Why do we need sustainable quality improvement?

Sustainability is a domain of value recognised by the Royal College of Physicians “which must run through and moderate other domains,” and be considered "not only in terms of what can be delivered to an individual today, but also to the population in general and the patients of the future.”

It follows that sustainability should be considered core to all decision making within our health system, and an integral part of what we consider quality care. Furthermore, given the urgent need to mitigate against the worsening impacts of the climate and ecological emergency, it is also essential that we recognise the need for environmental sustainability to drive change.

Quality Improvement is the dominant framework for achieving clinical change within the NHS, and therefore integrating sustainability within it as a core consideration and motivating factor is essential in cultivating a sustainability lens within healthcare, and engaging health workers to contribute to the creation of a sustainable health service.

The Centre for Sustainable healthcare has recommended a Sustainability in Quality Improvement framework, which outlines the key concepts of sustainable healthcare, and offers tools to support health workers to integrate these into their change-management work. This framework is entirely consistent with commonly used QI approaches such as the Method for Improvement and can be used to adapt current QI material to incorporate sustainability.

The Sustainability in Quality Improvement Framework has been piloted in a multi-centred, multi-disciplinary trial in undergraduate and postgraduate facilities, and was shown to be popular and engaging, but importantly, also motivated students and health-workers to engage in QI.