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Navigating the Sustainability Landscape: A Systematic Review of Sustainability Approaches in Healthcare

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Title: Navigating the Sustainability Landscape: A Systematic Review of Sustainability Approaches in Healthcare
Authors: Lennox, L
Reed, J
Maher, L
Item Type: Journal Article
Abstract: Background Improvement initiatives offer a valuable mechanism for delivering and testing innovations in healthcare settings. Many of these initiatives deliver meaningful and necessary changes to patient care and outcomes. However, many improvement initiatives fail to sustain to a point where their full benefits can be realised. This has led many researchers and healthcare practitioners to develop frameworks, models and tools to support and monitor sustainability. This work aimed to identify what approaches are available to assess and influence sustainability in healthcare and to describe the different perspectives, applications and constructs within these approaches to guide their future use. Methods A systematic review was carried out following PRISMA guidelines to identify publications that reported approaches to support or influence sustainability in healthcare. Eligibility criteria were defined through an iterative process in which two reviewers independently assessed 20% of articles to test the objectivity of the selection criteria. Data were extracted from the identified articles, and a template analysis was undertaken to identify and assess the sustainability constructs within each reported approach. Results The search strategy identified 1748 publications with 227 articles retrieved in full text for full documentary analysis. In total, 62 publications identifying a sustainability approach were included in this review (32 frameworks, 16 models, 8 tools, 4 strategies, 1 checklist and 1 process). Constructs across approaches were compared and 40 individual constructs for sustainability were found. Comparison across approaches demonstrated consistent constructs were seen regardless of proposed interventions, setting or level of application with 6 constructs included in 75% of the approaches. Although similarities were found, no approaches contained the same combination of the constructs nor did any single approach capture all identified constructs. From these results, a consolidated framework for sustainability constructs in healthcare was developed. Conclusions Choosing a sustainability method can pose a challenge because of the diverse approaches reported in the literature. This review provides a valuable resource to researchers, healthcare professionals and improvement practitioners by providing a summary of available sustainability approaches and their characteristics.
Issue Date: 9-Feb-2018
Date of Acceptance: 29-Dec-2017
URI: http://hdl.handle.net/10044/1/55761
DOI: https://dx.doi.org/10.1186/s13012-017-0707-4
ISSN: 1748-5908
Publisher: BioMed Central
Journal / Book Title: Implementation Science
Volume: 13
Copyright Statement: © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Chelsea & Westminster Hospital NHS Foundation Trust
National Institute for Health Research
Funder's Grant Number: N/A
Keywords: Assessment
Quality improvement
11 Medical And Health Sciences
08 Information And Computing Sciences
Health Policy & Services
Publication Status: Published
Article Number: 27
Appears in Collections:School of Public Health