The SusQI Education Project: Putting theory into practice

The Sustainability in Quality Improvement (SusQI) Education project was created by the Centre for Sustainable Healthcare to provide health professionals with the tools they need to innovate for a more environmentally, socially, and financially sustainable health system. The project's principal goal is to integrate sustainability into all existing Quality Improvement education in order to develop the knowledge and skills necessary for sustainable healthcare. The project uses the 'SusQI' framework to facilitate integration, which analyses value in healthcare through the lens of the "triple bottle line."

How is the SusQI Education project implemented?

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In 2019-21 the project ran eight pilots across undergraduate and postgraduate medical, nursing and dentistry education. More pilots are now underway in midwifery and allied health professions education. Extensive evaluation found that including sustainability enhanced students’ motivation for QI and developed their confidence and skills for improving sustainability in practice.

The project model and its evaluation findings have  been shared nationally and internationally, including at AMEE 2020 and 2021, ISQua 2021, IHI Forum 2021 and via a dedicated meeting of the Medical Schools Council Education Leads. The pilot at King’s College London was a Green Gown Awards Finalist in 2021.

Now in its third year, the project is transitioning to a spread phase: providing high-quality open-access resources,  supplemented by online courses for QI practitioners and educators, with additional support available through our SusQI Beacon Site programme.

How to become a Beacon Site

Organisations providing QI training to healthcare professionals can be recognised as a SusQI Beacon Site if they commit to (and later provide evidence of) the following:

  • Provide a named person within the organisation to act as a main point of contact for CSH
  • Review where QI is taught across courses / degree programmes and secure agreement from course leads to integrate sustainability
  • For each course:
    • Identify a SusQI Lead and train them in SusQI
    • Review current QI teaching to identify opportunities for the integration of sustainability
    • Integrate into curriculum and assessment, if applicable
    • Integrate into learning materials
    • Provide SusQI training to trainers
    • Deliver integrated SusQI teaching to learners
    • Evaluate and improve

"My students (working nurses) on the ICU nursing course are using the SusQI framework for their quality improvement project assignment.  I’m marking essays now and adding in sustainability as a component of quality has enhanced the academic writing this year – it has also prompted the students to develop more interesting projects.” Dr Heather Baid, University of Brighton"

What we can offer to SusQI Beacon Sites

Beacon Sites are featured on and our CSH website in list and map form, and are approved to identify themselves as SusQI Beacons and use the SusQI Beacon logo on their communications. Beacon Site status is reviewed by CSH annually for the first two years and three-yearly thereafter.

Resources and support provided to beacon sites include: 

  • Free Step-by-Step resources for running a QI project.
  • Free Educator Pack, including introductory learning material, pre-reading exercises, session plans and materials for interactive webinars/seminars.
  • 30-minute e-learning sessions, free to NHS staff and students on e-Learning for Healthcare
    • Building a Net Zero NHS
    • Introduction to SusQI (commissioned by HEE Northeast Faculty of Sustainable Healthcare, will be accessible from February 2022)

Additional support available:

  • Continuing professional development courses comprised of 4-6 hours online self-study followed by a half-day workshop to practise techniques, explore application to participants’ own context, meet SusQI experts and colleagues/peers.
  • Beacon Site support packages (organisations working towards Beacon site status can choose to commission additional support from CSH). This may include:
    • Block-booking discounts on CSH courses for SusQI Leads and other faculty
    • Review of current QI curriculum and material, recommendations for integration of SusQI
    • Co-delivery of SusQI training to faculty and students
    • Mentoring by the CSH team for faculty and students
    • SusQI Clinics – for online input into individual projects
  • The Green Ward Competition, a clinical leadership and engagement programme for NHS Trusts/Boards wishing to improve their environmental sustainability and reduce their carbon footprint. Using SusQI methods, CSH staff work directly with teams to help them develop, run and measure SusQI projects. The competition culminates in a Trust-wide judging and awards event that engages senior leaders as judges.
  • Education fellowships to provide training, mentoring and project guidance to a Fellow hosted by another organisation.
  • National and regional partnershipswhich may include outreach to universities, Trusts/Health Boards and QI providers, commissioning of closed courses or block-booking places on open courses, training and mentoring a “SusQI Faculty” to support further spread, Beacon site support, Fellowships, Green Ward Competitions, or bespoke projects.

Would your organisation like to become a Beacon Site and integrate SusQI into Quality Improvement Education? Send an email request to our QI Education Fellow, Dr Victoria Stanford. 

Who is already involved?

These are either former or present Beacon Sites, as well as additional collaborators and partners with whom we are collaborating to integrate sustainability into current QI education.

  • GGA finalistKing's College London Medical and Nursing Schools were one of our early supporters and pilot sites of SusQI in medical education. Year 4 students undertake the QI and Evidence Based Practice module in peer group teams with a supervisor to complete a project in a clinical setting. Over the course of five years, the module has trained over 400 students and 100 supervisors, delivering 100 projects per year across the South East of England's healthcare system. They have been named a finalist in the Green Gown Awards 2021 for their next generation learning. The KCL Nursing and Midwifery School is a 2021-2022 Beacon Site that is embedding sustainability into QI education across undergraduate and postgraduate nursing disciplines.
  • Severn Deanery Foundation School Sustainability Fellows are being supported by the SusQI Education project to embed sustainability into QI education across the Foundation School
  • East Anglia Foundation School clinicians are working to embed SusQI into postgraduate clinical trainee teaching.
  • Newcastle University Medical School have joined as a Beacon Site for 2021-2022 and are embedding sustainability into QI education for medical students
  • Queen's University Belfast (QUB) Medical School are a Beacon Site for 2021-2022 and are working on embedding sustainability into the existing QI curriculum across the undergraduate medical curriculum

Additionally, you may read this paper by Clery et al., who collaborated with CSH to pilot SusQI training for undergraduate medical students at the University of Bristol's medical school.


The SusQI Education Project is funded and supported by Health Education England, The Health Foundation, and Kings College London.

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