Sustain Improvements

How can we sustain the improvements we've made?

Most process improvement projects do not sustain their gain beyond six months. According to Lynne Maher of the British National Health Service, there is considerable evidence that 70 percent of improvement projects do not survive more than six months. That being the case, you can safely assume yours won’t survive either, unless you do something different.

What can you do that would be different? Answer: Use what you have learned from your patients who sustain recovery.

The focus here shifts to making sure the improvement changes are sustained over the long haul. The secret of sustaining changes is to make it as easy as possible for people to use the new methods and very difficult for them to revert to old ways of doing business. You will need to work with your Executive Sponsor and with other staff in your organization to complete this step. The Executive Sponsor is responsible for identifying the "Sustain Leader" – the person who will be responsible for monitoring the changes out into the future and making sure they are kept in place.

The Change Team's role is to:

• Update all documents and standard operating procedures to make sure they reflect the new methods
• Train all staff that need to use new methods or follow new procedures
• Hold an official "launch" of the new methods
• Make sure the process owner (Sustain Leader)—the person who has daily responsibility for the process or work areas affected—knows and understands the reasons for the change
• Help the process owner develop ways to monitor whether the new methods are being followed.

Ten Factors for Sustaining Change

According to the Sustainability Model developed by the British National Health Service, there are ten factors that help predict whether a change is sustained.

1. The change improves efficiency and makes jobs easier.
2. Benefits of the change are immediately obvious, supported by evidence, and believed by the stakeholders.
3. The process can be adapted if and when other organizational changes are made, and there is a system for continually improving the process.
4. There is a system in place to identify evidence of progress and monitor progress, act on it, and communicate results.
5. Staff have been involved from the beginning of the change and adequately trained to sustain a new process.
6. Staff feel empowered as part of the change process, and believe the improvement will be sustained.
7. Organizational leaders take responsibility for efforts to sustain the change process, and staff generally share information with and seek advice from the senior leader.
8. Clinical leaders take responsibility for efforts to sustain the change process, and staff generally share information with and seek advice from the clinical leader.
9. There is a history of successful sustainability and improvement goals are consistent with the organization’s strategic aims.
10. Staff, facilities, equipment, job descriptions, policies, procedures, and communication systems are appropriate for sustaining change.

How does your change project fare in light of these ten factors?