Before deciding on what changes your project will make, it is important to get a clear picture of how the system currently works.

The QI approach encourages us to really find out about how the system works currently, such as who is involved and what are all the steps in the process. In SusQI, this includes understanding how and where environmental, social and financial resources are being used, highlighting problems and opportunities for improvement.

Tools to Study the System

Tools which can be used to help study systems in a holistic way are Process MappingScanning for Waste and Recognising Resource Use and Scanning for Social Impacts. These are used together. 


Click on each of the tools below to learn more about how they can be used to study the system in your QI project.



Process mapping is used to develop a 'map' of a process within a system; it maps how a process operates in reality rather than how it might ideally work. Process mapping can be used to help a team understand which steps are creating value. Maps can also be annotated with the environmental, social and financial resource use.

Download this document to help learn how to create a process map. You can also download completed examples from outpatients, sexual health services and a pathway for a patient with unilateral tinnitus . 

This website has been created through the Sustainability in Quality Improvement Education project, which is funded and supported by Health Education England, The Health Foundation and Kings College London