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Sustainability-Embedded Quality Improvement
This playbook introduces the SE-QI framework and provides background information, resources, and considerations for embedding sustainability in healthcare improvement projects. It was developed in collaboration with key partners and experts in QI across Canada. It serves as a resource for clinicians, health care professionals, students, trainees, and decision-makers involved in QI work, aiming to inform them of: Sustainability-Embedded Quality Improvement (SE-QI) positions quality improvement (QI) as a practical pathway for embedding sustainability within clinical and operational practice. This playbook introduces the SE-QI framework and provides background information, resources, and considerations for embedding sustainability in healthcare improvement projects. It was developed in collaboration with key partners and experts in QI across Canada. It serves as a resource for clinicians, health care professionals, students, trainees, and decision-makers involved in QI work, aiming to inform them of: Why SE-QI is an essential and practical approach to quality improvement in healthcare, What tools are available to support planning and implementation, and how to effectively implement SE-QI into practice to advance high-quality, low-carbon, resilient healthcare.
Playbook

Health Quality BC
Our Vision is High-Quality and Sustainable Health Care for All. Every Day, Every Time, for Everyone in British Columbia.
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World Health Organization: World Hand Hygiene Day
WHO is calling on all civil society organizations and other partner organizations to engage with the campaign and accelerate progress at achieving effective hand hygiene at point of care!
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Squire-ENV Extension
The SQUIRE-ENV extension is being led by the Centre for Quality Improvement and Patient Safety (CQuIPS) in collaboration with CASCADES and national and international quality improvement leaders. Building on the internationally recognized Standards for Quality Improvement Reporting Excellence (SQUIRE), this extension establishes structured guidance for reporting environmental sustainability in quality improvement projects where sustainability is a co-benefit or primary aim. Because SQUIRE is widely used by journals, conferences, and healthcare systems to report improvement work, SQUIRE-ENV will help embed sustainability into how QI initiatives are designed, documented, and shared. Publication is anticipated in 2026.
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Use of hand sanitiser as a potential substitution for nonsterile gloves in reducing carbon emissions.
Hence, in settings with frequent use of sharp equipment, open wounds, and mucus membrane exposure, examination gloves should be required. In cases where most pathogens cannot be transmitted through intact skin, the procedure is not seen as an exposure risk, and natural defences form an adequate barrier against transmittable disease, and sanitation of the hands might be an adequate and more ethical consideration for use. We have illustrated some examples to help readers decide when removing gloves for a procedure is appropriate and when it is not.
Article
The Environmental Impact of Hand Sanitizer Ethanol [Internet]. [cité 23 août 2023]. Disponible sur: https://mediahub.unl.edu/media/16495
My research’s purpose was to help fight the global COVID pandemic by helping ethanol producers produce USP grade ethanol as well as study the environmental impacts of producing USP grade ethanol.
Video
Turning lights into flights: estimating direct and indirect rebound effects for UK households
We estimate the direct and indirect rebound effects from energy efficiency improvements by UK households. We allow for the capital cost of the improvement, together with the emissions embodied in the relevant equipment. We find rebound effects to be relatively modest, in the range 5–15%. The anticipated shift towards a low carbon electricity system will lead to larger rebound effects.
Article
United Kingdom : The Gloves are Off
The Lead Nurse for Infection Prevention and Control and two Lead Practice Educators at Great Ormond Street Hospital NHS Foundation Trust (GOSH) addressed the over-use of non-sterile gloves through education and training. This has improved patient safety and experience and staff are now following evidence-based practice rather than wearing gloves out of habit.
Case Study
Sustainability-Embedded Quality Improvement Toolkit (Beta version)
This toolkit will help individuals and teams incorporate environmental sustainability into quality improvement (QI) initiatives, and envision how you can adjust, measure and report those impacts.
Tool