In this cluster, we define both ‘Sustainability’ and ‘Stewardship’ in healthcare.
Sustainability
Quality services and systems include sustainability as a fundamental principle. This means minimising environmental impacts, enhancing health and building resilience with individuals and their communities.
Source: Sustainable Development Unit and Public Health England (2014) Sustainable, Resilient, Healthy People and Places. Module: Sustainable and clinical care models. Available from a weblink on: https://www.sduhealth.org.uk/areas-of-focus/clinical-and-care-models.aspx
Three examples of the term in use in healthcare:
One of the most unexpected findings in the study was the 4.06 million tonnes of CO2 attributed to the procurement of pharmaceuticals. The implication is that sustainability is not just about efficiency of NHS buildings: through use of equipment and consumables, clinical care itself is responsible for the greatest environmental impacts.
Mortimer F (2010) The sustainable physician. Clin Med 10(2): 111-112. doi: 10.7861/clinmedicine.10-2-110 http://www.clinmed.rcpjournal.org/content/10/2/110.full
Clinical specialties are uniquely placed to address the financial and environmental sustainability of services – from the design of the clinical pathway to the organisation and delivery of care.
Centre for Sustainable Healthcare. Sustainable Specialties. https://sustainablehealthcare.org.uk/what-we-do/sustainable-specialties
Any quality aims that cannot be maintained with the resources available to us are set up to fail. It is important to realise that working to improve sustainability will seldom be in conflict with the other dimensions of quality. In particular, low carbon environmentally sustainable healthcare is likely to improve cost efficiency and patient empowerment.
Quotation from Donal O’Donoghue. In Sustainable Development Unit and Public Health England (2014) Sustainable, Resilient, Healthy People and Places. Module: Sustainable and clinical care models. Available from a weblink on: https://www.sduhealth.org.uk/areas-of-focus/clinical-and-care-models.aspx
Stewardship
“Stewardship is to hold something in trust for another.”
Three examples of the term in use:
“The stewardship concept demands that we constantly ask the question: Will the resource be in better shape after my stewardship?”
“Doctors should embrace the values of resource stewardship in their clinical practice …”
Maughan D, Ansell J (2014) Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care. Academy of Medical Royal Colleges. November 2014. Page 8. https://www.aomrc.org.uk/wp-content/uploads/2016/05/Protecting_Resources_Promoting_Value_1114.pdf
“Doctors and nurses are stewards of something precious.”
Mullan F (2001) A Founder of Quality Assessment Encounters A Troubled System Firsthand. Health Affairs Vol. 20, No.1: Expanding Health Coverage. https://www.healthaffairs.org/doi/10.1377/hlthaff.20.1.137