overload, constantly changing protocols and schedules are not conducive to meetings Simple, straight forward messaging, face-to-face communication on multiple occasions, recruitment of Recycling Champions, flexibility to provide in-services at any hour of the day
Multitude of materials and a constantly changing recycling market Department specific posters, general recycling rules, visible contact details, on-line recycling reference, edits to signage when required
Housekeeping workload Simplify logistics of pick-up, centralize bin locations, contract negotiations where required
Contamination Clear signage, post implementation visual audits, follow-up face to face communication

As the Recycling Renewal program is implemented at each site the team works to address challenges that arise with creative and effective solutions. At UBC and Richmond Hospitals, staff have set up their own collection boxes in each clinical room and then sort out recycling at centralized stations ensuring as much material as possible is recycled.


The Lower Mainland Health Authority Recycling Renewal Project began in the summer of 2010.  Since then, the recycling team has added over 1,100 bins to seven acute care sites (St. Paul’s-SPH, Mount St. Joseph’s-MSJ, G.F. Strong-GFS, UBC Hospital-UBC, Royal Columbian-RCH, Lions Gate – LGH and Richmond – RH).  Planning is currently underway at Children’s & Women’s Hospital (C&W) and Burnaby Hospital (BH) with implementation scheduled this winter.

The proportion of recyclables in general waste has decreased at GF Strong Rehabilitation Centre, UBC Hospital and Royal Columbian Hospital as measured by the pre-program and post program waste audits. This decrease has varied between 3-13 per cent by site.

The proportion of staff reporting very low satisfaction levels dropped dramatically at GF Strong Rehabilitation Centre and Royal Columbian Hospital after the program was implemented, 80 per cent and 50 per cent respectively. Surveys for UBC Hospital are still to be conducted.

Post implementation awareness results at GF Strong Rehabilitation Centre and Royal Columbian Hospital show an increase in the percentage of people that know who to contact if they have questions regarding recycling, 15 per cent and 20 per cent respectively. Given that both sites still report less than 30 per cent of respondents know who to contact about recycling, we would like these numbers to be higher.

Post implementation visual audits are conducted immediately after the program is implemented.  Overall, these results indicate staff at each of these sites are generally informed on how to recycle correctly and are following through.

In general Health Authority staff from CFOs and executives to front-line doctors and nurses, are excited about the Recycling Renewal Program.

Although we encounter challenges with each site, we also find enthusiastic staff that continue to put great effort into recycling as much material as possible within their departments and hospitals. UBC Hospitals’ Transitional Care Unit immediately and significantly decreased glove contamination (they can’t be recycled) with strong internal communications, by doing their own visual audits, and truly taking the program under their wing. With site implementation on schedule and positive post-implementation results from our first three sites we anticipate this program to be a great success.

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