FlashMed

The Institute of Medicine recognizes six domains of quality within health care; high quality health care should be safe, timely, effective, efficient, equitable, and patient centered.1 On the evidence of his article, published in this edition of the journal, Professor Agar is among the increasing number of health care organizations and professionals for whom a seventh, equally important, domain exists—sustainability.2 Indeed, the Royal College of Physicians (London) has recently emphasized the importance of embedding sustainability into the delivery of health care.3 The meanings of the term “sustainability” are wide ranging.Within the health care setting, it is generally used to describe a reconciliation of the environmental, social, and economic demands influencing resource use, in order to facilitate “sustainable development”—the pattern of resource use that allows us to meet our current needs (including the delivery of health care) while preserving the environment in order that the needs of future generations might also be met.4

………..