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Discusses quality costing as part of an overall Total Quality Management (TQM) strategy and describes and analyses a practical quality costing exercise. Argues that quality costing exercises can provide considerable opportunity to be more efficient whilst enhancing the quality of patient care. Evaluates the benefits of the exercise and discusses its application to other areas.

The purpose of this paper is to see whether ethical and sustainable corporate strategy is not just an “add on” for good community relationships and publicity, and whether companies across the globe are approaching sustainability differently.

This paper is based on the assumption that company publications reflect the principle and philosophy of its business approach.

The paper identifies stark differences in global sustainability practice, with the USA, in particular, falling behind in terms of sustainability leadership, compared with similar organisations in both the European Union and the Asia Pacific region.

This paper implies that US multinationals need to improve their sustainability practice and to begin to think in terms of triple bottom line management, ethical standards and governance.

This paper implies that corporations need more effort in developing and managing ethics and sustainability as part of their competitive advantage and corporate strategy.

The original contribution of this paper is that it provides valuable insights into how different organisations are in reality putting sustainability first.