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How SusQI Is Transforming Diabetes Care in Denmark: 52 Tonnes of CO₂e and Counting

The Centre for Sustainable Healthcare (CSH) has collaborated with the seven Steno Diabetes Centers across Denmark, Greenland and the Faroe Islands, partly funded by Novo Nordisk Foundation, to integrate sustainability into diabetes care. Collectively, the Steno Diabetes Centers treat more than 30,000 people with diabetes, and benefit thousands more through research, education and preventive interventions.

Denmark’s healthcare sector accounts for around 6% of the country’s CO2e emissions, with hospitals being the primary contributors. Emissions from healthcare have nearly doubled since 1990, and projections suggest they could rise to 3.9 million tons by 2035 if no action is taken. Recognising this challenge, Denmark’s five regions have committed to halving emissions by 2035 through strategies focused on greener procurement, circular economy practices, staff behaviour change and transitioning to renewable energy.

The project aimed to embed the sustainable value equation and SusQI methodology, developed by CSH, into clinical practice of the centers, ensuring that health outcomes are maximised while minimising environmental, financial, and social costs, aligning with Denmark’s broader climate goals and demonstrating how clinical engagement and innovation can contribute to a greener healthcare system.

Delivering the training

The project ran in three phases:

1. Introductory Leadership Workshop in September 2025
2. Sustainable Healthcare and SusQI Training in person with project and operational management teams in October 2025
3. Post training project support from October 2025-March 2026

Introductory Leadership Workshop

The project began with an online leadership workshop attended by senior representatives from all seven Steno Diabetes Centers. Participants included CEOs and Chiefs of Staff, ensuring strategic alignment and commitment at the highest level. This session explored why environmental sustainability is a priority and introduced the concept of sustainable value in healthcare and its links to health outcomes and equity. Leaders reflected on carbon hotspots in their services and considered how sustainability could align with existing priorities. Breakout discussions focused on identifying current high-value practices and opportunities to reduce waste.

In-person training

An in-person training day was held at the beautiful Hotel Koldingfjord in Kolding, Denmark. Originally built as a hospital, the building served as a sanatorium for children with tuberculosis from 1911 to 1960. The building has since transitioned through various uses, including a psychiatric facility, before being renovated into a modern hotel and conference centre in 1990.

The in-person workshop brought together project and operational managers from the seven centres. Over two days, participants worked through the SusQI methodology, applying the sustainable value equation to develop project ideas aimed at improving diabetes care while reducing environmental impact. On day one, there was a focus on learning about why sustainability within healthcare matters, studying the system and identifying practical change ideas.

On day two, there was a focus on social and environmental sustainability measurement, including training in carbon footprinting. 

Participant feedback was positive. Attendees described the course as “inspiring,” “important,” and “cooperative,” highlighting the practical approach, group work, and clear steps for getting started as particularly useful. Participants reported feeling motivated to work on sustainability initiatives and appreciated the SusQI resources, case studies and CSH networks.

Post training project support

Ongoing support was provided from October 2025-March 2026, ensuring centres were best supported to plan and measure changes effectively.

Some centres opted to work on a concrete SusQI project, whereas others have worked more on a methodology level. The seven centres agreed to establish a methodology working group and develop a shared toolbox.

Outcomes

Across four projects undertaken at four of the centres, the combined modelling indicates a total potential reduction of approximately 52 tonnes CO₂e, equivalent to driving over 152,000 miles  in an average car. The projects also led to financial savings as a result of reduced equipment use, travel, catering and release of clinical time (equivalent to several hundred hours per year) that can be reinvested in higher-value care.

To read case studies of other SusQI projects, access our case study library.

Impact on Patients and Staff

The project’s impact reaches wider than environmental and financial savings, with a range of potential benefits for patients and staff.

For patients, these changes bring reduced travel time, cost and disruption to daily life, alongside greater flexibility and convenience through digital and needs-based care. Fewer unnecessary appointments and interventions can be expected, with improved access prioritised for those with the greatest need. Together, these factors have the potential to increase patient satisfaction, as care is better matched to individual needs.

For staff, the benefits centre on an increased ability to focus on higher-need or more complex patients, supported by a reduction in time spent on low-value or unnecessary activities. This leads to improved efficiency and workflow, with clinical work more closely aligned to patient need. In turn, staff are afforded greater opportunities to engage in more meaningful, value-driven care.

Collectively, the changes demonstrate how aligning care more closely with patient need can reduce environmental impact, lower costs, and improve efficiency, all while supporting more personalised and equitable care.

Author: Rachel McLean, Transformation Director (Acting)