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Sustaining change is one of the most difficult tasks in patient safety and quality improvement (QI) initiatives. There are several strategies that managers can use to ensure that a change becomes long-lasting that I want to share. Parand et al. (2012) stated that the central problem with sustaining QI initiatives is the discrepancy between the internal goals and external requirements. Parand et al. (2012) insisted that a QI may be sustained by aligning goals with external requirements as the results of the initiative become controlled by external stakeholders. However, such a strategy does not provide a clear step-by-step guide for implementing it.
The second strategy for sustaining change is based on the idea that the employees do not have the motivation to sustain it after the first success. Thus, Heath et al. (2018) insist that implementing strategies that increase motivation is the key to sustaining QI initiatives. Heath et al. (2018) offer ten strategies for maintaining motivation, including strengthening relationships, ensuring that the right people are in the right place, managing skepticism, addressing passiveness, and giving real responsibility. The researchers also recommend focusing on the results that should be measurable, achievable, and timely, as well as monitoring the success of achieving the goals.
Finally, Silver et al. (2016) state that QI initiatives can be sustained by using specific tools, including process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. All these instruments help visualize the success in achieving sustained change, motivating the stakeholders.
References
Heath, C., Clark, E., & Howard, J. (2018). 10 Ways to Keep Your Quality Improvement Team Motivated. Family Practice Management, 25(5), 23-26.
Parand, A., Benn, J., Burnett, S., Pinto, A., & Vincent, C. (2012). Strategies for sustaining a quality improvement collaborative and its patient safety gains. International Journal for Quality in Health Care, 24(4), 380-390.
Silver, S. A., McQuillan, R., Harel, Z., Weizman, A. V., Thomas, A., Nesrallah, G.,… & Chertow, G. M. (2016). How to sustain change and support continuous quality improvement. Clinical Journal of the American Society of Nephrology, 11(5), 916-924.
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