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There are a lot of challenges ahead of us in preparation for a CO2-neutral Radboudumc by 2030. What are some of the initiatives Radboudumc professionals have started? In this interview, we follow a conversation​ about current and future sustainability initiatives, and the impassioned colleagues behind them.
Estel Collado Camps, from the Radboud Green Lab Initiative, meets with intensivist Hugo Touw and Intensive Care Research manager Pleun Hemelaar, who are working towards achieving sustainable care next to their busy jobs. They first started talking about this goal a year and a half ago.
Hugo: ‘The nice thing about sustainability is that there are all kinds of networks and initiatives that pop up everywhere. Together with Harriette Laurijssen, the sustainability advisor of the Radboudumc, I’ve started sustainable care meetings, where professionals can meet. We want to make this ‘Netwerk Duurzame Zorgprofessionals’ the place where all these initiatives come together.’
Estel: ‘Before ‘formally’ starting the Green Lab initiative, together with Julie Verhoef, Teun Bousema and Harriette we helmed the Freezer Challenge. We wanted to raise awareness on ways to reduce the power consumption of Ultra Low Temperature Freezers. What are some of the initiatives you are involved in?’
Hugo: ‘At the moment, within the Radboudumc we are building a business case for reusable PPE-coats, which are frequently in use in the units that treat COVID-patients. These coats can be washed. It’s a win-win situation: they’re good for the environment and they’re more comfortable! And they would save us a lot of money and trouble if the disposable Personal Protective Equipment runs out again, driving up the price like crazy. In my experience, people like starting with win-win situations or so called low-hanging fruit. It’s the same with waste sorting – people really want to work towards that. When you sort at home, to then go to work where there is so much more waste and see they don’t do it – people feel that isn’t right and that we can do better. Such intrinsic motivation is needed to make projects succeed.’
Pleun: ‘We first talked about following a single patient through their admission and recording how much waste is produced throughout their stay. How much of this waste can be avoided, and how much is inevitable?’
Pleun and Hugo have also been busy writing a grant proposal: ‘It’s the first call of the Care & Climate round by ZonMW. Our aim is to involve the emergency department and surgical units as well as the intensive care. It’s not a done deal yet – this call gravitates towards fundamental research. But it’s a great message from the government, it shows that something’s happening. There is space for the subject now.’
Their ambitions are larger than their department – achieving sustainable care is not possible without interprofessional collaboration. Estel is familiar with this as well.
Estel: ‘When concluding the Freezer Challenge, we realized we had so many more ideas. We saw the great initiatives you and others are pursuing at the ‘clinical side’, and noticed that there were no specific plans for the ‘research side’. Now we want to create a Netherlands-wide platform (Green Labs Netherlands) to spread awareness about the contributions of research labs to climate change. Wider initiatives with the right support will also help us reach out to manufacturers, providers and transport companies. It’s to everyone’s advantage, so we need to be on the same page to drive change.’
Hugo: ‘We’re working with national research organizations that help us improve the process of buying supplies. How can we package our supplies in a way that they are clean and of high quality, yet still recyclable. We also need to talk to waste disposal companies – we’ve involved Suez – to see if we can negate their fears: materials that have come into contact with blood or cells can still be reused. It’s likely that we start with separating incontinence materials for recycling. On the one hand it’s about using less – on the other about innovation and looking for things to do differently.’
Estel: That’s great! Circularity will be key, and we can’t do this alone. We’ll need lab people, logistics experts, materials experts, companies… And researchers and clinicians might have problems that can be solved in common. Just as in the workplace, we can learn so much from each other. We should not be afraid to learn how to speak each other’s language.’
“We’ve heard of possibilities to clean, sterilize and re-use plastic materials used for cell culture, and colleagues from the Radboud Green Lab Initiative are looking into the possibilities to send back Styrofoam boxes and gloves to the producers. Kimberly-Clark and Terracycle have such a service for lab gloves in the UK.”
Pleun: ‘We also need to talk about ethics. Infection prevention currently causes us to contribute to unsustainable care. If we want to change that, we need to talk about the balance between these two goals. We know from earlier research that climate change could become the largest care challenge of the 21st century. If we can erase our contribution to the problem and work towards a healthier world, we’ll achieve a reduced care workload at the same time. That’s how we’ll achieve a positive feedback loop.’
Estel: ‘In research, ethics is also connected to sustainability. We hear more and more about the reproducibility crisis, about the need for FAIR and safe data, and even about the need for a new recognition system. Better planning of experiments, open sharing of data, and incentives to make sustainable choices would be ethical, good for ourselves, and good for the planet. Of course, it is important to close the gap between our bottom-up initiatives, and the policy makers and granting institutions.’
Hugo: ‘Eventually everything needs to be written into guidelines, to ensure that sustainability becomes another quality aspect that can be tested by inspectors. We have colleagues whose jobs are about improving the quality of care. We need the same for achieving sustainable care.’
Estel: ‘Rules are useful and needed, however just as everything else, they should be updated to fit new times and needs. To do that safely, we need to know more. Having the numbers also promotes trust. Both the Radboud Green Lab Initiative and Green Labs Netherlands have the mid-term goal to quantify the impact of our research activities, and the gains of alternatives. Assessments should include feasibility and safety. For example, probably not everything that is now thrown into the biological waste bins really needs to be there. Indeed, it would be great if new research teams were appointed to do that. The topic is urgent enough to invest professional resources in it. What are your short-term and long-term objectives?’
Hugo: ‘In the short term we hope to improve the sustainability network within the Radboudumc.’
Pleun: ‘If we strengthen the network, we will be able to find each other better – within institutes, departments, and nationally as well. In the long term, we need allocated funds towards achieving sustainable care and research. In that way, sustainability will become a part of normal care, and we won’t be dependent on impassioned individuals who do the work next to their normal workload.’
Estel: ‘That’s what we also envision. But while we set this up, we’ve started smaller actions. That’s the ‘low hanging fruit’ you mentioned. In the Research Newsletter you will find short monthly blogs, reflecting on different aspects of research sustainability. In these blogs we give sources of information, and tips to start right away with positive changes. After all, going sustainable doesn’t have to be uncomfortable or expensive.’
Pleun: ‘We already see so much enthusiasm for the topic in Radboudumc. It’s great to see that so many people are committed and that there is so much support. Now we just have to unite and organize our efforts.’
The Radboudumc is a highly international environment. Know that even if the ‘Netwerk Duurzame Zorgprofessionals’ holds meetings in Dutch, you can reach out in English to them. The Green Lab Initiative communicates and meets in English.
Links
ZorgVoorKlimaat.nl (Care for climate). This website is in Dutch and primarily for physicians. It aims to unite green initiatives and share knowledge.
Follow the Radboud Green Lab Initiative on Twitter, or get involved by sending an e-mail to: greenlabinitiative@radboudumc.nl
http://www.greenlabs-nl.eu/ The webpage of the platform Green Labs Netherlands. Consider it still ‘beta’, but keep an eye on it!
Blog by Estel Collado Camps and Nina Wubben
