Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice

BACKGROUND: The healthcare sector is a major contributor to climate change and there are international calls to mitigate environmental degradation through more sustainable forms of clinical care. The UK healthcare sector has committed to net zero carbon by 2040 and sustainable healthcare is a nation...

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Autores principales: Marsden, Oliver, Clery, Philippa, D’Arch Smith, Stuart, Leedham-Green, Kathleen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556782/
https://www.ncbi.nlm.nih.gov/pubmed/34717607
http://dx.doi.org/10.1186/s12909-021-02963-7
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author Marsden, Oliver
Clery, Philippa
D’Arch Smith, Stuart
Leedham-Green, Kathleen
author_facet Marsden, Oliver
Clery, Philippa
D’Arch Smith, Stuart
Leedham-Green, Kathleen
author_sort Marsden, Oliver
collection PubMed
description BACKGROUND: The healthcare sector is a major contributor to climate change and there are international calls to mitigate environmental degradation through more sustainable forms of clinical care. The UK healthcare sector has committed to net zero carbon by 2040 and sustainable healthcare is a nationally mandated outcome for all UK graduating doctors who must demonstrate their ability to address social, economic, and environmental challenges. Bristol Medical School piloted successful Sustainability in Quality Improvement (SusQI) workshop, but identified challenges translating classroom learning into clinical practice. This paper aims to identify and address those challenges. METHODS: We conducted five focus groups that identified and iteratively explored barriers and facilitators to practice among medical students, comparing a range of experiences to generate a conceptual model. We then combined our findings with behaviour change theory to generate educational recommendations. RESULTS: Students that applied their learning to the clinical workplace were internally motivated and self-determined but needed time and opportunity to complete projects. Other students were cautious of disrupting established hierarchies and practices or frustrated by institutional inertia. These barriers impacted on their confidence in suggesting or achieving change. A minority saw sustainable healthcare as beyond their professional role. CONCLUSIONS: We present a series of theoretically informed recommendations. These include wider curricular engagement with concepts of sustainable clinical practice; supportive workplace enablement strategies such as workplace champions and co-creation of improvement goals; and time and headspace for students to engage through structured opportunities for credit-bearing project work. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02963-7.
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spelling pubmed-85567822021-11-01 Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice Marsden, Oliver Clery, Philippa D’Arch Smith, Stuart Leedham-Green, Kathleen BMC Med Educ Research BACKGROUND: The healthcare sector is a major contributor to climate change and there are international calls to mitigate environmental degradation through more sustainable forms of clinical care. The UK healthcare sector has committed to net zero carbon by 2040 and sustainable healthcare is a nationally mandated outcome for all UK graduating doctors who must demonstrate their ability to address social, economic, and environmental challenges. Bristol Medical School piloted successful Sustainability in Quality Improvement (SusQI) workshop, but identified challenges translating classroom learning into clinical practice. This paper aims to identify and address those challenges. METHODS: We conducted five focus groups that identified and iteratively explored barriers and facilitators to practice among medical students, comparing a range of experiences to generate a conceptual model. We then combined our findings with behaviour change theory to generate educational recommendations. RESULTS: Students that applied their learning to the clinical workplace were internally motivated and self-determined but needed time and opportunity to complete projects. Other students were cautious of disrupting established hierarchies and practices or frustrated by institutional inertia. These barriers impacted on their confidence in suggesting or achieving change. A minority saw sustainable healthcare as beyond their professional role. CONCLUSIONS: We present a series of theoretically informed recommendations. These include wider curricular engagement with concepts of sustainable clinical practice; supportive workplace enablement strategies such as workplace champions and co-creation of improvement goals; and time and headspace for students to engage through structured opportunities for credit-bearing project work. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02963-7. BioMed Central 2021-10-30 /pmc/articles/PMC8556782/ /pubmed/34717607 http://dx.doi.org/10.1186/s12909-021-02963-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Marsden, Oliver
Clery, Philippa
D’Arch Smith, Stuart
Leedham-Green, Kathleen
Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
title Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
title_full Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
title_fullStr Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
title_full_unstemmed Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
title_short Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
title_sort sustainability in quality improvement (susqi): challenges and strategies for translating undergraduate learning into clinical practice
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556782/
https://www.ncbi.nlm.nih.gov/pubmed/34717607
http://dx.doi.org/10.1186/s12909-021-02963-7
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