Sustainable quality improvement and other practical solutions to implement sustainable healthcare

This chapter presents several conceptual frameworks to help clinicians and health system managers respond to the environmental, social and financial pressures-called the ‘triple bottom line’-on the health system. The sustainable value equation helps identify waste, harm, and benefits in those three areas. The principles of sustainable clinical practice direct attention from infrastructural or recycling projects upstream to more powerful drivers of pollution and waste. For example, using lower carbon options when available, making care pathways leaner and less wasteful, empowering patients to collaborate in the management of their illness, and, most importantly, keeping people healthy and, therefore, out of hospital. The chapter introduces a useful tool for triple bottom line quality improvement and quality management projects, and a number of well-quantified examples in various specialties are described.