Sustainable Radiology: Health Equity and Quality Improvement.

Environmental sustainability in radiology has a growing role in health care as climate changes intensify. Quality Initiative/Improvement (QI) projects lead to improved patient care and safety as well as efficient use of limited health care resources. When designing a QI project, including an environmental lens increases awareness of sustainability in medicine. This document will focus specifically on sustainability in QI (SusQI) in the field of Radiology, though similar principles may be applied in other medical fields. The sustainable QI model updates the value equation denominator from cost to the triple bottom line of environmental, social, and economic measures. Using this SusQI model can lead to a win (patient)-win (health care system)-win (environment). This article will also discuss the importance of the environment for human health and the link between quality initiatives and environmental sustainability in demonstrating the value of radiology and improving the quality of patient care. It will provide some examples of sustainability applied to many quality initiatives in radiology: For example, reduction in oral contrast use for many previously used indications, streamlined MRI protocols, as well as using ultrasound over CT or MRI for indications that are equally appropriate.