Sustainability in Quality Improvement (SusQI): A Case-study in Undergraduate Medical Education

Background: There is a pressing need for more sustainable healthcare. UK medical graduates are required to apply social, economic and environmental principles of sustainability to their practice. The Centre for Sustainable Healthcare has developed a sustainability in quality improvement (SusQI) framework and educator’s toolkit to address these challenges. We aimed to evaluate this toolkit at Bristol Medical School. Methods: We facilitated a SusQI workshop for all third-year Bristol Medical School students. We used mixed methods including questionnaires, exit interviews and follow-up focus groups to evaluate the outcomes and processes of learning. Results: Students reported: improvements in knowledge, confidence, and attitudes in both sustainable healthcare and quality improvement; increased self-rated likelihood to engage in SusQI projects; and willingness to change behaviour to reduce environmental impact in their healthcare roles. Factors for successful teaching included: interactivity; collaboration and participation; and real-life, relevant and tangible examples of projects delivered by credible role models. Conclusions: SusQI education supported by the toolkit was effective at building knowledge and skills, and reframing thinking on sustainability in quality improvement. Combining the topics provided enhanced motivation for and engagement in both together, not only each individually. Further research is needed on translation of SusQI learning into practice.