The Green Gab
*Cross-posted on Emerging Leaders for Environmental Sustainability in Healthcare’s (ELESH) website as “The Green Gab: Ed Rubenstein”
Ed Rubinstein is the Energy & Environment Manager at the University Health Network. He’s been leading the hospital’s many environment programs since 1999 and has helped UHN become a leader in greening health care.
Yousef: Alright so could you tell us a little bit about who you are?
Ed: Hello my name is Ed Rubinstein. I’m the Director of Environmental Compliance, Energy, and Sustainability at the University Health Network here in Toronto. My team oversees all things environmental sustainability related to health care. We don’t actually do a lot of the hands-on stuff but in regard to waste for example, we work with purchasing, we work with environmental services, we work with many different kinds of stakeholders and champions to get things through. We do a lot of energy stuff, that’s the one exception where we are a little more hands-on. We have several energy managers who identify projects, implement projects as well support the many other operational and capital things going on here in terms of trying to get as much efficiency and low carbon as possible. And we oversee things like Environmental Compliance – anything environmental kind of comes through us at some point.
Y: That’s great. And when were you initially attracted to the field of sustainability in healthcare?
E: This is how long ago, when I saw the job posting in 1999 in the newspaper. I’ve always been interested in environmental issues. I did my bachelor’s in organic chemistry at UofT. I did my masters in Forestry and Wood Science also at UofT. And it’s through that, going from chemistry through forestry, I decided I was really interested in environmental issues. So I wanted to get in the field, and I worked for a while as an environmental consultant doing mainly soil and groundwater assessments and remediation. And then this opportunity came into play with some background in Environmental Management Systems required. Again, in the newspaper, applied, got the job, and have been busy ever since. 1999, just over 20 years ago.
Y: Wow that’s incredible. So kind of getting a little bit broader here, what are your thoughts on how environmental sustainability impacts healthcare and vice versa?
E: So I think one reason why, I mean I obviously, hopefully, enjoy my job having been at it so long, is that health and healthcare and environmental health or sustainability are so interlinked. They are things that are high value for me. So for example, just looking at healthcare there, by its nature there’s a lot of waste and a lot of things happening and there’s concern about the overall sustainability of our health system. How do we find these things? By reducing some of the waste and streamlining and giving better working environments and you know better patient care we can support that. And then there’s the more traditional way, where we know a lot more now about how poor environmental health impacts human health, which puts a burden on our healthcare and things like that and we’re seeing very very clearly these days. By dealing with environmental sustainability in healthcare, I can kind of help the healthcare system but also help with health overall which also helps the healthcare system. So it’s all very closely interlinked. I like those connections and it calls for some bigger system thinking I think, but it’s also made it quite interesting.
Y: They definitely go hand-in-hand with each other. I’m sure you’ve got lots going on, but is there a sustainability initiative or program that you’re involved in or you would like to see that you could tell us about?
E: We have some big sites. So we’re very focused on energy efficiency as well as waste. Again when I say we’re involved in everything environmental, we really are. We’re doing some pretty exciting things around energy where we’re saving a lot of money for the hospitals. We’re making them more resilient so it kind of plays into being climate ready for future potential impacts of climate change, making sure the hospitals can withstand them better. But also they’re low carbon too, which is important – public institutions like hospitals are going to be around for a long time. We’re already investing a lot of money in them so we’re almost a good fit for some of these, I wouldn’t say leading edge, but some of these newer ideas. But it takes a bit of work to get these things pushed through. Really excited about that. But having said that, we’re applying the same thing towards transportation. You know lots has happened because of COVID around cycling and active transport. We’ve been working on this for years and now many of the things we kind of wanted to do for a while but didn’t have the resources or the bandwidth, we’re pushing forward with it now.
We’re doing work on food. Tying into the food we feed our patients, but also thinking about food security. Many of the things at the root of inequity we’re seeing with COVID and racial inequities in health, the same roots go for environmental justice. And they’re also tied to healthcare as well. By being able to try and deal with these from our perspective and maybe lead by example and implement things, we’re hoping that we can at least be part of the broader change that needs to happen in overall sustainability and equity.
Y: So we spoke to Lisa [Vanlint] last week which was fantastic. She told us a little bit about the cycling program you guys are recently doing. So exciting – it’s really great. Is there any other program you could tell us about?
E: I don’t know if you guys are familiar with the deep lake water cooling system? We’ve just, in the middle of pandemic, hooked up Princess Margaret Hospital to it. So now we have three of our hospitals hooked up to it. We have a research tower in the MaRS complex that we’re trying to get that hooked up to as well. We also have an education building, the Michener Institute, which we’re looking to get hooked up as well. And then I can’t give you a lot of details but at Toronto Western, which is not close enough to hook up to the Enwave system, we’ve got some really exciting things on the go there. It’s to use thermal energy from sewers.
Y: Wow!
E: It’s basic physics, there’s a few bits of secret sauce in terms of technology but nothing crazy. This is not like AI, this is mostly tried-and-true technology but a really good application and a fortuitous, unique setting we have at Toronto Western Hospital, where we think we can make it work.
Y: So I guess the goal here is to reduce the energy used to cool air and save costs as well as reduce your impact on the environment?
E: Yup and also as I mentioned to add to the resiliency and redundancy for our buildings, to make them more climate-ready if you will.
Cristian: So for the HVAC plan that you have going, and trying to get it to the Western Hospital, what are some of the challenges that you faced in trying to get this into different areas or different places?
E: So just generally speaking, again I can’t give away too many details at this point, it’s a big change, it’s very expensive. So we have to look at financing this. We have to do our due diligence. This is going to go to our boards, so they need to be aware of the risks and how those risks are being mitigated. I think the biggest challenge, again this is not leading edge, this is almost off-the-shelf technology, but the biggest challenge is that it’s a fair amount of work and there’s a lot of people who need to get involved in making sure it works.
The best example is like I said in April we brought Princess Margaret Hospital onto deep lake water cooling in the middle of pandemic, and that involved our energy managers, the consulting engineers, the project team, some of our clinical end users that are going to be impacted, our facilities- a lot of people had to come together, and throw in the pandemic again in April – there’s lots of uncertainty. It really is just juggling many balls and bringing lots of people together. It’s setting a vision and getting people to buy into the vision and working towards it, and making sure that you’re as ready as possible when you get asked those key questions. It’s just more bringing it together. That’s the biggest challenge. I know other organizations have looked at it. They haven’t been successful. And the only reason I can see is that they don’t have a dedicated team like we do who can actually take ownership of something and pay attention to details and see it through to the end.
There’s no difference why we should have this and SickKids doesn’t have it. Why don’t they have it? The fundamentals are exactly the same. It’s really just on their side, they just haven’t had the focus to drive it forward.
C: What are some of the factors that led to the success of the energy environment program?
E: Well what we do is, we have a strategic plan and we focus on making sure that we do good stuff, we engage people, we document what we’ve done and then use that to engage people. So we can show results, tangible results, and not just in dollars, cents, or recycling percentages, but also other benefits as well. That engages people even more and opens them up to ideas, and they’re more approachable when we have different things we want to try.
C: That sounds like you have a really good team of people.
E: Yeah! Everyone says they have the best team, but it is a really good team, and they’re all at some level personally engaged in environmental sustainability, which really helps drive things forward. You probably saw that with Lisa.
C: Yes we did. Now, is there anywhere we can learn more about any of your initiatives.
E: On the website [Talkin’ Trash with UHN] you’ll see there’s all kinds of stuff but if you dig a little deeper there’s some information on the projects we’ve done. So some of the deep lake water cooling, some of the energy retrofits, our food gardens that we’ve implemented, so there’s lots of good stuff there. And if there’s anything you want to dig a bit deeper on, for sure we’d always be happy to share some of those details.
C: Yes, that sounds great. What impact has COVID-19 had on these sustainability initiatives?
E: Good question. So, because we’re an essential service, we were still able to do some of our construction projects. Part of it is doing stuff and part of it is planning for the next round, so we always have something on the go.
The biggest thing, and we don’t know the full impact yet, is around waste. So there’s lots of PPE, and we’ve moved to a lot of single-use stuff due to the hesitancy to reuse things, especially in a hospital setting. We’ve also modified the way we run our buildings in terms of fresh-air, due to the uncertainty around the way COVID is transmitted. This is beyond our code, but we’re doing it for safety reasons, so there’s an energy impact.
We’re kind of in an uncertain mode right now, we’re getting back to basic things and making sure we’re safe. It’s like a bit of recovery I think, you know, for COVID, and for the next COVID whenever that is. Basically adjusting to the new normal, and I think, especially around reusable items, we need a lot more research about what can or can not be reused safely – you know, how many millions of masks and gloves are being used. So, how can we make sure people are safe, but reduce some of the environmental impact. No answers, but there are some people thinking about it and working on it right now.
C: That looks like it’s everything. We want to thank you so much for your time, we’re grateful for you taking the time to speak with us.
E: No worries, glad to be able to help out guys. Take care.