Considerations for getting started

By planning early and thinking long-term, your facility can develop a plan that considers not only the resources needed to implement a project but also ways to sustain the project in case there are challenges such as discontinued funding or staff departures. Planning early helps the team think about how it will sustain its goal despite changes such as resource shortages in the future.

Use this worksheet to brainstorm with your team about your sustainability goals for the practice change, and how to realize these goals.

• Choose and support champions who will be responsible for communicating to their colleagues and continually reinforcing the importance of the practice change. 
• Champions may be in formal or informal leadership roles or can be anyone who is passionate and committed to the practice change and who can effectively communicate the vision of the practice change.
• Champions can be identified and equipped so that they can motivate others.

Get a sustainability team together. This team should include stakeholders who:

1. Are passionate and invested in the intervention and implementation initiative.
2. Can influence other peers and colleagues (either informally or formally).
3. Show dedication  - this can be observed when they participate in implementation activities.
4. Understand the value of sustaining the practice change.
5. Are ready to participate for the long haul.

• Empower your staff and/or colleagues to feel comfortable in bringing up any concerns about the practice change to you or your change team member.
• If you or one of your change team members hold a formal leadership role, support a work culture in which speaking up is commended and viewed positively. 

• Assess readiness for sustainability.
• Determine what, when, and how to measure the extent of sustainability and who will collect and analyze the data being used for sustainability.
• Develop a robust follow-up and transparent feedback system that incorporates data to continuously improve the intervention or how it is being used in your setting.

• It is important to identify and address any barriers to sustainability.
• Is there resistance, skepticism or doubt about the practice change? Actively involve the champions to help encourage and motivate others to support the practice change.
• Think of other ways to address barriers. If you also identify facilitators, consider ways to leverage them in order to help you make the practice change.

• For other peers, colleagues and/or stakeholders who have yet to be engaged or have yet to know about the intervention, create opportunities to share stories of success.
• What did the practice change or intervention accomplish because of its use or adoption to your setting?
• Describe who was involved, and the journey to the success of the practice change or intervention.
• How might these peers, colleagues, and/or stakeholders benefit from the practice change or intervention?

• Celebrating achievements, both big and small, can make a difference in sustainability!
• Communicating success will help others gain the courage to speak up, as well as reinforce the importance of the intervention/practice change.
• Celebrations can be elaborate or low-key; they both help sustain implementation gains.

• Kotter’s practical 8-step Change Model sets out eight key steps of the change process, which includes sustaining the change (steps 7 and 8).

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