When sustainability is considered a domain of quality in healthcare, it extends the responsibility of health services to patients not just of today but of the future. This longer- term perspective highlights the impacts of our healthcare system on our environment and communities and in turn back onto population health. A sustainable approach therefore expands the WHO definition of value to measure health outcomes against environmental and social impacts alongside financial costs.
This would encompass the further elements of quality such as equity, affordability, cost-effectiveness, resilience and dynamic improvement as suggested by other HIFA members.
In this definition the objective of improving quality is to deliver the best possible health outcomes with minimum financial and environmental costs, whilst adding positive social value at every opportunity. This can be visually depicted in the SusQI equation from Mortimer F, Isherwood J, Wilkinson A, Vaux E. Sustainability in quality improvement: redefining value. Future Healthcare Journal, 2018 Vol.5(2):88-93.
Value = [Outcomes for patients and populations]
[Environmental + social + financial costs (the 'triple bottom line')]
Some of the team at the Centre for Sustainable Healthcare (www.sustainablehealthcare.org.uk) have been working on Sustainable Quality Improvement for the past 4 years and have now developed a website with lots of free resources. See www.susqi.org
Rachel Stancliffe, Director
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THE CENTRE FOR SUSTAINABLE HEALTHCARE
Cranbrook House, 287-291 Banbury Road, Oxford OX2 7JQ
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The Centre for Sustainable Healthcare is registered in England & Wales as a company limited by guarantee No. 7450026 and as a charity No. 1143189. Registered address: 8 King Edward Street, Oxford, OX1 4HL.
HIFA profile: Rachel Stancliffe is the Director of the Centre for Sustainable Healthcare in the UK. Professional interests: I am interested in the best use of good quality evidence and in creative partnerships to achieve change. I am very concerned at the damage we continue to cause to our environment and am working with all sectors involved in healthcare to make it sustainable. rachel AT sustainablehealthcare.org.uk