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Table 1 Factors proposed to affect likelihood of sustainability

From: Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement

Domain Factor Issues being explored
Process Factor 1: Benefits beyond helping patient Whether in addition to helping patients there are other benefits that will make a difference to daily working lives or make things run more smoothly such as reduced waste or duplication.
Process Factor 2: Credibility of the benefits Whether benefits to patients, staff and the organisation are visible, are believed by staff and can be described clearly.
Process Factor 3: Adaptability of improved process Whether changed processes will continue to meet the need of the organisations and can be maintained when an individual or group of people who initiated it are no longer there.
Process Factor 4: Effectiveness of the system to monitor progress Whether data are easily available to monitor progress or assess improvement and whether there are systems to communicate this in the organisation.
Staff Factor 5: Staff involvement and training to sustain the process Whether staff play a part in the implementation of changes to processes and the extent of training and development of staff to help sustain these changes
Staff Factor 6: Staff attitudes towards sustaining the change Whether staff ideas are taken on board, the opportunity they are given to test these ideas and their belief that this is a better way of doing things that should be preserved.
Staff Factor 7: Senior leadership engagement Whether credible and respected senior leaders are seen as promoting and investing their own time in changes.
Staff Factor 8: Clinical leadership engagement Whether credible and respected clinical leaders are seen as promoting and investing their own time in changes.
Organization Factor 9: Fit with the organisation's strategic aims and culture Whether the changes being made are seen as an important contribution to the overall organisational aims.
Organization Factor 10: Infrastructure for sustainability Whether staff, facilities, equipment and policies and procedures are adequate to sustain new processes.