Collaboration for Leadership in Applied Health Research and Care Northwest London

The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Northwest London is hosted by Chelsea and Westminster Hospital NHS Foundation Trust and academically led by Imperial College London, in partnership with Northwest London

Making Your Improvements Last:

A New Approach to Reflect Upon Sustainability

Laura Lennox PhD Student and Research Assistant

NIHR CLAHRCNorthwest London

What is the problem?• Many improvement initiatives don’t have a lasting

impact on care. • Only 1/3 achieve long term success and show

evidence of spread.1

NIHR CLAHRCNorthwest London

The NHS III Sustainability Model• Allowed teams to identify

risks• Helped to focus

conversations

But…• Time consuming • Inaccessible language• Missing factors

Past Experience

NIHR CLAHRCNorthwest London

Developing a New Approach

NIHR CLAHRCNorthwest London

The Long Term Success ToolTeam members

reflect upon factors and

enter ratings on WISH

Ratings collated for team and overall report

produced

Team discussion

and planning

Take action to mitigate

risks

NIHR CLAHRCNorthwest London

Factors for Long Term Success

Commitment to the improvement

Evidence of benefits Alignment with

political & financial

environment

Alignment with organisational strategies and

priorities

Leadership

Progress monitored for feedback and

learning

Resources in place

Team functioning

InvolvementRobust and adaptable processes

Support for ImprovementSkills & capabilities

NIHR CLAHRCNorthwest London

Overall ratings:“Lack of

engagement/contribution from senior managers in community services. No specialist nurse

yet.”

“Do not have necessary staff

therefore need to recruit more staff.”

NIHR CLAHRCNorthwest London

Summary• The Long Term Success approach

emphasises the importance of continuous planning, reflection, and action.

• The tool can provide a mechanism for shared learning and tacit knowledge translation.

NIHR CLAHRCNorthwest London

Discussion Question

1. How are people attempting to influence sustainability across diverse settings with the

use of tools?

NIHR CLAHRCNorthwest London

References1. NHS Modernisation Agency. Complexity of sustaining

healthcare improvements: what have we learned so far : Research into Practice report 13. 2004.

2. Maher L, Gustafson D, Evans A. Sustainability Model and guide. Coventry, UK: NHS Institute for Innovation and Improvement; 2005.

3. Doyle C et al. Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement. Implement Sci. Implementation Science; 2013;8(1):127.