Sustainability has never been a focus in my work. I've spent my career thinking about strategy, effectiveness and efficiency. How do we design better systems? How do we make them work better? How do we know they're producing the outcome we intended? How do we share our work to make those around us better at the same time?

My work today at AeroSafe Global has brought me much closer to the impact of those questions because, in pharmaceutical cold chain, the outcome isn't abstract. It directly connects to patient safety. As George (my husband, for those who are new) regularly says around our house: “Safety is no accident.” (Fun-fact the origin of that particular saying is from a 2012 Radiation Oncology paper! Who knew?)

When you're quite literally delivering life-saving medicine, there's no room for safety to be an afterthought. You have to design it into the system from the beginning. The same design decisions that determine how well we protect the medicine also shape how efficiently we operate and how much waste we create along the way.

I've always believed sustainability matters. I recycle. I believe in reuse. I have a compost bin. I respect the earth and believe the choices we make have ripple effects. But working much more closely with pharmaceutical cold chain has changed how I think about sustainability. It isn't a competing priority. Sustainability can be an outcome of designing the system better in the first place.

I've been a bit gobsmacked by the amount of waste involved in getting temperature-sensitive medicine where it needs to go. Imagine a large academic medical center receiving 1,000 parcels every weekday. If only a quarter are temperature-controlled, with three gel packs each, that's 750 gel packs arriving every day. About 195,000 a year. At 1.5 pounds each, that's nearly 300,000 pounds of gel material moving through a single receiving dock every year.

And that's a low estimate and just the gel packs. Picture the dumpsters behind that hospital being filled, emptied and filled again, and then multiply that across hospitals, specialty pharmacies, clinics and patient doorsteps.

 I've spent a lot of this year in warehouses, pharmacies, virtual calls, and conference rooms with the people who move medicine. Three problems came up again and again. These aren't new challenges. The industry has invested significant time, money, and technology trying to solve them. But I think some of our assumptions about what makes a solution effective deserve another look. 

Of course, making all of that material recyclable could be a step in the right direction. But wouldn't it be better to avoid creating much of that waste in the first place?

An earlier decision

I've been in a lot of conversations lately where packaging comparisons put “recyclable” and “reusable” side by side. Same font. Same checkmark. Same implied weight. I'm increasingly uncomfortable with that comparison, not because recyclable is bad, but because recycling happens after we've already made a series of decisions that created something we need to dispose of.

And then achieving the sustainable outcome depends on what happens next. Someone has to identify the material correctly. It has to be separated. The appropriate recycling infrastructure has to exist. The local waste stream has to accept the material. And ultimately, it actually has to be recycled. That's a lot of dependencies at the end of a system.

Reuse asks us to make a different decision much earlier. At AeroSafe Global, Full Cycle Reuse means our insulated box ships, comes back, is inspected and reconditioned, and goes back into service. This happens upwards of 70 times. Reverse logistics are designed into the system from the beginning.

That distinction has changed the question I'm asking. It's no longer simply, “Is this recyclable?” I'm increasingly asking, “Why are we creating something that needs to be discarded in the first place?”

That's where my strategy brain and my growing interest in sustainability have started to collide.

If we design a system that protects the medicine, makes packing it simple and efficient, streamlines operations, and prevents waste from being created in the first place, sustainability isn’t something we’ve bolted onto the end. It’s an outcome of a better-designed system.

And we can measure it.

AeroSafe Global has a 98.7% reuse rate. Third-party-reviewed sustainability data found that our AeroSafe Global solution delivers up to 95% lower environmental impact than single-use alternatives, including 65% less CO₂ than single-use EPS.

The numbers matter, but what's shifting my thinking is the philosophy underneath them. Don't just tell me something can produce a better outcome. Design the system so that it does, and then prove it happened.

Bringing my curiosity with me

I've been preparing to lead AeroSafe Global's Sustainability Symposium on November 10 (registration is now open), which has given me the opportunity to spend time with people who have been thinking about these issues far longer than I have. I'm coming into those conversations with a lot to learn, but I'm also bringing the same curiosity I've brought to my work for years.

• Where in the system are we making the decisions that ultimately determine the outcome?
• What could we design out rather than manage later?
• Where are we accepting complexity because “that's how it's done”?
• And when we make a sustainability claim, how do we know the outcome actually happened? Recycled by whom, where and how do you know?

I'm still learning, but I'm starting to see sustainability less as a separate discipline and more as another measure of how well we've designed the system. Strategy, effectiveness, efficiency, safety and sustainability are far more connected than I understood before I got this close to the work.

And if safety is no accident, I don't think sustainability should be either.