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Table 4 Framework/model/theory sustainability definitions mapped to sustainability constructs by Moore et al. [1]

From: Identifying relevant concepts and factors for the sustainability of evidence-based practices within acute care contexts: a systematic review and theory analysis of selected sustainability frameworks

Reference Synonym Definition Sustainability constructs by Moore et al [1] No. of constructs
total = 5
New constructs
After a period of time Continued delivery or use of innovation Maintain behavior change (use of innovation) by individuals Evolution or adaptions of innovation Continued benefits of using innovation Defined as process* Defined as a stage**
Buchanan et al. [25] Sustainability The sustainability of change can be broadly defined as the 'process' through which new working methods, performance goals and improvement trajectories are maintained for a period appropriate to a given context [25]. x   x   x 3 x  
Racine [42] Sustainability None provided
The framework alludes to the existence of 'stages' in the process through which an innovation goes from adoption to sustainability
      0   x
Maher et al. [39] Sustainability Sustainability is when new ways of working and improved outcomes become the norm. Not only have the 'process' and outcome changed, but the thinking and attitudes behind them are fundamentally altered and the systems surrounding them are transformed in support. In other words, it has become an integrated or mainstream way of working rather than something “added on.” As a result, when you look at the process or outcome one year from now or longer, you can see that at a minimum it has not reverted to the old way or old level of performance. Further, it has been able to withstand challenge and variation; it has evolved alongside other changes in the context, and perhaps has actually continued to improve over time [40]. x   x X X 4 x  
Slaghuis et al. [40] Routinization Sustainability is “a dynamic 'process' in which actors in a targeted work practice develop and/or adapt the organizational routines to a new work method. This process can also be described as routinization: through the development of organizational routines a new work method becomes part of everyday routine activities. This process also involves learning processes at different levels in the organization, as there is more to the daily performance of a work practice than just routinization” (40).   x x x   3 x  
Chambers et al. (34) Sustainability Sustainability is a 'process' of managing and supporting the evolution of an intervention within a changing context [35]. Sustainability has evolved from being considered as the endgame of a translational research process to a suggested “adaptation phase” that integrates and institutionalizes interventions within local organizational and cultural contexts (34]. X x   x x 4 x  
Fox et al. [43] Sustainability No explicit definition is provided with framework. ...only explicitly states it combines the concepts presented by Greenhalgh et al. [44] in their systematic review (e.g., successful routinization is strongly impacted by staff continuity, attrition, and perceptions of the value and need of the innovation), and the DSF Chambers et al. [34] which posits the concept is not an endpoint but rather involves a 'process' of innovation evolution or continual adaptation as a result of learning, problem-solving and evolution [43]. x x x x   4 x  
Fleiszer et al. [13] Sustainability Sustainability is a 'process' that emerges from and succeeds innovation implementation wherein improvements are maintained, new ways of working become routine, surrounding systems are transformed in support and the innovation may even be developed, over a period of time appropriate to a given situation [13]. x x   x x 4 x  
Frykman et al. [41] Sustainability Uses Stirman et al. [9] definition of sustainability, “the 'phase' of implementation when initial support has been withdrawn, core elements are maintained, and capacity for continued performance of the core elements is maintained” [41]. x x   x x 4   x
Total definitions referencing the construct 6 5 4 6 5   6 2
  1. *Defines sustainability as a process [25], [39], [40], [34], [43], [13]
  2. **Defines sustainability as an ongoing stage or phase of implementation [42], [41]