Learn from other health professionals who are using SusQI to improve systems and save money, whilst adding social and environmental value at every opportunity. 


These case studies have been gathered from health professionals across the UK who have embedded sustainability into their quality improvement projects. Many of these also come from the CSH's award-winning, tried and tested Green Ward Competition. We have selected these case studies as examples, if you would like to find a more comprehensive list of sustainable QI projects please visit out CSH Case Studies page, or join our CSH Networks.

Have a case study to share? Use our  Case Study Template to submit your project to us by emailing:

Royal Devon and Exeter 2018

Green Ward Competition

Reducing unnecessary cannulation in ED

This project focused on reducing unnecessary cannulation in the emergency department, and won the Royal Devon and Exeter 2018 Green Ward Competition.


Reduced infection risk 
Less inappropriate IV fluid use

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Annual savings £27,831


Annual savings 8,403 kg CO2e


Patients ↑mobility/independence, ↓pain

Staff ↑time, improved work flow

Improving inhaler prescribing and disposal in the paediatrics unit

This Frimley Park Hospital project undertaken in 2020 aimed to reduce the use of metered dose inhalers in the paediatric unit.


“I had no idea inhalers damage the environment if just thrown away, of course I don’t want that for the next generation. Now I know I’ll take them back to a pharmacy.”-Parent

More likely to know when inhaler empty
& no longer therapeutic

Inhaler switch is cost neutral.

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Potential annual savings 44 tonnes CO2e from safe disposal and 363 tonnes CO2e from 30% switch from Ventolin to Salamol across CCG


•Staff awareness of impacts and NICE guidance

•Cross-sector staff relationships & collaboration

•Parents awareness & action

Reducing the use of nitric oxide as an anaesthetic gas

This anaesthetics departments focused on "carbon hotpsots" and worked to reduce the amount of nitric oxide in theatres


Fewer side effects for patient

Reduced risk of abuse in community

Reduce miscarriage risk for staff

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£529 saved per year

70,714 litres of nitrous oxide 

49,906kg CO2e


Increased TIVA training (total intravenous anaesthesis-a core skill

for training anaesthetisits

Early Mobilisation in Cardiac Intensive Care

This pioneering project in a Southampton Cardiac Intensive Care Unit (CICU) aimed to improve both patient and service outcomes


Reduced ventilation days by 4 days 

Reduced overall cardiac intensive care stay by 6 days


Total savings of £1,266,327 over 2 years


Total savings of 48.5 tonnes CO2e over 2 years


More rapid recovery, quicker discharge and return to ADLs

Patients having more autonomy during their hospital stay

Increased staff satisfaction


Reducing duplicate medication ordering

This project in Southampton aimed to reduce the amount of wasted and disposed medication


Reduce potential drug errors


Annual savings of £26,000


Annual savings of 11,180 kg CO2e

↓ Waiting time for patients receiving medications


↑ Staff time

Green Walking for mental health recovery

Regular walking groups in local green spaces have been introduced in numerous adult inpatient psychiatric units in the UK. The positive impacts are significant. Watch these two videos by Occupational Therapists using Green Walking in their services to find out more:


Green space and exercise can help to reduce anxiety and improve physical fitness; walks can provide a therapeutic space and allow patients to reconnect with their identity


Cost of staff time (but calmer patients can reduce staff pressures on the ward); may be transport costs


Connection to nature can lead staff and patients to take action in other areas of their lives to protect the environment


Patients socialise with one another and with staff

Improved staff wellbeing & satisfaction, reduced risk of violence