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The SusQI Showcase Event,
May 2023

Thank you to all those who contributed to a successful 2023 SusQI Showcase Event

The event showcased eight great examples of SusQI practice, with the session divided into two topic areas:

Part 1 - Examples of integrating sustainability into institutional quality improvement education,

Part 2 - Examples of sustainability in quality improvement projects from clinical practice.

Please see below for further details of our speakers, a synopsis 0f their content, and recordings of their presentations. 

Part 1: 
Examples of integrating sustainability into institutional quality improvement education

Talk synopsis:

  • In June 2019 Newcastle’s NHS Hospitals Trust was the first healthcare organisation in the world to declare a climate emergency

  • Part of this strategy is to increase the proportion of QI projects that include sustainability metrics in their outcome measurement to 20% by March 2024. 

  • To support success in this project Trust QI training has been brought in-house and Newcastle Improvement have worked with the CSH to review existing materials and implement a strategy to integrate SusQI, 

  • As a result environmental sustainability and health inequalities have been added as key outcome domains for QI and audit in the trust. 

  • Feedback indicates that staff feel empowered to highlight project ideas that focus on sustainability, and that the new approach has expanded the reach of traditional QI projects.

Talk synopsis:

  • King's College London has worked with the CSH between 2021-24 to integrate SusQI into the nursing, midwifery and palliative care curricula.

  • A SusQI workshop is now delivered in 12 programmes and receives positive feedback from students. 

  • KCL has been awarded Established Beacon Site status by the CSH

  • Key factors in the success of this project include the support received from the CSH and alignment of the project with the university's climate and sustainability strategic objectives.

  • Projects completed by postgraduate students have resulted in measurable financial, clinical and sustainability improvements.

Talk synopsis:

  • Dentistry is responsible for 3% of the NHS’s carbon emissions, and until this project had no embedded sustainability training. Building sustainability into Dental Core Training therefore became a key priority.

  • The course pre-reading utilises the CSH’s open-source education pack contents, and the sustainability in QI teaching content is delivered in three parts: 1) Educational workshops, 2) Project development sessions, and the 3) Project presentation day.

  • Example projects are outlined in this presentation. 

  • Testimonials indicate that  trainees felt empowered through this content to initiate sustainable change in their workplace.

Talk synopsis:

  • The QI team is part of NHS Education for Scotland and have a remit for providing quality improvement training to a wide range of services including health care, social care and other public services e.g. policing and education

  • The ‘QI Zone’ developed by the team contains tools, resources and information on QI programmes with examples of case studies undertaken. The team believes that real life examples will persuade more people to take up sustainable QI projects.

  • Another important tool provided offers support to develop QI charts and graphs (e.g. fish-bone diagrams), and this has been adapted to incorporate sustainability concepts. 

  • A model they use is the ‘Quality Improvement Journey’ and for each step, they give  ideas for what you can do. Broad categories include developing aims, testing changes, leadership and  communication amongst others.

  • Future plans include adapting the current ‘Quality Improvement Journey’ resources provided, to include sustainability concepts.

Part 2: 
Examples of sustainability in quality improvement projects from clinical practice.

Talk synopsis:

  • Mucositis is a common condition in patients following chemotherapy and radiotherapy, causing severe pain and often requiring hospital admission and NG feeding.

  • Photobiomodulation involves treating patients at the time of radiotherapy to prevent mucositis. The treatment has NICE approval and patients can be taught to self-treat.

  • This project split 22 patients into a control and treatment group, with the treatment group, utilising PBM alongside radiotherapy.

  • Overall, the study found reduced hospital bed days, reduced analgesia requirements, cost savings, carbon reductions, improved quality of life, quicker recovery and increased patient empowerment in the treatment group.

  • In the future, the team hopes to purchase more devices and integrate PBM into standard treatment protocols.

Talk synopsis:

  • HIV is an example of a condition, for which often stable patients are reviewed more frequently than is required.  

  • Prior to this project, in Northamptonshire, a review and bloods were taken every 6 months for all HIV patients regardless of clinical condition.

  • The project intervention involved identifying a ‘stable’ patient group who were asked if they would be happy to be followed up annually (as opposed to every 6 months).

  • Benefits of the change included a reduction in travel, clinical and non-clinical resource use, as well as patient and nursing time, and had a high approval rate amongst patients

Talk synopsis:

  • The home enteral feeding team in Gloucestershire have a contract with Nutricia to provide feeding equipment and formulas. Nutricia developed and tested more sustainable changes to their equipment and the feeding team piloted their use within the Neurological Centre.

  • The equipment changes consisted of using reusable containers for feeding (suitable for up to 30 usages), and giving sets that can be used multiple times within a 24 hour period.

  • Eligible patients were identified, training was delivered to staff and a pre- and post-pilot questionnaire was sent out to patients and staff to gauge environmental opinions. 

  • Results indicated a strongly positive response to the new equipment, with 90% of staff additionally indicating a greater understanding of the impact of healthcare on the environment. None felt that patient care was compromised.

  • Future plans include extending the change made to a wider population and working with commercial partners to encourage them to develop further sustainable solutions such as having patients return excess feed for use as biofuel.

Talk synopsis:

  • Carpal tunnel release surgery is a common orthopaedic procedure, and therefore a hotspot of resource use within the department. 

  • The team worked to identify unnecessary surgical instruments and drapes and were able to introduce a new ‘lean and green’ surgical set-up.

  • Additionally, they adapted the pathway so that the surgery was performed in a procedure room rather than in theatre, and so that patients bypassed ward admission and instead attended the procedure area at a given appointment time 

  • A 65% reduction in clinical waste, 80% reduction in carbon footprint, and 65% reduction in cost was achieved. there were no adverse patient outcomes.

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