Sustaining Change: Once Evidence-Based Practices Are Transferred, What Then?

Virani, Tazim; Lemieux‐Charles, Louise; Davis, David A.; Berta, Whitney

doi:10.12927/hcq.2009.20420

Cited by 59 publications

(79 citation statements)

References 20 publications

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“…The six factors of the Legacy Sustainability Model comprise components that others have also considered important for sustainability, such as leadership support, human resources support infrastructure, the maintenance of financial resources, technologies, ad-hoc training, clear goals, and research-seeking behaviours [10,19,20]. Ongoing assessment and adaptation to ensure continued good fit are further essential components discussed in the literature [21,22].…”

Section: Framework Usedmentioning

confidence: 99%

“…This outcome illustrates that the six factors are "interdependent and massively entangled" [18, p. 13], making it difficult to predict their individual or joint impact. Some scholars assert that careful and systematic planning at the beginning of implementation leads to a higher likelihood of achieving sustainability [19][20][21]. As Edwards argues, "if sustainability is only a latent concern, it is likely that the project will not be sustained" [19, p. 38].…”

Section: Connectionsmentioning

confidence: 99%

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Using a Complex Systems Perspective to Achieve Sustainable Health Care Practice Change

Suter¹,

Deutschlander²,

Lait³

2011

JRIPE

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Background: There has been a surge of interventions at healthcare settings to achieve practice change, but sustaining these new practices remains a challenge. The purpose of this study was to use the Legacy Sustainability Model, a framework grounded in complexity science, to examine the implementation and sustainability of an interprofessional (IP) collaboration intervention in healthcare. The model considers six factors-communication, connections, coherence, continuous assessment, commitment, and constructs-as essential to build capacity for sustainability.

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Section: Framework Usedmentioning

confidence: 99%

Section: Connectionsmentioning

confidence: 99%

Using a Complex Systems Perspective to Achieve Sustainable Health Care Practice Change

Suter¹,

Deutschlander²,

Lait³

2011

JRIPE

View full text Add to dashboard Cite

show abstract

“…The measures are designed by those who affect them and are affected by them, thereby improving their chances of being acted upon. 22,35,91,141 Health care organizations are CASs, and the effect of multiple agents and their interconnectedness is a necessary and important consideration when implementing change. 10,119 Solution identification incorporates the organization's context because it has been identified as a major barrier to the implementation of evidence-based practices.…”

Section: Efficacymentioning

confidence: 99%

Enhancing Learning, Innovation, Adaptation, and Sustainability in Health Care Organizations

Persaud

2014

The Health Care Manager

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The development of sustainable health care organizations that provide high-quality accessible care is a topic of intense interest. This article provides a practical performance management framework that can be utilized to develop sustainable health care organizations. It is a cyclical 5-step process that is premised on accountability, performance management, and learning practices that are the foundation for a continuous process of measurement, disconfirmation, contextualization, implementation, and routinization This results in the enhancement of learning, innovation, adaptation, and sustainability (ELIAS). Important considerations such as recognizing that health care organizations are complex adaptive systems and the presence of a dynamic learning culture are necessary contextual factors that maximize the effectiveness of the proposed framework. Importantly, the ELIAS framework utilizes data that are already being collected by health care organizations for accountability, improvement, evaluation, and strategic purposes. Therefore, the benefit of the framework, when used as outlined, would be to enhance the chances of health care organizations achieving the goals of ongoing adaptation and sustainability, by design, rather than by chance.

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“…Sustainability of change requires systematic, thoughtful planning in conjunction with organizational memory so that changes are embedded within the system and knowledge retention is ensured. 9 Studies show that some hospital staff continue to be resistant to following safe sleep guidelines. 10 However, staff commitment of modeling and providing consistent safe sleep messaging to caregivers is imperative.…”

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confidence: 99%

The Use of the Child Fatality Review Committee to Contribute to a Longitudinal Quality Improvement Project on Safe Sleep

Kuhlmann

Ahlers-Schmidt

2018

Hospital Pediatrics

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As sudden unexpected infant death rates have plateaued in the United States over the last decade, the rate of sleeprelated deaths due to accidental suffocation and strangulation in bed has revealed an upward trend. 1 There has been much focus on infant safe sleep over the last few years to reduce these preventable deaths. The American Academy of Pediatrics revised its sudden infant death syndrome reduction recommendations to include safe sleep environments. These recommendations advise that infants sleep on separate sleep surfaces designed for infants to prevent accidental suffocation, strangulation, layover, or entrapment that could occur in the adult bed, chair, or couch. In addition, the sleeping surface should be free of any loose objects, such as blankets, pillows, or toys, that could obstruct an infant' s airway. 2 Some of the efforts to reduce deaths have included public service campaigns, 3 community programs and initiatives, safe sleep education and modeling in the hospital setting, and identifying and addressing barriers to safe sleep. 4,5 The direct impact of individual interventions on the overall infant mortality rate, measured as infant deaths per 1000 live births, is difficult to determine.State Child Fatality Review (CFR) teams and Fetal and Infant Mortality Review (FIMR) teams are public health strategies used to understand child and infant deaths at the local level through a multidisciplinary team review. A systematic process is used to collect and analyze data from multiple sources, identify systems-related factors and risks, and make recommendations to improve systematic care, address resource gaps in the community, and reduce preventable deaths. 6 Krugman and Cumpsty-Fowler 7 have taken a novel approach using infant sleep-related death rates from the local CFR team to target systematic change within their hospital (Medstar Franklin Square Center, Baltimore, MD). Their longitudinal quality-improvement project was focused on creating a culture of safe sleep with consistent messaging and modeling within their institution, and they used sleep-related deaths of infants discharged from their nursery as the primary outcome measure. By collaborating with the local CFR, the hospital was able to receive feedback when infants who had been born at their hospital and discharged from their nursery died of unsafe sleep environments. The infant deaths were considered sentinel events, and each death was reviewed by using root cause analysis. Through the reviews, the hospital was able to identify process changes that needed to be made to the

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Sustaining Change: Once Evidence-Based Practices Are Transferred, What Then?

Cited by 59 publications

References 20 publications

Using a Complex Systems Perspective to Achieve Sustainable Health Care Practice Change

Using a Complex Systems Perspective to Achieve Sustainable Health Care Practice Change

Enhancing Learning, Innovation, Adaptation, and Sustainability in Health Care Organizations

The Use of the Child Fatality Review Committee to Contribute to a Longitudinal Quality Improvement Project on Safe Sleep

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