Sustainability is a full-time job

IDNs such as Virginia Mason Medical Center are serious about sustainability. John Leigh is proof.

In December 2019, eight major health systems in Washington state formed the Washington Health Care Climate Alliance, whose mission is to advocate for “climate-smart” policies. The participating systems represent 40 hospitals and more than 1,000 healthcare facilities. Specific policy areas the coalition plans to take on include energy, transportation, food, waste, infrastructure and community resilience.

John Leigh is director of sustainability for one of the participating systems – Virginia Mason Medical Center in Seattle. Share Moving Media, publisher of The Journal of Healthcare Contracting, presented Leigh with some questions about healthcare providers’ concerns and goals regarding sustainability, and how distributors can address them.

The Journal of Healthcare Contracting: Please talk about your role as director of sustainability at Virginia Mason. What are your days/weeks like?

John Leigh: In general, they’re full of variety. But one constant element is that I am frequently urging my colleagues within the organization to find ways, with my help, to reduce the environmental footprint of their department or operational area. Another is that I am regularly interacting with my counterparts at other organizations regarding best practices, learning what others are up to in the sustainability space, and sharing what we are doing.

JHC: You have been involved in sustainability all the way back to 1990, when you went to work for the U.S. Environmental Protection Agency. Thirty years later, what makes you optimistic about where we are today as a society in general, and healthcare providers specifically?

Leigh: One thing that gives me hope in the face of the climate crisis is the rapidly growing awareness of its importance, especially among younger generations and among healthcare providers, which is spurring a desire for action. I’ve noticed that many more clinicians are recognizing that climate change is already occurring, and that it will have dramatic public health and well-being impacts. There is a quickly growing sentiment that we have an ethical obligation to act on this knowledge and reduce greenhouse gas emissions in a variety of ways.

Trends that will help with this are the declining cost and improving efficiency of renewable energy technologies and electric vehicles.
Another trend that gives me hope are plant-based materials being used to make medical supplies in place of single-use plastics.

JHC: We have read that buyers might be more interested in “environmentally preferable purchasing” if they had access to life cycle analyses of medical products or equipment — that is, analyses that account for raw material consumption, cost of manufacturing and distribution, actual usage by the provider, and disposal. Are healthcare providers capable of performing such analyses?

Leigh: No. True life cycle analyses are too involved and complicated for health systems to perform ourselves. But there is environmental attribute information short of a life cycle analysis that can be useful in getting a feel for the environmental preferability of many products, such as durability, reusability or added chemicals of concern.

JHC: If the vendor were to perform such an analysis, how can the provider ensure that the analysis is accurate?

Leigh: By relying on the establishment of accepted standards and on independent, third party organizations to perform verification, certification or comparison services. Some of those exist and more continue to emerge.

JHC: It seems that the difficulty of performing life cycle analyses is the fact that there are so many players involved in the manufacturing, distribution, usage and disposal of a medical device or supply. Just as providers struggle to create a “continuum of care” for their patients (encompassing preventive care, pre-admission, acute-care stay,
post-acute care), are the various supply chain players collaborating on conducting reliable life cycle analyses regarding the sustainability of their products and equipment?

Leigh: The short answer is “No, I don’t believe such collaboration is taking place, unfortunately.” But I also believe what you’re describing is very similar to Extended Producer Responsibility, a concept that has been around since my time at the EPA in the 1990s. This has been far more widely accepted and regulated within the European Union, but only barely in some product areas in North America (like rechargeable batteries), and certainly not in the healthcare products industry, to my knowledge.

Extended Producer Responsibility laws shift the responsibility for the treatment or disposal of post-consumer products to producers. This gives them a strong incentive to design with environmental impact in mind, prevent wastes at the source, and integrate the cost of treatment, reuse, recycling or disposal into the purchase price. It’s an approach that we’d greatly benefit from adopting, from the sustainability perspective.

JHC: Please talk about the Washington Health Care Climate Alliance. Can you elaborate about what your eight members can do better than each of you could do on your own?

Leigh: First, we are already talking about climate issues across our own health systems as well as with other Washington Health Care Climate Alliance members in ways that we had not done before. We are talking about climate mitigation and resilience legislation with our government affairs directors, and about energy conservation targets among our facilities directors. We’ve already succeeded in fostering much greater engagement and agreement on climate and energy topics within our industry in Washington. This has been valuable.

Second, by speaking with one collective voice, representing 40% of the hospitals in the state, we are a more powerful advocate for climate and health, using our trusted role in the community along with our influence as large employers who serve more than 8 million patients each year. The Alliance structure will help us be more effective on policy issues as well as technical issues, with the goal of protecting people from the worst health impacts of climate change.