Reflecting on recycling in hospitals

The Recycling Renewal Program, implemented in hospitals and residential care sites across the Lower Mainland between 2010 and 2016,  is preparing itself for a next phase.

The program is now in place, but sustainment of the program over the long term depends on where we focus efforts to move the program forward. In particular, we want to reduce contamination of the recycling stream and increase education and communications about what can and can’t be recycled. Here are some learnings that are helping us shape future actions:

  • Some clinical customization is necessary: signage and educational materials don’t adequately represent clinical waste items. Also, the discontinuation of soft plastic recycling was disheartening for clinical staff because medical supply packaging makes up the majority of their waste.
  • On a practical level, all waste types need to be consolidated: connect recycling education and communication efforts with garbage and biomedical waste efforts so that staff have all waste info at hand.
  • Increase ownership and accountability for the recycling program at the hospital level: the recycling program is often considered someone else’s responsibility, for instance, housekeeping. Although, housekeeping plays an important role in ensuring the containers are in place and that waste is emptied regularly, it is the generator of the waste (health care staff) and the decision they make when disposing of an item that impacts contamination.
  • Recognize that recycling is not always possible in health care: patient care comes first in many situations: ICU and emergency situations, waste from isolation room patients is all considered garbage or biomedical, and processes that put infection control first.
  • Continue to make recycling a priority: recycling and materials reduction is repeatedly considered the top environmental priority for front line staff. Moreover, we’ve heard that satisfaction with recycling is key for engaging staff further in greening the workplace.
  • Improve key messages: staff respond positively to understanding “why” they can’t recycle certain items. It seems to be the hook that’s needed to educate them what is and isn’t recyclable.

Sharing learning from a group reflective process

8 months into a strategic framework refresh process, my three “collaborators in crime” and I decided to undertake a group reflection on the process.

Background: the aim of the refresh was to take a strategic framework that talked about sustainability without much consideration for the sector in which we worked, to one that better connected healthcare to sustainability, simplified our work for stakeholders, facilitated their engagement in our work, and was up to date in terms of sustainability practice in other sectors.

The group: 4 team mates (including myself) volunteered to take on the strategic framework refresh on behalf of our team. No one asked us to do it, and it certainly wasn’t a part of our job descriptions. But, we all felt it was important for the success of our team and the implementation of sustainability across the organization. We did have the go ahead from our Director.

The purpose of the reflection: we didn’t want to reflect on what we had refreshed in the strategic framework, but rather, on how we had come together and worked to create it. A formal reflection was important because the process had been largely ad hoc and self-driven in the sense that we set our own deadlines and determined the path along the way.

Why reflect on the process? For me personally, I knew that it was time to touch base with my fellow collaborators because I was starting to lose steam and interest, and I thought that some of my colleagues might be in the same boat. I also knew that if we were going to continue to work well together in the future, it was important to touch base and ensure that we addressed anything that wasn’t working. Admittedly, the need to reflect on how we were doing was overdue (this we realized after undertaking the reflection).

How did we undertake the group reflection?

The process was simple and aimed to create a platform where we could listen to each others experiences:

  • What we liked about our process
  • What we would do differently if we had to do it again

We finished off by identifying what we wanted in the process moving forward.

So why do I feel compelled to share this?

The process of group reflection helped me reconnect and see the process through my colleagues eyes and experiences. I was able to gain a new appreciation for the process, as well as, identify some of the key aspects of successful collaboration.

So here are some of these learnings:

What we liked about the collaborative process:

  • strong team approach
  • new understanding of each other’s roles and challenges
  • approach to meetings was fun and informal which allowed us to build personal relationships, rather than just professional ones
  • everyone brought something different to the table (fresh eyes and perspectives) which created stronger outcomes
  • strong sense of optimism for what we can accomplish working together

Key things to do differently moving forward:

  • more clarity and formality on allocation of roles, including how strategy should be included in all members of our teams work (in other words, greater engagement with the broader team).
  • since we were all busy with our regular jobs, spend more time at the end of meetings determining how best to distribute follow up tasks so as not to overload any one member.
  • periodic reflections about our engagement levels and creation of opportunities for re-engagement
  • importance of recognition from the team director for work done voluntarily and formal inclusion of work in job descriptions.

Side note, and to end this post…

As I mentioned above, the reflective process helped me understand some of the key aspects of successful collaboration. Successful in the sense that we worked together effectively to create a great outcome.

In hind site, unlike a lot of the collaborative processes in our organization, the process of refreshing our strategic framework was entirely bottom-up and highly creative (we were given confidence and freedom to get the work done how we best saw fit with in deadlines that we created for ourselves). It wasn’t until I was tired and stressed from feeling that I didn’t have enough time to dedicate to my regular job and this process, which I had volunteered to do, that I started to lose steam. I also started to resent what appeared to be a lack of recognition for our hard work.

So when asked by our Director: would it have been as successful if it was lead by a manager in a more formal structure? My answer: I am not so sure…

Freedom from deadlines and pre-determined actions and outcomes allowed us to explore ideas, get creative with complexity, and come up with great ideas (this doesn’t mean that we didn’t have clear action items after every meeting, just that we didn’t know what exactly the pathway to our outcome was going to be until we moved through it). So then, perhaps letting things happen is also key to success. It reminds me that things are not always linear, but rather fluid, circular and sometimes chaotic. Interesting that we often consider this to be unproductive…. and that’s not necessarily the case.






Sechelt Hospital – Improving quality of care & social and environmental sustainability

2013 renovations and an expansion at Sechelt Hospital were recently awarded for social and cultural integration, as well as, improved clinical environments.

“The project evolved from the ambition to create a meaningful and supportive environment for all staff,  patients and visitors, reflecting the place, culture and people it would serve.”

Good practice initiatives included:

  • Extensive consultation and collaboration with healthcare providers and First Nations
  • External architecture inspired by First Nations traditions
  • Interior designs created to support community integration and connect to nature for optimum health and well-being
  • Maximum use of daylight and patient rooms and inpatient areas with views and windows that open and close
  • On-site respite gardens for patients and visitors
  • A climate specific landscape plan that eliminates potable water for irrigation
  • Design that prioritizes passive and low carbon strategies for energy: natural light, high efficiency glass and framing fenestration, solar shading and operable windows.
  • Design flexibility to allow for future growth of the hospital

“Both the design team and Health Authority believe the best way to learn is to engage and communicate. Health and well-being are often dependent on strength of community, thus engaging occupants and stakeholders to inform design was essential to the success of this project.”

Full article seen can be seen in SabMag.

Why hospitals are making us sick

I had the pleasure of seeing Robin Guenther, author of Sustainable Healthcare Architecture, speak at Clean Med 2015.

Here is an earlier version of her excellent keynote at TEDMED 2014.

It’s eye opening to listen to Robin’s thoughts on how the US has created a “sick care system” that has been caught in an industrial paradigm for the last 70 years:

“The Texas Medical Center is the largest in the world… With 106,000 employees at 54 institutions, co-located on 1.5 square miles. This is a 20th century industrial system. Like agriculture, chemicals, or fossil fuel energy. And like those systems it creates waste, some dismal work environments, and a load of externalized impacts. The inconvenient truth for all of us, is that it [healthcare] contributes to the problem it is there to solve.”

Robin talks about the environmental and health impacts:

“Healthcare is energy intensive…While we seek to perfect our antiseptic care environments, we dump pharmaceuticals in our water, disposable products in our landfills and greenhouse gases in the atmosphere. These all contribute to environmental degradation. And they are all preventable.”

She focuses on changing mindsets to build hospitals that make us healthy:

“The US healthcare system is beginning to wake up. To connect healing the earth and healing people. To accepting and acting on the core notion that you can’t have healthy people on a sick planet.”

“So how do we transform this 20th century model? And move from a system that delivers health care, to one that creates actual health.

“Restorative design is about moving from so-called solutions that degrade health and the environment to true solutions that do no harm and heal some of the harm we have already done. It’s about finding solutions that stop making us sick.”

“Right now the environmental and health costs of our healthcare system are not transparent.”

“Whether you are outside or inside of a restorative hospital, it is always healing.

“It is not money that stops us, it is mindset. The reason we don’t do these things…it’s because sometimes it’s difficult to see the harm, and, sometimes, it’s more comfortable to design the way we always have.”

So much of what she says resonates with the environmental footprint of health care in Canada, and around the world. Of all buildings that have environmental and health costs, it is ironic that this is the very place we go to when we are sick.

What attributes are necessary for creating a collaborative work environment?

photo 4I recently participated in a Group Methods Facilitation Course run by ICA. The last activity gave me the opportunity to facilitate a Consensus Workshop around the question: What attributes are necessary for creating a collaborative work environment?

I was thrilled not only by the richness of the responses (too good not to share), but also, by the diversity and similarity of responses. This last part sounds like a contradiction, but, what I am really trying to get at is, even though we all come from different workplaces and backgrounds, and have different roles and responsibilities, we still have common needs, goals and interests!

Here is a quick overview of what I did with the group:

1) I asked everyone in the group to come up with  6-7 responses to the question and write them on a piece of paper.

2) Then I asked them to share the ones they were most passionate about, and I placed them up on the board so that everyone could see.

3) As a group we clarified anything that wasn’t clear and grouped those that were similar.

4) Then I asked the group to share the rest of their responses and we continued to create groups or add them to existing.

5) Lastly, we decided on a summary name or phrase that best described the responses in a category (in another words, a consensus answer to the question!).

In the end we had 6 different categories of responses. We summarized these as the following (I have included a few of the individual answers under each of the six categories so that you get an idea of the individual responses):

  1. Team support
    • Help team members as needed
    • Best practice database to share resources
  2. Framing the work
    • Create work plan
    • Define roles and responsibilities
  3. Building staff rapport
    • Informal conversation spaces
    • Opportunities to “walk in my shoes”
    • Chance to come together and have fun
  4. Common goals
    • Annual team goal setting workshop
    • Specific goals and outcomes
  5. Shared vision of success
    • Shared expectation of what “success” looks like
    • Collaboratively create a way to measure success
  6. Consistent communication
    • Regular team meetings
    • Include everyone in dialogue
    • Formal conversation spaces

This is the result in a short amount of time (20mins) with a group of people that work in totally different work places. I am looking forward to trying this with my colleagues.


Highlights from the ICA Group Facilitation Methods course

I just completed ICA’s Group Facilitation Methods course in Vancouver.

I was pretty excited to finally get some theory behind all of my experience. We worked on two methods in particular:

  • Focused Conversation Method
  • Consensus Workshop Method

Some of the highlights of the course included:

Use of an installation to demonstrate the focused conversation method (basically using Objective, Reflective, Interpretive and Decisional questions to guide conversation around a question/subject/event/issue). Not only did I get to experience being part of a focused conversation audience, but, I was able to see value in how installations can demonstrate diverse thinking/experiences amongst a group and inspire profound/creative thinking around future actions/take aways.

photo 2 photo 3









Toys (?!)

Each table had a basket of toys accessible to participants during all times. In the beginning, it was a mystery if we were able to do something with the toys or not. Most of us chose to leave them alone, however, after awhile we realized we had permission to play with thems. On the second day I indulged. However, I felt a bit embarrassed after choosing toys that made noise or created a distraction while the facilitator was speaking. In hindsight, I believe the toys were there to create a playful setting, and perhaps to keep us busy when we finished a task earlier. However, I am not totally sure. I will consider using baskets of toys in future workshops, but I would limit any toys that make noise.

photo 3









Practicing the Consensus Workshop Method:

Practicing the Consensus Workshop Method in small groups resulted in some really rich information about Collaborative Work Environments and How to Contribute to Individual Health and Wellness. An individual brainstorming session on these topics lead to collaborative categorization and naming of our ideas. We all felt like we had achieved some really practical insights. For instance we identified that the following can contribute to individual health and wellness:

  • Celebrating work and life (balance, recognition of successes)
  • Incorporating break time into your life (time for yourself)
  • Body care (exercise/meditation)
  • Putting joy into your life (have fun and do things you love)
  • Reflection time (journalling, “tech” turn off, mental health time outs, positive people, express feelings)
  • Rest and recharge (lots of sleep)
  • Fuel yourself (good food and beverage)

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Qualities for relationship building and collaboration

I have been doing a lot of thinking around relationship building and collaboration. In particular, what qualities make someone a good relationship builder or collaborator. Here are some of my ideas:

  • Humble: ability to put one’s ego aside, receive feedback on their ideas, and hear opinions different to their own.
  • Open minded: ability to ascertain diverse solutions to a problem and avoid quick judgements.
  • Curious: ability to ask questions to find out more about others opinions, interests and contexts. Avoids making assumptions about a situation or other.
  • Good Listener: hears what is being said not what one wants to hear. Asks more questions.
  • Empathetic: ability to put oneself in another’s shoes and understand different perspectives.
  • Perceptive: ability to recognize difference of opinion or understanding about a topic. To recognize when someone feels like they are not being listened to. Or notice when someone has not given their opinion.

Employee engagement brain storm

A co-worker brought up the topic of staff engagement at our team meeting the other day. She is one of the representatives of a team working to increase staff engagement across the organization. The dire news is that only 21% of staff are engaged, 58% not engaged and 21% actively disengaged across the organization (according to a 2011 Gallup Survey commonly used to measure engagement).

Engaged: these employees are loyal and psychologically committed to the organization. They are more productive and more likely to stay with their company for at least a year.

Not engaged: These employees may be productive, but they are not psychologically connected to their company. They are more likely to miss workdays and more likely to leave.

Actively disengaged: These employees are physically present but psychologically absent. They are unhappy with their work situation and insist on sharing this unhappiness with their colleagues.

She asked us what we thought about engagement, and what are some of the issues around engagement.

An interesting discussion followed, including everything from engagement theory and practice, to humor. I thought I would post a few of the thoughts that came up:

  • There is a spectrum of engagement…not everyone engages in the same way, for the same amount of time. Those details can be important when considering priorities, current levels and goals for future levels of engagement.
  • There are different types of roles in engagement. For example, some people are listeners while other play more a proactive role. It was even mentioned that one of our co-workers tasty treats (cakes and baked goods) provides the social context for other employee engagement.
  • It is important to consider the barriers and challenges to engagement that exist. For example, often we try and engage staff with out all of the necessary support/infrastructure in place to really allow them to fully engage (take action). Or that some disengaged staff may have personal challenges going on in their lives that do not allow them to be engaged at work. For example they are struggling with depression and personal problems outside of the workplace.
  • Interest in engagement can be sparked by different types of opportunities. For example, someone really concerned about the environment at home, might be interested in becoming a sustainability champion. Also, our engagement efforts often land on the already converted. It is important to think about how to reach those hard to reach groups.
  • Engagement is directly related to how you use your discretionary time. We all had a good laugh at the idea of having discretionary time in the work place. But, it is true that engagement requires devoting time for tasks beyond ones immediate responsibilities.

Entrevista con Luis Chavez – EcoAldeano

El hombre:

Luís Chávez, de 50 años, amigo mío desde el 2004, amante de Jacques Cousteau, parte biólogo, parte oceanógrafo, con título de acuicultor. Los que lo conocen en la ciudad, saben que es profesor de inglés, matemáticas, o Director de Programas Internacionales. Lo que no saben es que previamente fue exportador de peces para acuario e instructor profesional de buceo submarino.


Quería hacer una maestría en Recursos Marinos Costeros Sostenibles pero se tuvo que “aguantar” una de Alta Gerencia. Finalmente, después de un intento final de aprobar el tema de Emprendimientos Sostenibles para su tesis, cambió de idea, y empezó a enfocar su vida hacia el campo, en un terreno de su propiedad que hoy quiere convertir en una Eco-Aldea*.

Ubicada en la Comuna Dos Mangas, provincia de Santa Elena, Ecuador, la eco-aldea de Luis tiene 3.6 ha. El terreno fue inicialmente comprado en el año 2000 con el objetivo de construir una hostería con cabañas para alquiler.

Fue el sueño típico de muchos ciudadanos urbanos: tener una casa de campo con caballos y alquilar cabañas para ganar un poco de dinero extra. Sin embargo, Luis aprendió bastante rápido que este sueño no era sostenible.

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Emotions and Sustainability

Lately, I have been hearing a lot about the importance of working with emotions in sustainability.

In particular, that sustainable development depends on one’s emotional capacity to deal with the impacts of climate change and other difficult socio-cultural and environmental disasters. In other words, we need a sort of emotional resilience to be able to stay positive, pro-active and deal with climate change.

It has made me reflect on some of the typical reactions we have when we hear about the uncomfortable realities associated with climate change and other impacts:

  • ignorance – the facts are wrong!
  • depression/negativity – what can i do if it is already too late?
  • apathy – doesn’t affect me!
  • fear – head in the sand…another type of ignorance

These are reactions that make us freeze, and not do anything; continue as always and hope the issue will go away.

So what will help us be pro-active and take responsibility for our own actions?

Could it be emotions or being emotional? In other words, recognizing our emotions, accepting that we are emotional beings, expressing our emotions and working through them and supporting others to do the same.

Based on my previous experiences in sustainability, I do believe that there is some truth to this theory. There is a very personal piece of the sustainability puzzle that is related to a person’s beliefs, culture, and values. These some how shape our experiences: thoughts, feelings, wants…etc.

“Changing is not just changing the things outside of us.” Thich Nhat Hanh

I do think there is something key in the above quote… a need to look inside, in particular, about what is going on for me right now in my life, what do i really feel when i hear about negative impacts, and how does that make me act/react. What is it that motivates us to take action?

The root of the word emotion is to move. So perhaps emotions do have the potential to make us move and act for a more sustainable world.