From Policy to Practice: Sustainability in Quality Improvement and the Emerging National Movement for Sustainable Healthcare in Australia

Healthcare systems are increasingly recognising that environmental sustainability is integral to safe, high-quality and value-based care. In Australia, this shift has been accelerated by the National Health and Climate Strategy, emerging safety and quality standards, and growing professional commitments to climate-resilient, low-carbon healthcare. However, translating policy ambition into routine clinical practice remains a major implementation challenge. Sustainability in Quality Improvement (SusQI) offers a practical framework for embedding environmental, social and financial considerations into established quality improvement methods. By aligning sustainability with existing governance, clinical improvement and workforce development structures, SusQI enables healthcare professionals to redesign care in ways that improve patient outcomes while reducing environmental harm and unnecessary resource use. This manuscript describes the initial Australian efforts to integrate SusQI into healthcare education, accreditation, clinical governance and service improvement. Early examples include SusQI Beacon Sites at the University of Notre Dame Australia and the University of Melbourne, clinician-led environmental sustainability competitions, specialty-based accreditation through GreenED, and large-scale diagnostic stewardship initiatives such as Sustainability in Quality Use of Diagnostics in Emergency Departments. These initiatives demonstrate that sustainability can be operationalised through familiar quality improvement approaches and can deliver measurable environmental, financial and clinical benefits. As health systems work to decarbonise while maintaining safe and equitable care, the Australian experience offers transferable lessons. Sustainable healthcare should not be viewed as an additional burden, but as an essential dimension of quality, safety, stewardship and health system resilience. SusQI provides a bridge from policy to practice, empowering clinicians to lead practical change that protects both people and the planet.