Global shifts in the recycling market eliminated many markets for recyclable materials, including all clinical packaging. Zero error recycling collection is the new standard. KSH participated in a stakeholder working group including leaders from City and Waste Hauler zero waste divisions, and hospital facilities and clinical divisions, aimed at recovery of the Clinical Recycling Program. Together we established a process for review and approval of recyclable materials and new service roles in healthcare waste prevention. Waste prevention streams are high value materials benefiting from special Clinical Recycling Quality Assurance.