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Sustainability of Organizational Change
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UTI Toolkit – Module 5Narration by:
Jay Ford, PhD, FACHE, LFHIMSSAssistant Professor
School of Pharmacy, University of Wisconsin-Madison
Content developed in partnership with the WisconsinHealthcare-Associated Infections in Long-Term Care Coalition
Funding for this project was provided by the Wisconsin Partnership Program at the UW School of Medicine and Public Health
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Objectives
• Learn about sustainability• Why does it matter?
• How is it defined?
• What do we know – lessons learned?
• Identify and understand the role of sustainability influencers on sustainment of organizational change
• Understand the importance of sustainability planning
• Learn how to develop a sustainability plan
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Learning about Sustainability
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Why should you care about sustainability?
• Implementation ≠ sustainment of change
• A change not sustained does not achieve patient or
team goals
• Failure to sustain change means that you may have to
o Re-investigate and solve an old problem
o Increase change fatigue in your organization
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Why should you care about Sustainability?
• If a change is not sustained, it…
• Is a direct waste of invested resources,
• Has costs associated with missed opportunities,
and
• Affects the ability to implement change in the
future.
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Sustainability Defined
• Change continues after a defined period of time
• Program, clinical intervention, and/or implementation
strategies continue to be delivered
• Individual behavior change is maintained
• Program and individual behavior change may evolve or
adapt while continuing to produce benefits for
individuals/systems
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Sustainability vs. Sustainment
• Sustainability Capacity refers to “the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based policies and activities” (Schell et al, 2013)
• Sustainment of change refers to “the extent that an evidence-based intervention can deliver its intended benefits over an extended period of time” (Chambers et al, 2013).
Schell S, Luke D, Schooley M, Elliott M, Herbers S, Mueller N, Bunger A: Public health program capacity for sustainability: a new framework. Implementation Science 2013, 8:15Chambers DA, Glasgow RE, Stange KC: The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci 2013, 8:117.
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What do we know about Sustaining Change
• Innovation change matters when thinking about sustainability
• Success has to do with talent (i.e., team) and the complete
execution of the sustain (i.e., game) plan
• Change complexity appears to influence sustainability
• Short term sustainability is possible but long term is not certain.
• Change linked to the underlying organizational culture is more likely to be sustained
1. Scheirer MA, 2013. Linking sustainability research to intervention types Am J Public Health. 2013 Apr;103(4):e73-80
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What do we know about Sustaining Change
• Clinicians and managers have different opinions
• Leadership support is a facilitator and barrier
• Change linked to the underlying organizational culture is more likely to be sustained.
• Participation in a given QI intervention appears to influence staff perceptions about sustainability
1. Scheirer MA, 2013. Linking sustainability research to intervention types Am J Public Health. 2013 Apr;103(4):e73-80
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What do we know about Sustaining Change
Focus on creating a culture of change vs. making the measures
Recognize that sustainment is only good for so long.
Over time sustainment becomes the new norm.
Address the need for continuous improvement.
Reach a point where the tipping point of better practice is the goal
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Sustainability Influencers• Innovation and Organizational• Organizational and Staffing• Innovation and Staff