The Sustainable Healthcare Podcast

What if the plastic waste from a hospital's clinical areas could come back as the ID card holders every nurse and doctor wears every day? That is what SMALLrevolution is doing, and it is one of the more elegant circular economy stories I have come across in healthcare. About the guest: Arendse Ekegren Baggesen is the Founder of SMALLrevolution, a Danish design-to-manufacturing company that collects plastic waste from hospitals, municipalities, and companies, transforms it into recycled raw material, and produces furniture and functional products that go back to the original waste producer. Three key takeaways:
According to Arendse, only 8-10% of plastic collected in Denmark is actually recycled. Sorting quality in the waste stream, not collection, is the primary bottleneck.
SMALLrevolution's closed-loop model: they collect a facility's waste, produce products from it, and return those products to the same facility, along with full LCA and ESG data.
According to Arendse, producing one kilo of virgin plastic requires two kilos of crude oil. Redirecting to recycled material reduces both CO2 emissions (around 30% vs. virgin plastic, based on SMALLrevolution's own LCAs) and crude oil demand.
Timestamps:
00:00 - Introduction and origins of SMALLrevolution
02:00 - Why recycled plastic for outdoor furniture?
05:00 - Finding the first factory willing to work with household plastic waste
07:00 - How COVID pivoted SMALLrevolution from B2C to B2B
08:00 - The closed-loop model: collect, produce, return
09:00 - LCAs and ESG data on every product
10:00 - What actually happens to plastic in the "normal" waste stream?
12:00 - Why sorting quality, not collection, is the real bottleneck
14:00 - How hospitals can get started: two live case studies
18:00 - The "not another bucket" problem in surgical theatres
21:00 - CO2 impact: around 30% reduction vs. virgin plastic (based on SMALLrevolution's own LCAs)
23:00 - According to Arendse: 2 kg of crude oil per 1 kg of plastic, and what that means for resource resilience
Pull quote: "All vases in the world should be produced in a recycled material. There is demand, and there is a lot of waste, so why not connect those two dots?" Contact Arendse:
Website: smallrevolution.dk
LinkedIn: Arendse Ekegren Baggesen You might also enjoy:
Episode 088: Circular Material Flow of Medication in the Intensive Care Unit (Nicole Hunfeld, Erasmus UMC)
Episode 074: The Future of Reprocessing in Healthcare (Lars Thording, Innovative Health)
Episode 096: Recycling Pharmaceutical Transport Packaging (Arne Kloke, SCHOTT Pharma)

What happens when a doctor applies the rigour of clinical research to the carbon footprint of surgery?

In this episode, Frederik speaks with Anna Roe Rasmussen, MD, MSc Health Policy — a scientific researcher at the Regional Unit for the Green Transition in Region Zealand.

Anna recently defended her PhD at the University of Copenhagen and the Technical University of Denmark, where she applied lifecycle assessment (LCA) to total hip replacement surgery, working towards the integration of environmental impact into clinical decision-making.

About Anna:
Anna has spent over a decade at the intersection of climate and health — as a co-founder of Doctors for Climate Denmark (Læger for Klimaet), as part of the working group that drafted the Danish Medical Association's climate and health policy (published 2022), and as a scientific researcher applying LCA methodology to surgical care pathways.

Three things you'll take away:
Why the field needs to distinguish more clearly between carbon footprint screenings and full ISO-compliant LCAs — and what gets lost when clinicians can't tell the difference.
Why specialty-level carbon literacy is the missing link between organisational sustainability targets and meaningful action on the ground in clinical departments.
Why acting — finding someone to act with — is Anna's personal antidote to climate anxiety.
Timestamps:
00:00 — Introduction
03:00 — Anna's PhD: applying LCA to total hip replacement surgery
08:00 — From medical student at COP to co-founding Doctors for Climate Denmark
10:00 — The Danish Medical Association's 2022 climate and health policy
13:00 — A passionate but fragmented global movement of healthcare workers
17:00 — The publication explosion in healthcare LCA — and why quality must keep pace
21:00 — Carbon screening vs. ISO-compliant LCA: the precision vs. direction trade-off
27:00 — Specialty-level carbon literacy as the next step for healthcare decarbonisation
33:00 — Carbon budgets and financial budgets: an uncomfortable but necessary analogy
38:00 — The hard conversations healthcare systems avoid
41:00 — What makes Anna hopeful: engaged colleagues and the power of acting together
References and links mentioned:
ISO 14040/14044 standards for lifecycle assessment (see iso.org)
DTU Centre for Absolute Sustainability
Doctors for Climate Denmark / Læger for Klimaet — Facebook [Joachim/Frederik: add official website if available]
Danish Medical Association climate and health policy 2022 [Frederik: add direct link]
International Federation of Medical Students' Associations: ifmsa.org
Guest links:
Anna Roe Rasmussen on LinkedIn
Sjællands Universitetshospital
DTU Centre for Absolute Sustainability
You might also enjoy:
Episode 097: Visualising Circular Healthcare — Tamara Hoveling (TU Delft) on LCA methodology in healthcare
Episode 101: Sustainable Healthcare: Implementation and Hope — Maria Gaden
Episode 088: Circular Material Flow in the ICU — Nicole Hunfeld (Erasmus UMC)
[Episode Spotify/platform links to be added by Frederik] Hosts:
Joachim Almdal on LinkedIn
Frederik van Deurs on LinkedIn
Care Pathway Consulting
Pull quote: "If you want to do something — act. And find someone to do it with. That's always both more fun and more productive." — Anna Roe Rasmussen

The first episode of our Sustainable Clinical Trials mini-series, produced in partnership with the Sustainable Healthcare Coalition (SHC), following up on the Community of Practice conference in London on 4 November 2025. Each episode brings one of the CoP speakers back to share their story in long form.
 
GUEST
Christian Hieronimi, Founder & CEO of ONCARE (myoncare) and co-founder of Convien. A serial healthcare entrepreneur based in Munich, with previous exits to Elekta (Medical Intelligence) and Varian (humediq).
 
WHAT YOU WILL LEARN
How Convien's meeting-point optimiser can cut around 30 to 35% of travel cost and 40% of the CO2 footprint of investigator meetings, by jointly optimising ticket price, travel time and carbon per kilogram.
Why roughly half of corporate travel spend in international organisations is driven by meetings, not customer visits, and why that makes meetings the biggest under-addressed decarbonisation lever in clinical operations.
How myoncare uses wearable data, symptom questionnaires and guideline-based thresholds to "fill the void" between doctor visits, and how the same platform can decentralise a trial by routing blood work, imaging and eligibility checks to local providers.
 
TIMESTAMPS
00:00 Introduction by Nathalie Preiswerk (Sustainable Healthcare Coalition) and series framing
02:00 Meet Christian: serial founder, robotics and oncology background
03:30 Convien origin story: Beijing vs. Barcelona, 2010
06:00 The three-variable optimisation: cost, time, carbon
10:00 How big is the meetings prize inside corporate travel
11:00 Applying Convien to investigator meetings and site selection
13:00 Introducing myoncare: a care orchestration platform
16:00 A chronic kidney disease use case, end to end
20:00 Decentralised trials: bringing the site to the patient
22:00 Bring-your-own-device and the International Patient Summary
25:00 Care pathways that trigger the next step automatically
 
REFERENCES MENTIONED
Sustainable Healthcare Coalition Community of Practice conference (London, 4 Nov 2025): https://shcoalition.org/cop-conference/
SHC Sustainable Clinical Trials Knowledge Hub: https://shcoalition.org/sustainable-clinical-trials-knowledge-hub/
Convien Smart Meeting Location Planner: https://www.convien.com/
myoncare Virtual coordinated care: https://www.myoncare.com/
Convien Meeting Point Optimiser (Siemens partnership, Microsoft AppSource): https://marketplace.microsoft.com/en-us/product/office/wa200001588
EU MDR 2017/745 (myoncare is classified as MDR Class IIa)
International Patient Summary (ISO 27269)
 
CONNECT WITH THE GUEST
Christian Hieronimi on LinkedIn: https://www.linkedin.com/in/christian-hieronimi-066a394/
ONCARE / myoncare: https://www.myoncare.com/
Convien GmbH: https://www.convien.com/
 
YOU MIGHT ALSO ENJOY
091 SHC: the Sustainable Healthcare Coalition (Fiona Adshead, Keith Moore, Nathalie Preiswerk), the backstory to this mini-series.
089 Koen Kas on transforming healthcare and clinical trials, another conversation on reimagining the trial operating model.
083 Sustainability requirements in public procurement, relevant if you are thinking about where the buy-side pressure lands.
 
HOSTS
Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/
Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/
Care Pathway Consulting: https://carepathwayconsulting.com
 
PULL QUOTE
"In between two doctor's visits, nobody looks after the patient, because the patient's pretty much invisible. We are filling up that void." Christian Hieronimi
 
Produced in partnership with the Sustainable Healthcare Coalition.

Why do hospitals with good data, proven cases and clear economics still fail to implement sustainability solutions at scale?

That is the question Maria Gaden is spending three years answering.

Maria returns to the podcast as Chief of Development at Center for Sustainable Hospitals in Central Denmark Region, and as a public industrial PhD student at the University of Copenhagen's Globe Institute. Her research is in implementation science: what actually determines whether a sustainability intervention gets adopted across a whole hospital - not just one passionate department.

In this conversation, Frederik and Maria cover:

- Why the reusable surgical gown project has not yet launched and why she still calls it a success
- Moving from "heroes" to systems, and from passion to governance
- 38 hospital interviews across Denmark, a trip to Karolinska Institutet, and a visit to Singapore's Centre for Sustainable Medicine
- How to start if you work inside a hospital and how it differs if you sit inside pharma
- Why human irrationality is the real implementation barrier, and what to do about it

**Timestamps**
00:00  Welcome back
01:30 New title, new PhD
02:30 The reusable textiles project update
07:30 Heroes to systems, passion to governance
09:00 Why implementation science
13:30 The research: 38 interviews, four countries
17:30 Rationality is not the main driver
22:30 Advice for healthcare professionals
29:30 Advice for pharma and medtech
38:30 What gives Maria hope

**Pull quote (Maria):** *"We know the solutions. We have the data. So what is really hindering implementation right now? That is what I keep asking."*

**References and links from the episode**

- [Center for Sustainable Hospitals, Central Denmark Region](https://www.rm.dk/om-os/organisation/center-for-baeredygtige-hospitaler/) [URL to confirm]
- [Globe Institute, University of Copenhagen](https://globe.ku.dk/)
- [Global Green and Healthy Hospitals (GGHH)](https://greenhospitals.org/)  free to join; hosted by Health Care Without Harm
- [Health Care Without Harm  Europe](https://europe.noharm.org/)
- [Centre for Sustainable Medicine, NUS Singapore](https://medicine.nus.edu.sg/cosm/)
- [Karolinska Institutet](https://ki.se/en)
- [*Harry Potter and the Methods of Rationality* (free online)](https://hpmor.com/)  referenced by Frederik

**Connect with Maria**

- [Maria Gaden on LinkedIn](https://www.linkedin.com/in/mariagaden/)
- [Center for Sustainable Hospitals](https://www.rm.dk/om-os/organisation/center-for-baeredygtige-hospitaler/) [URL to confirm]

**You might also enjoy:**

- Episode 090 — *Data-Driven Decarbonisation of Danish Hospitals* (Rasmus & Thea, Region Midt)
- Episode 087/086 — *Sustainability insights from 290 nurses and clinicians* (Michael Maagaard, Region Midt)
- Episode 044 & 043 — Maria Gaden's previous appearances on the show

**Host links**

- [Joachim Almdal on LinkedIn](https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/)
- [Frederik van Deurs on LinkedIn](https://www.linkedin.com/in/frederikvandeurs/)
- [Care Pathway Consulting](https://carepathwayconsulting.com)

Liz Willetts has spent 20 years at the intersection of nature and health.

In this conversation, she explains why nearly 200 governments have been asking for integrated biodiversity-health indicators for over a decade, and why the scientific community still hasn't delivered them. About the guest: Liz Willetts is a science-policy expert on global governance of the health-environment nexus.

She has served as Planetary Health Policy Director at Harvard T.H. Chan School of Public Health, science-policy advisor to the Convention on Biological Diversity, and is a Team Leader, Editor and Writer at IISD's Earth Negotiations Bulletin. She is also a primary care clinician with experience in Micronesia, Central America, and the US. Key takeaways:
196 countries have called for biodiversity-health metrics through the Convention on Biological Diversity for decades, but the health and environmental science communities remain siloed, and integrated indicators still don't exist
Even senior clinicians with 10+ years of experience may not know how to define "biodiversity", pointing to a fundamental gap in medical education
The post-consumption lifecycle of pharmaceuticals, what happens when drugs exit patients and enter wastewater, represents a massive blind spot in both environmental monitoring and clinical training
Timestamps:
00:00 - Introduction and Liz's background
03:00 - How environmental decisions are public health decisions
08:00 - Air quality policy as a biodiversity example (Copenhagen low emission zones)
12:00 - The decade-long gap: governments asking for indicators nobody has built
18:00 - The grand rounds anecdote: a clinician who didn't know "biodiversity"
22:00 - Plant blindness and the siloing of scientific education
26:00 - Chronic kidney disease carbon footprint and biodiversity
30:00 - Practical advice for national biodiversity-health strategies
36:00 - Held v. State of Montana: climate litigation as a model for ecosystem values
42:00 - The nature footprint of healthcare: a blank canvas
46:00 - Pharmaceutical pollution and the end-of-life gap
50:00 - What gives Liz hope References mentioned:
Liz Willetts, "Metrics for Biodiversity and Health Policy Integration," PLOS Global Public Health, 2025: PubMed
Convention on Biological Diversity (CBD) and the Kunming-Montreal Global Biodiversity Framework (2022)
Global Action Plan on Biodiversity and Health, adopted at CBD COP16 (2024)
Held v. State of Montana: Climate Case Chart
Plant blindness (academic concept): Literature review 1999-2024
Pharma Pollution Hub / Kelly Thornber: pharmapollution.org
Global Biodiversity Framework: https://www.cbd.int/gbf
Global Action Plan on Biodiversity and Health:
https://www.cbd.int/health/GAP.shtml
Links:Liz Willetts on LinkedIn: https://www.linkedin.com/in/liz-willetts-2336749/
IISD Earth Negotiations Bulletin: https://enb.iisd.org/
Joachim Almdal on LinkedIn: https://www.linkedin.com/in/joachim-espeland-almdal-017a6973/
Frederik van Deurs on LinkedIn: https://www.linkedin.com/in/frederikvandeurs/
Care Pathway Consulting: https://carepathwayconsulting.com
You might also enjoy:Episode 092: Planetary Boundaries & Health with Mia Heide (WELA)
Episode 098: Tackling Pharmaceutical Pollution: A Systems-Based Approach
Episodes 023/024: The Biodiversity Crisis in Healthcare (two-parter)