Cited by 167Health Policy Implementation ScienceHealthcare Quality and ManagementHealth Sciences Research and Education

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

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Doyle, Cathal, Howe, Cathy, Woodcock, Thomas, Myron, Rowan, Phekoo, Karen, McNicholas, Chris, Saffer, Jessica, Bell, Derek·2013·Implementation Science

Abstract

The implementation of evidence-based treatments to deliver high-quality care is essential to meet the healthcare demands of aging populations. However, the sustainable application of recommended practice is difficult to achieve and variable outcomes well recognised. The NHS Institute for Innovation and Improvement Sustainability Model (SM) was designed to help healthcare teams recognise determinants of sustainability and take action to embed new practice in routine care. This article describes a formative evaluation of the application of the SM by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL). Data from project teams' responses to the SM and formal reviews was used to assess acceptability of the SM and the extent to which it prompted teams to take action. Projects were classified as 'engaged,' 'partially engaged' and 'non-engaged.' Quarterly survey feedback data was used to explore reasons for variation in engagement. Score patterns were compared against formal review data and a 'diversity of opinion' measure was derived to assess response variance over time. Of the 19 teams, six were categorized as 'engaged,' six 'partially engaged,' and seven as 'non-engaged.' Twelve teams found the model acceptable to some extent. Diversity of opinion reduced over time. A minority of teams used the SM consistently to take action to promote sustainability but for the majority SM use was sporadic. Feedback from some team members indicates difficulty in understanding and applying the model and negative views regarding its usefulness. The SM is an important attempt to enable teams to systematically consider determinants of sustainability, provide timely data to assess progress, and prompt action to create conditions for sustained practice. Tools such as these need to be tested in healthcare settings to assess strengths and weaknesses and findings disseminated to aid development. This study indicates the SM provides a potentially useful approach to measuring teams' views on the likelihood of sustainability and prompting action. Securing engagement of teams with the SM was challenging and redesign of elements may need to be considered. Capacity building and facilitation appears necessary for teams to effectively deploy the SM.

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  • The fifth most cited article is "Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement", published in Implementation Science in 2013 by a UK research team.

    “The fifth most-cited article is entitled “Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement” [87], and was published in Implementation Science in 2013 by a UK research team.”
  • Effectively engaging staff, and in our case, clients, establishes a sense of empowerment that they are a part of the change process, enhances staff motivation to participate in the change process, and leads to more actionable steps by staff to promote sustainment of the change.

    “Effectively engaging staff, and in our case, clients, establishes a sense of empowerment that they are a part of the change process, enhances staff motivation to participate in the change process, and leads to more actionable steps by staff to promote sustainment of the change [40,44-48].”

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Authors
Doyle, C., Howe, C., Woodcock, T., Myron, R., Phekoo, K., McNicholas, C., Saffer, J., & Bell, D.
Affiliations
Chelsea and Westminster Hospital (GB)
Corresponding author
Doyle, Cathal
Venue
Implementation Science
Published
2013-10-26
Volume
8
Issue
1
Pages
127-127
ISSN
1748-5908 (ISSN-L)
OpenAlex
W2156517163
Cited by
166
References
15
Citations by year
2026: 8 · 2025: 8 · 2024: 20 · 2023: 17 · 2022: 15 · 2021: 20 · 2020: 13 · 2019: 17 · 2018: 15 · 2017: 9 · 2016: 9 · 2015: 9 · 2014: 5
FWCI
13.89
Type
journal article
Language
en
Open access
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UWL Repository (University of West London) (acceptedVersion)
  • Spiral (Imperial College London) (submittedVersion, cc-by)
Funders
National Institute for Health and Care Research (NIHR-KMF-2012-01-08)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
evidence-based practice implementation, team engagement, sustainability drivers, formative assessment, opinion diversity, capacity building, healthcare quality improvement
MeSH terms
Diffusion of Innovation, United Kingdom, Hospitals, Public, Patient Care Team, Quality Assurance, Health Care, State Medicine, Program Evaluation, Models, Organizational, Evidence-Based Medicine, Quality Improvement

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