Transcript: Series 2, Episode 1 - AHDC - Clean and Green Health Design with Amir Girgis

Friday, November 25, 2022 11:29 | Anonymous

David Cummins: 0:09

G'day and welcome to the AHDC podcast series, Health Design on the Go. I'm your host, David Cummins, and today we are speaking to Siobhan Leach, who is a group sustainability officer at Ramsay Healthcare. Siobhan has been working with Ramsay for over two years as a qualified Civil Scientist, Siobhan has continued her studies to achieve a Masters of Environmental Law and Science. Siohan now leads the way in the private healthcare sector for improving sustainability in all Ramsay Healthcare hospitals globally. As part of the Australian Health Sustainability Committee, Siobhan has been extremely enthusiastic and forthcoming with her work to help improve sustainability in healthcare around Australia and the globe. Welcome to Siobhan, thank you for your time to be here.

Siobhan Leach: 0:54

Thanks David. It's lovely to be here and talking to you about healthcare and sustainability. They're two good topics to link.

David Cummins: 1:02

Yeah, they are. So this is part of the Australian Healthcare Sustainability Series for the podcast. And I thought, what better person to ask than someone who's literally at the forefront of it. Ramsay Health has done such amazing work in the sustainability space over the last few years and won many, many awards. What's it been like to be part of that journey?

Siobhan Leach: 1:20

I think it's been a really exciting time to join a healthcare organisation, particularly with the challenges that have been going on around Covid and, and . I don't think I need to restate any of those, but it's been exciting because despite all of those challenges, Ramsay still decided to continue on the sustainability journey and, and so, As a result of that, there's so much motivation to do more in this space. It's a, it's fantastic. So I think, yeah, that is the most exciting part for me in my role.

David Cummins: 1:54

Yeah, I agree. Especially during Covid, even the NHS when they were really struggling to maintain patient numbers and beds in, in hospitals, they still made sustainability the priority. For the NHS and I believe Ramsay's done the same, you haven't actually lost focus on your sustainability goals, which has been amazing.

Siobhan Leach: 2:14

No, and it's been, really because we've been responding to what our people want, and that's really important to our board and our executive. And it's really, you know, the links between sustainability and healthcare are strong, so it makes sense that we, we do stuff more in this space.

David Cummins: 2:33

Yeah, I agree. For for those who aren't necessarily familiar with all the great work that Ramsay does in the sustainability space, do you mind. Sort of briefly telling our listeners exactly what Ramsay do, and especially in the healthcare sustainability space and what you've done in the last few years, especially some of those awards that you've won, which I've been very impressed by.

Siobhan Leach: 2:50

Yeah, I you know, Ramsay's been on the same journey as a lot of healthcare organisations and, and in the past we really, you know, totally focused on patient quality and our people. So in recent times we've expanding that to make sure we're covering what we're doing from an environmental perspective. And so that's an area that, you know, is part of our focus. So, We've over the past couple of years brought together our regional businesses and developed what we call 'Ramsay Cares', our sustainability strategy, which is about caring for people, caring for planet, caring for community. And so that was the first time for us to really Focus on sustainability. Globally, we created a global sustainability committee and we started improving our reporting. But as part of that, there have been fantastic things going on in each of our regions around sustainability. And, for example, in Australia they've been really focused on trying to swap out single use plastics. And you know, there's a commitment to swap out. 50 million pieces over by the end of the year. So that's quite ambitious. But at the same time, you know, when you do small things, it could be a small thing. In healthcare, it does make a big impact because, you know, when you aggregate all this, the material that goes through hospitals, you know, across you know, more than 500 locations globally, it does make a big difference. So that's one of the key areas we've been looking at. We've been making sure we're putting our money where our mouth is when it comes to sustainability. So we've embedded a lot of our sustainability goals into our financing. So we've did a one and a half billion dollar sustainability loan. And so, you know, when you link your financing with your sustainability targets, it really. Focuses the organisation on delivering on those targets. So that's been a really fantastic thing. And in addition to that, I guess, you know, working around some of the, the other areas we've been looking at, greening out theaters looking at anesthetic gases and, and, and reducing the impact of that. So there's a lot to do in healthcare. I'm not gonna say we're anywhere near the end of the journey. I'd still say we're at the start of that journey. But it's an exciting time for us.

David Cummins: 4:59

Yeah, I, I agree. And even though there is a long way to go, . Even though you're saying you haven't achieved all your goals yet. I would say Ramsay, especially . Are our leaders in this space, especially in the private sector space we've all worked in hospitals, officially private and public, where to even make a decision about a simple design is challenging. But you guys have got a global commitment and a global agreement, so that's very impressive. Where, where do you think that agreement came from? Was it more CEO? Was it from the ground up? Was it from the patients or the staff? Like how was that commitment made?

Siobhan Leach: 5:31

Yeah so, just before the pandemic, before my job was created, actually, they did some time talking across all our regional businesses talking to, hospital CEOs down to, hospital catering staff, trying to understand what was important to our people at Ramsay around sustainability. And so that's where 'Ramsay Cares' came from, and that's where, you know, there was. Obviously key issues around waste, climate, all those areas looking after our own people, mental health those key issues came through. So that's really where 'Ramsay Care' started. And then my role was created as, as part of that. So it's really, it's really been the executive and the board listening to our people is how I would say.

David Cummins: 6:16

Wow, that, very impressive. I know through my research in sustainability healthcare, I think the statistics are about 75 to 80% of staff always wanna be part of the solution, and they constantly see opportunity for improvement in their hospitals, but it's very hard to make the change. So it's a very clear example of the research proving that, you know, the users want to be part of that change and the executives being able to implement that change, which is very rare, but also, very humbling to to hear I suppose.

Siobhan Leach: 6:46

Yes, there's, again, there's still plenty that people wanna do out in their hospitals, but, you know, we're trying, we're doing our bit.

David Cummins: 6:54

It's very impressive, and you, you touched base before on your single use plastic removal which is very impressive. I assume that's things like water bottles, everything down to pharmaceutical medication holders. Would that be correct?

Siobhan Leach: 7:08

Yeah, so there's a range of areas they first started in, like the non-clinical space. So, you know, cuttlery, straws, medical cups for your tablets and those sorts of things. Some of the exciting. That they've been focusing on. You know, piloting across a few hospitals is the rigid containers to replace Steri wrap in our sterilisation process. So there's some really good initiatives that as they prove themselves up, hopefully we can roll out at scale. But, you know, all these things need a lot of thinking through and understanding, you know, the implications of that. But a lot of that's been led by, you know, really dedicated people on the ground, you know, CSSD, staff who've really sort of led the way and help design the solutions. So that's really exciting.

David Cummins: 7:56

And would that also include throughout the supply chain procurement where some of your suppliers have to use, specialist plastic or, It's pretty much at the moment it's contained within Ramsay.

Siobhan Leach: 8:07

Yeah. At the moment it's been more focused on the things that we can swap out or change. Like sometimes it might be totally removed, so we were giving out a lot of water bottles, that's for sure. But now we've gone back to jugs and, and that has meant we've had to put in capital and put in more washing machines and there is a labour . Issue. in. terms of more staffing, but it's been a really positive initiative. In other areas, we're really starting to work with our suppliers around, you know, we require 80, you know, by 2026, we wanna have 80% of our spend. The supplies that make up. That to have an independent sustainability assessment. And so that's really the starting point for us to have that conversation with our suppliers around, you know, a whole range of issues, you know, from modern slavery through to, you know, our carbon emissions, our scope three emissions. So there's, yeah, there, we, we are trying to put a lot of the foundations in place so that we can then get into a more mature discussion with our suppliers in this space.

David Cummins: 9:08

Yeah. Yeah, it's very impressive. You touched on before some of the resistance for change being a financial resistance where it does sometimes cost a little bit more money to create a more sustainable change. What are, what are some of the other challenges that Ramsay have faced in implementation of some of these changes?

Siobhan Leach: 9:25

Yeah, when it comes to things like waste, actually the biggest challenge is having space in your loading dock for extra bins. You know, we can put as many bins as you want and separate down to a degree, but if there's no room in the loading docks, you can't do that. So there's some sort of logistics and, and space challenges, so that's why it's really important to design these things. In. but overall, I guess it's making sure we are thinking about things from a whole-of-life cycle perspective rather than just, a short term, CapEx, assessment. That's probably the challenging part, you know, I'm sure everyone has that challenge.

David Cummins: 9:59

Yeah. agree. you also just briefly touched on design where you mentioned that loading dock, which we've all been on a loading dock that doesn't have the capacity to. You know, achieve the operational functions of waste management and procurement and deliveries. So in reference to the design of a hospital, at what point does sustainability get involved? Is it during initiation, during the early phases of design or more than later phase?

Siobhan Leach: 10:25

Well, I think we understand the need to bring it in earlier, and we are working with our development team about how best we do that. You know, I don't think we have all the solutions on that one yet. And, and it also comes down to yeah, some of these things were designed quite a while ago and they're still, you know, yet to be. You know, built or so whether you can go back into these designs and change is a challenge, but I think obviously we all recognise that the earlier you can get in with these requirements, the better.

David Cummins: 10:58

Yeah. I a hundred percent agree. A lot of research shows, even with way finding and sustainability, the sooner you get in the conversation and if you make that your KPI and your Target, the easier it is to create and design the hospital based on everyone's KPIs and everyone's goals. And especially if sustainability is a goal, whether it be the CEO or the designers or the sustainability team or the the nurses, then it's a much easier hospital to build and design around knowing that everyone's got that goal in mind.

Siobhan Leach: 11:28

Yes. And I think it's a challenge, you know, cause most of our developments would be, you know, extensions to existing facilities, you know, and, and I think if you're starting from a brand new Greenfield site, it's a different conversation as well. So I think these are the challenges that I think the whole sector faces, to be honest.

David Cummins: 11:47

Yeah, I agree. What do you think some of the best teachings are from your personal career and also your work at Ramsay? Other people could learn from?

Siobhan Leach: 11:56

I think well from my career over time, I guess for me being in sustainability, it's a pretty exciting and sustainability at the moment. But in over the past, you know, decade, you had to be pretty persistent and, and stick to your principles when there's so many. You know, positive conversations. So understanding that sometimes it's just not the right time for these initiatives. And then actually you can go back and revisit these later and, and it becomes the right time. So I think that's a big story for sustainability. At Ramsay. I think it's been, for me, it's just been a very positive experience. People really wanna help, you know, they are people who care for people and they people are very motivated to do the right thing and, and try new ideas. So I think listening to the people on the ground and making sure, you know, their voices are heard in, in how you design these solutions is really important.

David Cummins: 12:51

Knowing that the sustainability industry has been slow to start in comparison to the rest of the world, and those people in the sustainability industry have been really, really challenged over the last few years to get their voice heard. What do you think some of the improvements that other hospitals could be making right now and that they're constantly getting wrong when it especially comes to operations design rollout of new hospitals and refurb of hospitals?

Siobhan Leach: 13:18

Well, that's a very big question. David. I think an issue is is that people are used to saying no to sustainability initiatives and I think in more recent times, there's an appetite to do these things and, and bring them into projects but, everyone's mindsets might be, 'oh no, we won't do that'.... But so I think you have to challenge the status quo because I think the appetite is there now to make a change on, on these areas. So things that might not have got up 10 years ago will get up now. And I, I think that's across the board when it comes to, you know, from design of hospitals through to operations, so things that might have been tried in the past will have their, you know, their golden age now. So, so go for it.

David Cummins: 14:03

Yeah. I think also the, the people in charge now, the people, the decision makers are 10 years older than they were, you know, 10 years ago, and they're that younger generation and the more-educated generation around sustainability and there's a lot of research now that just didn't exist 20 years ago, especially in health design. Especially in health sustainability, that what was a maybe without much evidence is certainly now a definitely with a lot of evidence. And that has proven even with climate change, where there were the naysay, but the research is irrefutable now. So I do think research has had a lot to do. With that change as well. And when you've got strong governments around the world leading the way it, it makes sense for, you know, our industry to follow as.

Siobhan Leach: 14:50

Yeah, and I in every industry being data-led is really important. Being data and customer-led is super important. So you're, right now we have the data on a lot of this stuff, but there's still lots of things out there where we don't have the data. There's a lot more to do particularly. around climate, around scope re emissions, trying to, you know, move beyond estimating your scope three. So actually, you know, being able to get hard data from your suppliers is an area that will evolve as well. So, this is not, done and dusted. Now this is still an involving still lots of areas that need to be improved on.

David Cummins: 15:24

Yeah. Yeah. I hundred, a hundred percent agree. You are currently part of the Australian Health Sustainability Committee, which is a very passionate bunch of people who are leading the way in sustainability and helping reduce the carbon footprint. Within the Austral healthcare sector what was, what were some of the reasons why you chose to join the AHSC, and what would you like to achieve out of being part of the committee?

Siobhan Leach: 15:46

I think, again, being part of the change for the, in the sector, and I think there's lots of really good design ideas out there, but they need to be brought to life through, you know, Organisations like my own. So part of it for me is also learning to see what's best practice out there and what we should be aiming for. But also to make sure that sector moves together, you know, because it's hard when you are the. You know, moving on your own. So we do wanna see everyone move with us on sustainability in the healthcare sector.

David Cummins: 16:21

Yeah, I agree. The, the benefit of benefit of the ah, HSC is we've got people literally from around Australia, all experts in their field, whether it be construction, design operations, models of care development, and everyone has this common goal and common passion to try and help reduce the carbon footprint of Australian healthcare, and everyone approaches it very differently, but that common thread that we have there is certainly a good uniting front for all of us. And then as we move forward as a team, it will certainly help not only us, but also Australia, but hopefully the private and public sector as well. So what would, have you been in this industry for several years yourself? What would be some of the things that you would like to see in the next 10 to 20 years in this sector?

Siobhan Leach: 17:04

I'd really love to see, more than, you know, what is Net Zero? What is the net zero hospital? You know, there, there is a few examples out there around the world, but really starting to see that come to life generally in the market. How we do that effectively from an existing facility perspective as well. There's loads of opportunities, particularly around moving to more renewable energy in terms of helping to reduce the impact of hospitals from a scope one, scope two perspective. So there's really good opportunity there, but seeing the whole sector move on, that would be fantastic. And the consumables, I think the waste and consumables is the biggest challenge for the sector. And, and how we solve for that. But whilst maintaining high quality patient care is really, you know, it's re that is a big challenge, I think.

David Cummins: 17:58

Yeah, I, I agree. I'd love to see Australia's first carbon-neutral hospital. It's something that I think a lot of people have a vision for, and I think we're getting close, but hopefully it does happen in the next few. And finally, before we go today, what would be one of those take home messages for people in the industry and in the sector who are trying to make a change?

Siobhan Leach: 18:18

Yeah, small changes make a big difference in the sector. I would keep coming back to that. Small changes because it such a big sector. So if you can make those small changes, which you might might not be making a difference, but when you add them up across all those hospitals and all those healthcare clinics, it does make a big difference. And to, yeah, just don't let perfect be the enemy of good. Just keep going. You know? I think we just need lots of passionate people to really drive change in the sector.

David Cummins: 18:46

Very wise words, and thank you very much. Thank you so much, Jovan, for your time. It's been a pleasure talking to you.

Siobhan Leach: 18:51

Great, thank you.

David Cummins: 18:53

No worries. You have been listening to the Australian Health Design Council podcast series, Health Design on the go. If you would like to learn more about the AHDC, please connect with us on our website or LinkedIn. Thank you for listening.



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