Lauren Koch - How Change Actually Shows Up in Patient Rooms

[00:00:00] Adam: Hello and welcome to Green Champions.

[00:00:02] Dominique: Thanks for joining us in a conversation with real people sharing sustainability success stories.

[00:00:07] Adam: From entrepreneurs to artists, scientists to activists. This podcast is a platform for green champions to share their stories and plant new ideas. I'm Adam.

I'm Dominique.

Today we are joined by Lauren Koch. She currently serves as a sustainability senior program manager at Mars Veterinary Health.

[00:00:23] Dominique: Mars Veterinary Health is a global division of Mars PET Care dedicated to delivering high quality pet healthcare in service of its mission, a better world for pets. Mars cares for over 10 million pets every year, and they're a part of a family owned business with 90 years of experience caring for pets.

[00:00:40] Adam: Before this role at Mars, Lauren was a sustainability program manager at the Ohio State Wexner Medical Center. In case you missed it last time we talked to Lauren about her career journey, how she got into sustainability and some of the ways of making strides in sustainability in healthcare. I really loved how she was able to speak up and ask for advice from professionals and kind of carry that ethos forward.

So today we're talking about sustainability as it relates to healthcare. Lauren, welcome back.

[00:01:07] Lauren: Thank you. Thanks for having me.

[00:01:09] Dominique Hadad: So Lauren, start us off by just talking about what you do right now. What does the sustainability manager at Mars Veterinary Health do?

[00:01:15] Lauren: So, as a sustainability manager, I'm part of a sustainability team and we are working towards Mars net zero goal. We're working on waste reduction goals and biodiversity and nature goals with a focus on responsible pharmaceutical stewardship. So, happy to get into what the heck that all means.

[00:01:36] Dominique: Just a quick question on that. Do you feel a difference? I know we talked last time a little bit about like how different and similar, your work from Medical Center to veterinary health has been. But just 'cause you mentioned biodiversity, do you notice a different conversation around biodiversity from an animal centric organization? 

[00:01:53] Lauren: Absolutely. That was not something that came up. That is a very different and unique.

[00:01:57] Dominique: I hear that far less in like a average medical center environment. So I was like, wait. That's cool.

[00:02:02] Lauren: So you just think about veterinarians, right? How purpose driven they are, how much they care for animals, how much they care for ecosystems. And biodiversity is a top concern for them. Their number one concern though, waste and recycling. But we really, there's a ton of great surveys that have come out recently, we're internally surveying. But this is how we're trying to structure our work around is like, what do our associates care about? 'Cause we actually have 70,000 associates worldwide. Yeah. 

[00:02:32] Dominique: What exactly is biodiversity in the veterinary world? Like what does that mean?

[00:02:37] Lauren: The way that we are starting to define it, 'cause this is a new space, is thinking about two different ways. So one, is we own or we lease clinics and property and how do we do pollinator gardens in native landscaping or be in bug hotels. Yes. Some of our clinics have this.

It's so cool. So it's all about like, how do we use our spaces to support biodiversity in our native landscapes. And then the second way we really think about it is what we output into the environment. So if we think about our pharmaceuticals, which is very similar to medical center. How are we properly disposing of them? Are we making sure to not flush them down the drain and think that that's a way versus making it into a water stream, right? Or even beginning to think about just the medications that we prescribe and the impacts on biodiversity in the natural world.

[00:03:35] Dominique: It sounds like accountability in terms of like the footprint you have on the community and the effects that might have for biodiversity, but then also thinking about the fact that you have like physical facilities that are in communities.

[00:03:47] Lauren: And we have this opportunity, right, to make it more beautiful and have this impact.

[00:03:52] Dominique: A mental image that brings up for me is, there's a hotel, I'm blanking on the name right now, but there's a hotel that has like a rooftop that like is a bee sanctuary and it's like brought back the, I think they're in a community that was like really struggling with their like bee survival rate. And they like brought back the community by having this hub on top of the hotel. But just like a cool use of space which sounds, that sounds like the right vein.

[00:04:15] Lauren: Yes. Exactly. How do we maximize the spaces that we're in across our clinics?

[00:04:21] Adam: Well now what does it mean to advocate for sustainability at Mars? Like what sort of projects are you doing the most? 

[00:04:26] Lauren: Oh, recycling waste projects for sure 'cause as we talked about that's the number one thing we hear from associates. So this is anything from just making sure, like, does that clinic have a recycling program or a compost program? And then we're testing out recycling programs we talked about in the last episode about the mail back.

So because these are smaller clinic footprints, they generate much less waste than a human acute care hospital and a mail back program is really a good fit for them. And what we're hearing is they're just so grateful to have somewhere else to put that plastic other than the landfill. 

So that's one of the biggest places I think that I'm spending my time, and not just on recycling, but how do we help them avoid waste in the first place, right? So, we're looking at moving to reusable sterilization tins as one of the examples. So instead of wrapping instruments and human healthcare does this, so Ohio State was doing this even before I joined. Instead of wrapping them in this blue polypropylene wrap that maintains that sterility on its way from being sterilized to the procedure, they have these stainless steel tins that they can put them in, and those can be washed and used up to 10 years of life. So it avoids the waste in the first place, or looking at reusable gowns instead of disposable gowns, that kind of thing.

[00:05:48] Dominique: You mentioned how you advocate for waste. You mentioned how you advocate for it for biodiversity. Can you give us a mental image of what it means, like for net zero? What would those activities look like? 

[00:05:57] Lauren: Well, we are already partially on that journey. So for all of our clinics in the US and UK, we source a hundred percent renewable electricity for those clinics. So that's part of it, right? First is ideally we're reducing the footprint, so installing LEDs, putting our clinics on automatic occupancy sensors or a system that's gonna reduce our energy use, and then sourcing renewable electricity and eventually sourcing renewable natural gas thing, things of that nature.

So that's the scope one and two, that's the big chunk of net zero. The other scope one that's very unique to healthcare and something I worked on at Ohio State as well, is anesthesia gas. Anesthesia gas is a greenhouse gas emission. And different anesthetics have different global warming potentials. So something called Sevoflurane has a global warming potential of 130 times carbon dioxide all the way up to Desflurane , which has about 2,500 times the global warming potential of carbon dioxide. So the more you can move away from those higher GWP anesthetic gases and the more that you can use less of them.

So there's a new practice, and I'm not a clinician, I leave this to my anesthesiologist, but there's a practice called low flow anesthesia or lower flow anesthesia. So again, kind of the same idea of energy efficiency, use less energy and then use better substitutes. And then finally, we're testing a new technology in our UK businesses to capture and recycle and reprocess that gas.

So that's the net zero journey for scopes one and two. 

I wanna pivot a little bit into your previous role to medical center and what that looked like, what your biggest success has been. So maybe starting there, what was your role when you first started? And just kind of what that environment was like?

I was a sustainability program manager and doing many of the same projects that I am today. It was anything from supporting the energy efficiency work that I think other guests probably have talked about, right? NG has this performance contract on Ohio State's campus. So it was figuring out how to support NG to do, to get in and have access to LED light swaps that they needed to do. Or looking at new energy conservation measures that they wanted to proceed with.

It was working with our environmental services on loads of recycling projects. It was employee engagement. So you helped a bit with the green team. The green team was a big chunk of that time in a really engaged group of passionate associates. So designing events around Earth Day or education. And then we also had something called the Sustainability Council. So we would bring in kind of the operational leaders on a monthly or quarterly basis and talk about the various projects that they were working on, how we could support them. On our last episode, we talked about grant writing. So I did a bit of that to get funding to do some of these projects.

[00:09:01] Dominique: What was the biggest success you had or the most impactful project you got to work on at the medical center?

[00:09:08] Lauren: I think it was probably, I mean there was a lot that I could pick from, but I think to like stick in the sustainability and healthcare and very unique space. We did a transition right as I started, actually, they had just signed the contract, so I didn't have to make the pitch to do this. They had decided they were gonna do it, but I actually helped implement it and that was to move to reusable sharps containers. Have either of you ever heard of such a thing?

[00:09:35] Adam: What's a sharp container to begin with?

[00:09:37] Lauren: For needles. Yeah. And other pointy things. Perfect description, Adam. 

[00:09:43] Adam: Can you tell, I started off in the medical robotics world? 

[00:09:45] Dominique: I was I gonna say. You've never picked up litter, worked in the lab or worked in a clinician's office?

[00:09:51] Adam: My, my career started doing knee surgery, hip surgery. With medical robots in the operating room. Yep. 

[00:09:57] Dominique: Oh, I didn't know that. 

[00:09:59] Lauren: So he can picture the sharps container that I am talking about. 

[00:10:04] Dominique: Okay. You do know the Sharps container very well. 

[00:10:05] Lauren: In every OR, in every patient room we had. I think, if I remember correctly, over 3000 sharps containers across Ohio State Medical Center. And so the job was to figure out how do we transition this to a reusable sharps container. Now, these sharps containers, instead of buying them, having to figure out how to move them logistically around that, over 1 million square feet, and then taking that sharps container and then either, depending on what was inside, sending it to be autoclaved or incinerated. Now that sharps container is managed by a third party, so they are responsible for picking up and replacing those sharps containers as needed. And that sharps container can be used up to 600 times. So the amount of waste that you avoid just in our first year alone.

[00:11:04] Dominique: And purchase orders, I imagine.

[00:11:05] Lauren: Oh, and purchase orders. Yeah. So it's this is like getting back to that cost savings. This is cost savings, labor savings, and then waste avoidance. So it was like 70 tons of waste every year avoided.

[00:11:17] Dominique: Did these containers stay on site or it was like a returnable?

[00:11:21] Lauren: So the third party would go and replace them as they became three quarters full or a nurse called and asked for them to be replaced and then they took them offsite to be treated reprocessed, right? They like have robots that dump out these reusable sharps containers and then they sterilize the sharps containers so then it can go back into use. And then they treat the waste that was inside it and do what they do.

[00:11:44] Dominique: What percentage do you think of medical centers would have programs like that? Like how novel is this initiative? I know it's not a number you would have just in your head. 

[00:11:53] Lauren: You know who would actually have this is Practice Greenhealth. They have, at least from the people who submit data to them. So they would have a portion of this. My guess is half. It's not necessarily a cutting edge idea. I think I bring this up as the project to share because it sounds easy enough. Guess how long this took?

[00:12:16] Adam: How long did it take?

[00:12:17] Lauren: It took almost two years because, all of our sharps containers, most of their sharps containers were on a wall. So they were mounted with a different type of stand. So that mount had to change. Guess what you have to do when you drill into a wall in a patient room? You have to ensure that there's no asbestos in there. You have to ensure that a patient isn't in the room. So you have to coordinate with janitorial services to figure out

[00:12:45] Dominique: Every install?

[00:12:46] Lauren: Every install. So I share this for two reasons. One, it's a really impactful project that I know this sounds bad, but would be hard to turn back from. So, to change it again, would have this long haul of a process to do it. So it's harder to take away than it is a recycling program. And then the other reason I share it is because oftentimes, these sustainability projects sound like they're gonna be so easy. And then you realize there's no easy button, particularly in healthcare. So I think what I would say is persistence is necessary for projects like this.

And then we talked about on the last podcast, Adam, you asked about the like safety and risk versus sustainability, this was a great example of that. Like the amount of coordination that we had to have with our safety and risk teams to approve going into a patient room, going into isolation spaces like this. That's why it took as long as it did.

[00:13:47] Dominique: it's really cool to see because it is so close to that intersection point of sustainability and safety, which I think sometimes seems that the conversation then pivots to, okay, well then sustainability cannot be accomplished here. And I think that it's really cool that you were like, okay, it's a matter of how. And I kind of like the poetic nature, that the harder it is to get the program installed means it's more permanent in terms of like the operations and the processes. because of that hard work you did, it really is going to last.

[00:14:14] Lauren: And also I can remember being so frustrated with the vendor one day of like guys, I just need you to figure this out 'cause I need to get back to the million other things on my desk. And then it turns out when I look back, this was one of the most important things that I did. So I try and remember that now when I'm getting frustrated with a vendor or a stakeholder or just a really hard project, like I have no idea.

I might look back in five years and be like, "Oh, thank goodness that you spent as much time as you did on it 'cause that was the biggest thing that you ended up walking away with."

[00:14:46] Dominique: And your impact numbers are huge. You also hinted earlier that like the scale of the clinic with the veterinary health work you're doing is just smaller waste diversion in comparison to the medical center. Do you have any numbers for the medical center waste to give us an idea of how much?

[00:15:02] Lauren: Well that has been a thing that is very different. Like when I look at, we've done some waste audits at our clinics and I look at the pounds of waste that are produced per day and then annualizing that. We look at tons of waste per day at the medical center. It is astonishing how much is produced. They do daily compactor pickups. It's like 10 tons a day. I mean, it's just a whole other scale. I can't imagine what it's gonna be like with the new hospital opening.

[00:15:34] Dominique: I know I think about that when I look at the building.

[00:15:36] Lauren: I feel for my old colleagues. I'm thinking of you guys. Hang in there. 

[00:15:40] Adam: Well, now a lot of this is often behind the scenes. Like how can the average person kind of feel the impacts of this work? How does it come across?

[00:15:48] Dominique: And maybe especially when they're at a medical facility, maybe like, because we know this is such a shared experience where we go to appointments and things. How can you be like a informed observer?

[00:15:58] Lauren: It's so hard in human healthcare, right? Because we don't have a choice. We go where our insurance accepts us. And so it's tough to tell a consumer look for these things and then go and pick that. We have to go where we have to go.

[00:16:14] Adam: How does it impact them when they're at the Wexner Medical Center? 

[00:16:17] Lauren: I mean, I guess what I would encourage them to do is to look for those recycling bins. Look and see if they're a sharps container In their room is one of the reusables. They can ask their nurse. Look and see if they're using a reusable gown. That's probably the most visible. Everything else is behind the scenes and it wouldn't necessarily touch them or they wouldn't even learn about it. Maybe the best place to learn about it is to go to their website. That was something that I did and I know they're keeping up with is like just sharing what projects that they've worked on.

[00:16:50] Dominique: You mentioned the gown, which is interesting. Was that a hard transition to make?

[00:16:55] Lauren: Yeah, and that, I don't know if it ended up fully transitioning. It was interesting. It came up more out of necessity 'cause it came up during COVID. So when all the PPE shortages were happening, that's when they ended up making an investment. 

[00:17:09] Dominique: But that's a wonderful, resilient aspect of sustainability that, that you have consistent supply of what you need. Would you have to sterilize it with, like, how would that process work?

[00:17:18] Lauren: Typically in human healthcare, you have a third party launderer. And it depends if it's a gown for a exam versus a gown for a surgery. There's different sterilization requirements, but a third party launderer can both wash it and then sterilize it.

I forget what the standard setting body is, but they have standards that they require. And then they also have RFID chips that are embedded in them because those gowns now, they have to look for rips and tears in anything else that shows that the wear and tear on it. But the RFID chip also tells you, oh, this is nearing, its 75 turns, it's time to order another one. 

[00:17:59] Dominique: Oh, and the data on that just sounds so cool, to have that like visibility of what's in circulation and how long and then you can make the monetary savings argument.

[00:18:07] Lauren: Oh, totally. That one is a win-win for sure. And a lot of other healthcare systems are doing this. I know UCLA for sure is one of them. If people wanna learn more about that.

[00:18:16] Dominique: What are all the low hanging fruit when you're like to Adam's question about like being a patient maybe in a patient room. So now you've mentioned the gown, you've mentioned the reusable sharps container. Just like putting for one second, let's, let's imagine we're in the patient room. What else is low hanging fruit?

[00:18:30] Lauren: LED Lights. Cost savings, especially in 24/7 hospitals. If they notice the temperature, right? So if they're keeping it in a higher or lower temperature, depending the season. Anything that is gonna save money like that is gonna be low hanging fruit. I think looking for any signs of recycling or diverting streams, diverting waste streams. Another thing that especially at Practice Greenhealth, we talked a lot about, and I know OSU did a great job on, is reducing your regulated medical waste. So anything you can keep out of the red back waste is gonna save money because that's a much higher cost per pound than sending it to a typical landfill or even recycling.

[00:19:16] Dominique: I like how much you tie these initiatives to money, because I feel like that just helps like send the initiative home in the sense that it's gonna work. 

[00:19:22] Lauren: Reflex. I don't even think about it because that is just what has been trained into me the past 13 years. 

[00:19:29] Dominique: But that's great. I mean, that's why I'm also passionate about it, is like, it just makes sense. Like it's, if you're throwing less away, you didn't buy that stuff. Like why is this an argument we have to have? But

[00:19:38] Lauren: Yeah, even if you didn't buy that thing. That's such a good one. That's one that I think we could all do some better work on is like just even inventory management and or on the opposite end of donation. And we did a lot of that at Ohio State. That was one of my favorite parts actually, was I got a grant and every month or every couple weeks we would like fill a truck of supplies and equipment that we no longer needed and send it to this organization that distributed either to teaching hospitals or globally to clinics in need.

[00:20:11] Adam: So aside from these things that have been trained into you, what's the favorite part of your work that you do? 

[00:20:15] Lauren: I think it's the impact, like knowing the reduction or the changes that we've been able to make in the business of like just shifting to a more sustainable process. Knowing the waste that we've diverted, that's what I think gets me really excited. And then, the people, so, anytime I hear from a champion that they're just so excited that we've created this resource or this easy way to make the more sustainable choice, I'm like, ugh. Okay. Yeah, that's it.

[00:20:44] Dominique: Which was a very nice little echo to the fact that this podcast is all about the same thing of like, it's so cool to hear people really share how they got where they are and what makes them so excited to keep doing it. And it's all also just like very affirming to know that you've also noticed that across organizations that like that is the secret sauce. It's people who are excited, who have their eyes open and wanna do their role, but also be conscious of like what more they could be doing about impact in that role. Looking ahead in terms of your work at Mars and your career going forward, what is next for you or Mars that makes you optimistic?

[00:21:18] Lauren: What's next for me career-wise? I am in a moment of this is just like perfection.

I don't, I'm not looking for anything. I have a great job. I have a great boss and I've got two little kids. I don't need anything more. I don't need anything less. Like I just wanna keep jamming at this. 

[00:21:41] Adam: we're so glad you could be on today. It was really fun diving in both to the work that you're doing at Mars and the work that you did at the Wexner Medical Center. 

[00:21:49] Lauren: Thank you.

[00:21:50] Adam: How can people connect with you or be an advocate for the work that you're doing?

[00:21:54] Lauren: Yeah, just feel free to connect with me on LinkedIn. And I think I said out on the last one, advocate, if you're in Columbus, go to Green Columbus 'cause that's a great organization that you should all be supporting.

[00:22:06] Dominique: Thank you. Thanks for doing this. Thanks for sharing. I'm so grateful. And I think you have really sent home a lot of very interesting ideas, but you also put a lot of examples I think that we're all gonna relate to in terms of like spaces we share. we really don't often talk about how much potential and like optimism there is around sustainability in healthcare. So I'm very grateful that you share that with us. As always, our guests have found a unique way to champion sustainability. We're here to put real names and stories like Lauren's, behind the idea that no matter your background, career, or interests, you really can contribute in the fight against climate change. 

[00:22:37] Adam: You can find our episodes, donate or reach us at thegreenchampions.com. Give us a review and follow us on your favorite podcast platform. Our music is by Zayn Dweik. Thanks for listening to Green Champions. We'll dig into another sustainability success story in our next episode.