Sustainability in Health Care with Virginia Mason’s Brenna Davis

July 22, 2015

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John Shegerian: Welcome back to Green Is Good. This is the GoGreen edition of Green Is Good and we are so honored to be here in downtown Seattle at this amazing GoGreen Conference. Today we have got Brenna Davis. She is the Director of Sustainability of Virginia Mason. Welcome back to Green Is Good. Brenna Davis: Thank you. I’m happy to be here. John Shegerian: I’m happy to have you on. We don’t get to talk enough on this show about sustainability in health care, so to have Virginia Mason on and to have you, Brenna, on talking about sustainability in health care is really important today for our audience members. But before we get talking about that, I want you to talk about Brenna Davis a little bit. You haven’t been on the show yet, so this is your first turn on Green Is Good. Talk a little bit about when did green start becoming part of your life? Your upbringing? College? High school? Who turned you on to this whole sustainability thing? Brenna Davis: Thank you, yeah. Well, I have been doing sustainability work for about 20 years. John Shegerian: Wow. Brenna Davis: I got started in – I was raised in the Pacific Northwest. My family is from here and I spent a lot of time in the forest and in the parks in Seattle, and I really loved nature, and because of that I was more interested in studying the environment. John Shegerian: Really. Brenna Davis: And I went and got a degree in Environmental Science from Huxley College of the Environment, which was actually one of the first environmental colleges in the country and that was amazing. I had great mentors there. And my first job right out of school, I worked in my field and I’ve been doing that for about 20 years. John Shegerian: So you really had it as a part of your DNA growing up, because you grew in this area and you were enjoying and really appreciating the outdoors a lot. Brenna Davis: I did. I did. And I had a lot of mentors growing up. My family really loved the outdoors. My grandfather was an avid fisherman. Both of my grandfathers were avid fishermen. I guess you can’t be in the Northwest and not be. John Shegerian: Yeah. Brenna Davis: So I was around nature my entire childhood and it really did inspire me to want to protect it for future generations so that nature can be there for my nieces and nephews and those that are coming. John Shegerian: You can leave the world a better place. Brenna Davis: Yeah. That’s right. John Shegerian: So we are here today in this beautiful city of Seattle, very sustainable, one of the hubs of innovation in this whole country. You are the Director of Sustainability for Virginia Mason. Why has Virginia Mason chosen to be very involved today at this great conference? Brenna Davis: Oh, thanks. Well, Virginia Mason views sustainability as just integrated into everything we do. Because human health is so linked to the environment, if we don’t have a healthy planet, we can’t have healthy people. John Shegerian: Great point. Brenna Davis: Yeah. John Shegerian: Good point. Brenna Davis: Thank you. So it’s really our mission to figure out how can we reduce our environmental impact and, beyond that, inspire health care as an industry to do more. John Shegerian: And your organization is one of the sponsors here today. Brenna Davis: Yes. John Shegerian: And your boss spoke on a panel today. Brenna Davis: Yes. She was great. Yes, Secretary Chapman. She is our Senior Vice President and she is a hospital administrator at Virginia Mason and she is actually a microbiologist, which is how she got into her field. She is amazing. Smart woman. John Shegerian: What was the panel speaking to today? What was their topic? Brenna Davis: Their topic was on the Washington Business Climate Declaration. The Climate Declaration was a call for business to get engaged on climate and Virginia Mason led that call. I chaired that group. It’s called Washington Businesses for Climate Action. We put the Climate Declaration together based on Ceres’ existing climate pledge and made it sort of more specific to Washington State. Then we went out and recruited businesses to sign on to this declaration calling for action on climate. And when we rolled it, out we had 100 businesses. Now we have over 180 businesses signed on to call for action on climate in Washington State. John Shegerian: So great. So although climate change is this big global issue, you have made it very local in your call to action. Brenna Davis: We did, because we felt like Seattle and Washington State, we have such a culture of innovation and we have such a pioneering spirit that sometimes we need our own declaration, our own thing so that we can feel that we own it a little bit more and that reflects the culture here. John Shegerian: That makes sense. And for our audience members out there, to see what Brenna and her colleagues are doing at Virginia Mason, you can find them at Let’s talk a little bit about Virginia Mason. What is the mission? It’s a .org. What does Virginia Mason do in sustainability and health care? Brenna Davis: Well, Virginia Mason is a health care system. John Shegerian: OK. Brenna Davis: We have a large hospital downtown and then we have seven regional medical centers around the region. So we are really focused on providing the highest quality health care, and we are award-winning in terms of our quality. We were the first health care organization to adapt the Toyota production system into our work so that we could ensure that there is the highest quality. Just like you expect the highest quality car, why wouldn’t you expect the highest quality health care? John Shegerian: No kidding. Brenna Davis: Yeah. That’s a huge part of how we make all of our decisions in our culture. So we do that and we also have a Virginia Mason Institute, which teaches the Virginia Mason production system and how to integrate quality work into you day-to-day operations. John Shegerian: Talk a little bit about that. What does that mean? That system? That Toyota system that you mentioned? Brenna Davis: So when you think about how Toyota makes cars, they use a production system to identify areas of waste. John Shegerian: Yeah. Absolutely. Brenna Davis: You just say you’re making a part and you don’t need to do these extra steps, you don’t need to move this part here and it takes extra time or money. So our CEO, Dr. Gary Kaplan, and the senior leadership decided in 2002 to use this production system for health care. So now we use it. For example, if you are a cancer patient. In the past – maybe four years ago, five or six years ago, I don’t know when, but in the past…. John Shegerian: Yeah. Brenna Davis: If you were a cancer patient and you came in, we measured and we found out you had to walk something like 2,000 steps. So you’d have to come in and go to the doctor, go to the radiologist, go somewhere else. So we were asking our sickest patients to walk something like a mile to get their care. So using the production system we identified all this waste in movement and the waste of walking and we used a system to change the way we did things so it was centered on the patient. So now the patient comes in, they sit down and everyone comes to them. John Shegerian: Oh my gosh. Brenna Davis: If you were there as a cancer patient, that’s a big benefit is that everything comes to you and it’s patient-centered. So the same thing with sustainability. We use our production system to identify waste, to implement green ideas. If people bring new green ideas, to measure them so that we can understand what’s the actual impact of this idea, and if it is successful, let’s spread it across the organization and use that idea. John Shegerian: Just so our listeners and our audience can get a little bit of a feel – how many beds or how many patients does Virginia Mason service? Brenna Davis: We have 295 licensed beds. John Shegerian: OK. Brenna Davis: I’m not sure. At the moment. John Shegerian: Right. Brenna Davis: And then we have about 326 beds total. John Shegerian: Wow. Brenna Davis: So at any time, it’s around 300 beds. I’m sorry I don’t have the numbers in front of me for today. John Shegerian: No, that’s fine. That’s just a general idea. Brenna Davis: It’s around 300 beds. John Shegerian: Right. Brenna Davis: Yeah. John Shegerian: So you are one of the big health care providers here in Seattle and the Seattle region. So sustainability in health care. How long have you been the Director of Sustainability at Virginia Mason? Brenna Davis: About two years. John Shegerian: Two years. Brenna Davis: Yeah. John Shegerian: Was there a director of sustainability before you? Brenna Davis: No. John Shegerian: So this was a new position? Brenna Davis: Yes. John Shegerian: You truly are a pioneer at Virginia Mason, which is probably – if I were to guess – one of the leading health care agencies in America who have integrated sustainability in healthcare. Brenna Davis: That’s right. John Shegerian: So let’s talk about all the opportunities. Now, you are not a rookie anymore, but now you see how much can be done. Brenna Davis: Yeah. John Shegerian: Talk a little bit about what you’ve accomplished in those two years in sustainability and healthcare but talk a little bit also about the future if you don’t mind, Brenna, on how big the universe can really be when it comes to health care and sustainability. Brenna Davis: Sure. Well, I can give you some highlights. John Shegerian: Yeah. It would be exciting. Brenna Davis: Before I arrived, we already had a culture of sustainability and it just wasn’t as organized as our senior leadership wanted it to be, and they saw there was more interest in it, and they saw the value in it, so they created my position and brought me on. What’s interesting and very cool about Virginia Mason is they started their energy efficiency work in the 1990s and they have been working on it ever since then. So we are saving so much energy – and you can look more on the website. We are saving 6 million gallons of water every year just from the work we are doing in trying to eliminate waste. John Shegerian: So you are saving water. Brenna Davis: Saving water. John Shegerian: Another one of our biggest issues. Brenna Davis: I know. Especially in California John Shegerian: In California and around the globe, though. Brenna Davis: Yes, around the globe. John Shegerian: So you are saving water and then you are saving energy…. Brenna Davis: Yes. John Shegerian: Great. And then obviously you have also made the great case about patient care. Brenna Davis: Yeah. Yeah, that’s right. John Shegerian: The steps. Bring the care to the patients, not make the patients go to the care. Brenna Davis: Yes. John Shegerian: So what other things have you gotten under your umbrella? Brenna Davis: So we have been working on water. We have been working on waste. We decided that 80 percent of the landscaping that we plant on our campus is native plants or pollinator-friendly to reduce water and create habitat for plants and pollinators, which we are really passionate about. We do food. Thirty-six percent of our food is all local and sustainable that we serve, and we are working on expanding that and doing more from scratch cooking and just innovating that whole side of it so that hospital food is delicious and local and sustainable. John Shegerian: I want to come back to that. I just want to give a shout out. To our audience members that just joined us, we are so excited to have Brenna Davis with us. She is the Director of Sustainability at Virginia Mason, and to learn more about Virginia Mason, it is It’s a health care agency here in Seattle. In Seattle today is where we are at Green Is Good. This is the GoGreen edition and to learn more about GoGreen go to October 6th in Portland. You can buy tickets to come to that conference. It’s an amazing conference. We are so honored to be here. Let’s go back. I’m a vegan. Brenna Davis: Are you a vegan? Good for you. I just ate a vegan meal. It was delicious. John Shegerian: I had a vegan meal last night in your great city here in Seattle. Most of us tie health care and hospitals with ubiquitous horrible food, unfortunately. Brenna Davis: Yeah. John Shegerian: Talk a little bit about the importance of nourishing your patients. And as you just said, you are sourcing some of the food locally. Is some of the food also then being – like you just said – made from scratch? And are we taking more nutritional elements into it and health care elements that we know now are true, plant-based food and other opportunities to organic products to your patients? Brenna Davis: Yes. Virginia Mason is part of the Healthier Hospitals Initiative. We partner with them on a challenge – it’s a healthier hospitals challenge – that we’ve implemented on a free nutrition side. So we have expanded organic. We serve organic and local whenever possible whenever in season. John Shegerian: That’s great. Brenna Davis: Yeah. It is great. Then, recently, we are moving towards buying more, higher vegan, but we are really towards inspiring antibiotic-free meats. John Shegerian: Wow. Brenna Davis: And we are doing more and more of that. And then we just recently were certified. We are the first self-operated hospital in the world to be certified by MSC – the Marine Stewardship Council – to serve Marine Stewardship Council fish. John Shegerian: Wow. Brenna Davis: So we serve fish that is captured sustainably and from healthy fish stocks. And then we do hormone-free dairy. We do cage-free eggs. John Shegerian: So you have taken food as a very important mission in the ecosystem of how you treat your patients. Brenna Davis: Absolutely. Because health is so tied in nutrition and the food that we eat, and so we have the idea of how can we just eliminate as much as we can sugary sodas. Get the sugar out of our cafeterias. We are transitioning to eliminating fried foods. We take it very seriously. And we want it to be delicious so people want to eat it. John Shegerian: Right. Brenna Davis: So we have an amazing chef, Brian Brooks. He is a trained chef, and he used to own a place called “Hunger.” His wife is an amazing chef, too. So anyway, he does all of our cooking now and he is working really hard to transition into it so that the food is healthy, sustainable and delicious. John Shegerian: That is just wonderful. Talk a little bit about other initiatives that you are working on at Virginia Mason. Brenna Davis: Well, climate change is a huge one that we have been really leading on in the industry. Climate change – as Piteri shared – is a major human health concern of the CDC and the World Health Organization, the Obama Administration and the Health and Human Services. They are all still concerned about it, and you probably know that the Surgeon General recently came out with a Twitter chat on climate and health. John Shegerian: Yeah. Brenna Davis: And that was amazing. We’ve been partnering with the Healthier Hospitals Initiative on a national level to basically expand the involvement of health care on climate so we are part of the Health Care Climate Council – it’s called. John Shegerian: Share what that is and share also for our audience members what Healthier Hospitals is. Brenna Davis: Healthier Hospitals Initiative is an initiative by a group of hospital leaders to reduce the environmental impact of hospitals and the health care system. We are part of that and we’ve been partnering with them. John Shegerian: How big is the growth? Brenna Davis: It’s international at this point. John Shegerian: Really? So hundreds of hospitals are part of it. Brenna Davis: Yeah. But the Climate Council, it started out we were invited to join very early on by a group Health Care Without Harm, which kind of created the Healthier Hospitals Initiative. There are only eight health systems engaged. We were invited to participate. And it’s continuing to grow. We were invited to go meet with the Obama Administration, so I went to the White House and met with the President’s staff, John Podesta and some of his cabinet members in Health and Human Services, Secretary Burlock – basically looking at how can we create health care organizations that are resilient to climate change and that are ready when the climate change impacts come down the pipe. We’re already feeling them but when we really start, the pain starts coming. John Shegerian: Right. Brenna Davis: And the people at the table had experienced Hurricane Isaac, Katrina, Sandy and they had seen health care organizations just be crippled. I mean, they were just decimated because of these storms and so the idea was, how can we deal with this as a climate resilience issue so that we can be centers of climate excellence as health care organizations so that our communities can come to us when they need us the most? And making sure that we are available and that care is available to the community. John Shegerian: That is so amazing. What other things are you working on? Brenna Davis: My dream, one of the things that I would really like to do is to eliminate bottled water. And we are in the process of that. John Shegerian: Process of that. Brenna Davis: It’s been a process, so that is one of the things I would like to work on. John Shegerian: You mentioned earlier at the top of the show, Brenna, that your CEO – about the Toyota principles implemented. Brenna Davis: Oh yeah. John Shegerian: Talk a little bit about some of the pain points that exist for patients when they go into a hospital. I know most patients always complain about constantly being woken up or excessive light noise. Are some of those things part of your initiatives too? Or some of the things that you can possibly work on in the future? Noise reduction and light reduction for proper resting? Brenna Davis: Yes. Thank you. You make a very good point. John Shegerian: OK. Brenna Davis: And I have to say I am an environmental scientist not a clinician. John Shegerian: OK. Brenna Davis: But we have implemented using the Toyota production system. We worked really hard on raising that patient satisfaction level in our hospital so that people – when you are injured or trying to heal, you need that quiet. John Shegerian: Right. Brenna Davis: You need that calming time to sleep and recover, and so we’ve been winning awards consistently on patient experience and lowering the noise that happens. The biggest source of sort of dissatisfaction with hospital stays is associated with who your roommate is. So if you get a bad roommate. So we are trying to work and shift that so it’s not as contingent on that. John Shegerian: That is so exciting. Brenna Davis: We don’t know. But you know how it is. John Shegerian: Right. Brenna Davis: Maybe you don’t mesh with the guy. John Shegerian: Right. For our audience members out there that are in health care, are there any resources you could share with them or any points of inspiration in terms of how to green or make their health care agencies more sustainable? Brenna Davis: Oh, absolutely. The two major most incredible organizations to share with those folks is first of all Practice Green Health. John Shegerian: Practice Green Health. Brenna Davis: Practice Green Health is an organization that works on integrating sustainability into our everyday work as health care. John Shegerian: OK. Brenna Davis: And you have to be a member, but I’ll tell you it’s worth every penny because their staff will help you integrate sustainability principles and you can learn from other health care organizations. Health care is really at the beginning of this journey, and they are there to kind of help you. John Shegerian: It’s or something like that? Brenna Davis: Yeah. John Shegerian: OK. Brenna Davis: Amazing people. Hermine is my facility person. She is amazing. John Shegerian: OK. Brenna Davis: And then also I would say Health Care Without Harm and Gary Cohen and Eric Lerner over there. Two incredible people that are just passionate about reducing the environmental impact of health care, and they are working on a global scale. They are getting ready to go to Paris. We have been working with them on a global rollout of the 2020 health care challenge, which is basically we are one of eight organizations globally to roll this out. Kenderson Health and Kaiser Permanente are friends there and us and then the British government and a Korean Hospital, another one in South Africa, we all work together to rollout this global challenge. Health Care Without Harm really is working on climate change and health care has such a unique voice on climate because we have this moral authority. People trust us. John Shegerian: That’s true. Brenna Davis: We are in every community. We are focused on data so we are working hard to get health care to speak up and start being the leaders that we are on health and health impacts in climate. John Shegerian: Health Care. Brenna Davis: Without Harm. John Shegerian: .org? Brenna Davis: Yeah. John Shegerian: Brenna Davis: And it might be Sorry. I apologize for that. John Shegerian: OK. But if they type that into their search engine, they’ll be able to. Brenna Davis: Yeah. Amazing people. John Shegerian: But isn’t that one of the credos of even becoming a doctor or a medical practitioner? Do less harm? Brenna Davis: Do no harm. John Shegerian: Do no harm. Brenna Davis: Yup. And we take that seriously. Harm includes harm to the environment, because when we harm the environment we harm people. John Shegerian: Two last questions. Now with you becoming the Director of Sustainability at Virginia Mason, has this set off sort of a sustainability race? Are other hospital and health care organizations now putting that position in and really highlighting and making that role very important? Director of Sustainability? Brenna Davis: There aren’t many Directors of Sustainability in health care, and that was really a decision by our senior leadership to make it a senior-level position. John Shegerian: Right. Brenna Davis: And I hope there is a race. John Shegerian: Right. Brenna Davis: I have been working with – I started a group of health care sustainability professionals and we meet quarterly to talk and support each other. John Shegerian: Right. Brenna Davis: So we are pretty collaborative, even though we compete, but we are very supportive. John Shegerian: That was my last question. Do you share best practices? Brenna Davis: We do. We share. And I hope it creates competition. I hope that it creates more action on the part of other health care organizations and if it did that would be wonderful. John Shegerian: That’s perfect. Brenna Davis: And I am so supportive of my colleagues. John Shegerian: We hope you come back on the show and share more of the journey in sustainability at Virginia Mason and in the health care industry. Brenna Davis: Thank you. John Shegerian: Brenna, thank you for your time. And for our listeners out there, we’ve had Brenna Davis on. She is the Director of Sustainability at Virginia Mason. To learn more about Virginia Mason and all the great health care practices they’re using in sustainability and sustainability practices they are actually using, in health care go to Brenna Davis: Thank you. John Shegerian: You know, Brenna, you are an inspiring health care professional and also sustainability superstar, and truly living proof that Green Is Good. Thank you very much for being with us today and sharing with our audience all that is going on at Virginia Mason. Brenna Davis: Thank you and thank you for your important work. John Shegerian: Thank you.

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