Table 1 Areas and factors that comprise the NHS sustainability model [13, 14]
Areas | Factors | Explanation |
|---|---|---|
Process | Benefits beyond helping patients | Are there any other benefits to the change besides patient care, e.g. more efficient working practices, or reduced waste? |
| Â | Credibility of the benefits | Are the benefits obvious to, and describable by, everyone involved, and are they supported by evidence? |
| Â | Adaptability of the improved process | Can the new process withstand internal pressures? Can it meet ongoing needs without reliance on any individual/group/finance? |
| Â | Effectiveness of the system to monitor progress | Are there monitoring and feedback systems in place to be used beyond implementation, and is this information communicable? |
Staff | Staff involvement and training to sustain the process | Do staff play a role in the design and implementation, and are they suitably trained? |
| Â | Staff behaviours toward sustaining the change | Are staff encouraged to express ideas, and do they think the new change is a better way of doing things? |
| Â | Senior leadership engagement and support | Are senior leaders trusted, involved, knowledgeable and responsible? |
| Â | Clinical leadership engagement and support | Are clinical leaders trusted, involved, knowledgeable and responsible? |
Organization | Fit with the organization’s strategic aims and culture | Are the goals clear, and do they contribute to the overall aims of the organization? Have similar changes done well in the past? |
| Â | Infrastructure | Are staffing, facilities, policies and equipment suitable to sustain the implementation over time? |