What Next? Sustaining a Successful Small-Scale Alcohol Consumption Harm Minimization Project

Milne, Sharon; Greenaway, Sarah; Conway, Kim; Henwood, Wendy

doi:10.1080/10826080701532825

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…Finally, the role of adaptation to support sustainability was highlighted within four strategies. These strategies demonstrate the importance of fostering learning, feedback, and responsiveness in improvement teams [ 38 , 92 ]. Research has indicated changes to interventions are often desirable to support initiative sustainability, ‘especially if changes reflect additions to the intervention rather than subtractions from it’ [ 94 ].…”

Section: Discussionmentioning

confidence: 99%

“…These strategies provide insight into how the initiatives can be built into current systems and processes to foster continuation. The value of integration in sustaining improvements has been promoted in a number studies [18,23,61,92]. For example, Martin et al described how impacting organisational memory through integration in systems influences stakeholder support and decreases the chance of staff making further changes to interventions [93].…”

Section: Discussionmentioning

confidence: 99%

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Unpacking the ‘process of sustaining’—identifying threats to sustainability and the strategies used to address them: a longitudinal multiple case study

Lennox

Antonacci

Harris

et al. 2023

Implement Sci Commun

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Background Although sustainability remains a recognised challenge for Quality Improvement (QI) initiatives, most available research continues to investigate sustainability at the end of implementation. As a result, the learning and continuous adjustments that shape sustainability outcomes are lost. With little understanding of the actions and processes that influence sustainability within QI initiatives, there is limited practical guidance and direction on how to enhance the sustainability of QI initiatives. This study aims to unpack the ‘process of sustaining’, by exploring threats to sustainability encountered throughout the implementation of QI Initiatives and identifying strategies used by QI teams to address these threats over time. Methods A longitudinal multiple case study design was employed to follow 4 QI initiatives over a 3-year period. A standardised sustainability tool was used quarterly to collect perceptions of sustainability threats and actions throughout implementation. Interviews (n=38), observations (32.5 h), documentary analysis, and a focus group (n=10) were conducted to enable a greater understanding of how the process of sustaining is supported in practice. Data were analysed using the Consolidated Framework for Sustainability (CFS) to conduct thematic analysis. Results Analysis identified five common threats to sustainability: workforce stability, improvement timelines, organisational priorities, capacity for improvement, and stakeholder support. Each of these threats impacted multiple sustainability constructs demonstrating the complexity of the issues encountered. In response to threats, 12 strategies to support the process of sustaining were identified under three themes: engagement (five strategies that promoted the development of relationships), integration (three strategies that supported initiatives to become embedded within local systems), and adaptation (four strategies that enhanced understanding of, and response to, emergent conditions and contextual needs). Conclusions Sustaining improvements from QI initiatives requires continuous investment in relationships, resilience to integrate improvements in local systems, and flexibility to understand emergent conditions. Findings provide practitioners, funders, and researchers with a better understanding of, and preparation for, the threats associated with sustaining improvements from QI initiatives and offer insight into specific actions that can be taken to mitigate these risks. This learning can be used to inform future initiative design and support, to optimise the sustainability of healthcare improvements. Trial registration Not applicable

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Unpacking the ‘process of sustaining’—identifying threats to sustainability and the strategies used to address them: a longitudinal multiple case study

Lennox

Antonacci

Harris

et al. 2023

Implement Sci Commun

View full text Add to dashboard Cite

show abstract

“…34,51 and support initiative continuity. [93][94][95] Capacitate health system with an efficient and reliable supply chain management system to minimize stock-outs 96 and conduct routine surveillance of drug resistance as an integral part of HIV programs. 1,97…”

Section: Discussionmentioning

confidence: 99%