QI In Action: A Sustainable Water Reuse Initiative at the Sydney Local Health District
We spotlight QI Awards 2024 Winner of the Non-Clinical Service Delivery Category.
The ACHS Quality Improvement (QI) Awards 2025 are now open for submission. This year we are supporting the movement for sustainable healthcare and expanding our non-clinical service delivery category to promote sustainable care strategies. The expanded ‘Sustainable Healthcare and Service Delivery Category’ (formerly ‘Non-Clinical Service Delivery’) acknowledges demonstrated outcomes in non-clinical service delivery, including improvement and innovation in sustainable healthcare, patient/consumer and organisation-wide practice.
Last year’s winning submission titled, ‘Harnessing Byproduct Water: Advancing Sustainable Water Management in Local Community,’ was a joint initiative led by the Royal Prince Alfred Hospital and the City of Sydney Council. This initiative showcases innovative reuse of wastewater by repurposing it for street and footpath cleaning. Currently, 20,000 litres of water per week are collected and utilised by City of Sydney sweeper trucks.
Project Background
The production of ultrapure water for kidney dialysis at the Royal Prince Alfred Hospital (RPAH) generates a significant volume of wastewater, primarily in the form of reverse osmosis (RO) reject water. This reject water, typically discharged into the sewer system, remains safe for various non-potable applications.
Recognising the environmental impact and opportunity for sustainability, Sydney Local Health District (SLHD) initiated a project to repurpose this RO reject water to enhance water usage efficiency.
Driving Sustainable Water Solutions
The project was delivered through effective teamwork and meticulous coordination across multiple teams and stakeholders. From the outset, the team engaged extensively with stakeholders, including the local community, to understand their concerns and priorities around water conservation, environmental sustainability and public health. This input shaped the project’s goals and ensured it met community needs.
Leadership provided clear strategic direction, fostering a culture of innovation, teamwork, and continuous improvement. Practical steps included securing water harvesting tanks, upgrading plumbing infrastructure, and developing detailed safety procedures for water collection and use.
Regular monitoring, testing, and feedback loops allowed for ongoing refinements, such as improving hose setups and water transfer points to enhance efficiency. The project delivered tangible benefits by repurposing around 20,000 litres of RO reject water weekly for street cleaning, reducing potable water use, lowering costs, and minimising environmental impact. Its success strengthened community relations and demonstrated a scalable, sustainable model for water management in healthcare and municipal settings.
The project exemplifies innovation and excellence in sustainable practices, that serves a model for others in healthcare and beyond. You can read the full submission on pg. 22 of the Quality Initaitves Booklet our website here.
Submit to the QI Awards 2025
We are keen to hear about the innovative work happening across the sector and to showcase the dedication, creativity, and impact of your teams. Your project could be the next to inform and influence positive change in healthcare. Visit our website to lean more here.
