Episode 043 | February 13, 2023 | 35:57
Guest: Maria Gaden (Center for Sustainable Hospitals, Head)
Published: February 13, 2023
Duration: 35:57
Description
In this episode, Joachim has Maria Gaden, Head of the Center for Sustainable Hospitals — a regular sustainability superstar — in the studio for a conversation on all things sustainability within hospitals and healthcare systems. Maria shares cases and her hands-on experience on how to actually, successfully implement sustainability programs in large healthcare systems.
Full transcript
About this transcript
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We managed to reduce the consumption of cleaning products by 14.6% in less than a year — on a small hospital with 2,000 employees, that was almost 500 litres of cleaning products. We reduced plastic bag consumption by 16% (2.4 tonnes of plastic) just by asking: is this bin too big for the room, do we have three bins where we could use one or two?
Hello and welcome to the Sustainable Healthcare Podcast. I am Joachim. Today I have Maria Gaden — head of Center for Sustainable Hospitals at Denmark’s second largest healthcare system, Central Region of Denmark. She leads a team that integrates sustainability at hospitals across care pathways with clinical personnel.
Maria: I work with the sustainable transition focusing on circular economy in the Danish healthcare sector — hospitals as the focus area. I lead the Center for Sustainable Hospitals in Central Denmark Region. Established 2021, growing rapidly. Our raison d’être: support all units in Central Denmark Region to reach the strategy goals concerning circular economy. Our region has multiple hospital units plus psychiatry and social area.
What drew me to sustainability? Meaningfulness. I was a midwife and saw our consumption move from multiple-use to single-use tools while every other organization seemed focused on sustainability — but inside healthcare, in 2017, it was not on the agenda anywhere. Present in a shadowy way through the SDGs framing development strategies, but not concrete and not focusing on our own consumption — which turned out to be the largest emitter of CO2.
How did we start? I am from a midwife background — dealing with things concretely. We started concrete projects without knowing if they were the right priorities, because we needed to start somewhere. Luckily we had hospital management that supported the journey. First action: reach out to the Nordic Ecolabel asking how they can help us in a hospital. We started with certification of cleaning services — never done before. Hospital cleaning at Regional Hospital of Randers was certified with the Nordic Ecolabel in 2020 — took almost two years, revealing the complexity. Cleaning in a hospital is not normal cleaning; it is life-and-death.
It turned out hundreds of employees had the same concern and motivation. Healthcare workers are driven by inner motivation to make a positive difference. Many people stood up. Regional sustainability strategy approved by Regional Council in 2021 — first strategy targeting our own consumption within the organization (the hospitals), not the geographic region. Politicians taking responsibility of our own business, not just trying to make corporations between municipalities. It was the first time we included Scope 3 — and we put up quantitative goals within Scope 3.
For listeners — Scope 3 is emissions from the supply chain outside your own organization and outside the power you buy. Largest emissions come from our Scope 3. People felt vindicated — yes, there is a lot of garbage, that is the actual problem, not just the light in the ceiling.
To deal with Scope 3 you have to do many things differently inside your own organization. There are many layers and it is value-chain cooperation, but there is a lot we can do ourselves about how we consume.
How do we deal with the complexity? We learned how to do it by building structure. Everyone is busy with patient safety and treating patients — sustainability is an add-on. We built a volunteer network across the region. We give people information on circular economy and why “stop things from getting in” matters more than recycling — we have to do both, but the butterfly diagram from Ellen MacArthur Foundation: closer to the centre, less material in, the better. We also have micro-financing projects — clinicians who see “could we stop using that, why is that single-use” get resources and support to test the idea, then we scale it.
Scaling out is well-known from health innovation — not invented here, professional pride, hygiene and safety. What works on one ward might not work on another. In an operating theatre there is a different codex than in birth. We call them “churches” — we need to pray in all the churches: hygiene, work-environmental specialist, etc. Then when approved, scale out. We are building a catalogue of knowledge.
Concrete cases: cleaning certification — 14.6% reduction in cleaning products in under a year, almost 500 litres. Plastic bag reduction — 16%, 2.4 tonnes. The cost of certification was earned back by those reductions. Then new regulation on garbage sorting came, so we will see if we can stay that low — but the methodology transfers. We have 30,000+ employees in the region.
Target in our strategy: 30% reduction of total garbage. We probably will not find one or two things that reduce garbage by 10-15%. We need many many small things. That is the difference from Scope 2 (power) which has big chunks.
LCA screening of single-use vs multiple-use suturing sets (including soap, water, transport, packaging) — multiple-use reduced CO2 by 90%. The one thing we did not include: if we switch to multiple-use we may need a bigger sterilisation department. We are starting an implementation project to analyse. Clinicians generally prefer multiple-use because the precision and feel is better. It used to be multiple-use for most things — we are switching back.
Advice for other healthcare systems starting out: build an organisational structure. We have sustainability consultants now at every hospital. You need network to scale and to receive good ideas from those consuming every day — they have a feel for what truly adds quality to treatment and what does not.
You need leadership decisions. Sometimes you need to take big decisions to change a lot of people’s behaviour. Get top management on board. Make the connections to other agendas — digitalisation is not the contradiction of sustainability. The stick: KPIs. If we do not do what needs to be done now we will be even more busy and have fewer resources in the future. The lack of clinical workforce we have today is the result of a system that did not see human resources as limited. If we keep using material resources the way we are, in five years we will be in lack of those too. Be proactive.
Sustainable business cases — there are good savings in consuming less, but switching to multiple-use needs upfront investment that pays back. Often there is even more hesitation toward sustainability investments than software ones, even though they are structurally the same — CapEx with payback time. Many things are not priced yet (CO2, plastic, waste, water) — very likely they will be priced higher within ten years.
Thank you Maria for an absolute joy of a conversation. She is active on LinkedIn — follow her. Thanks for listening — please subscribe.