Here's one model from Shediac
and Rizkalla that comes from 1998 which I like quite a bit.
Well, we begin probably at the top with
the project design and factors that are inherent to the implementation.
How do we do it? And we sort of think that's the whole story.
But before that there are factors in
the broader community that dictated implicitly what we do, limited what we do.
There are also factors within the organization that certainly influence us.
Together, we hope to achieve programs sustainability.
We hope to maintain health benefits certainly.
We would like to institutionalize the program within the organization.
And we would like to build capacity within the community to allow that to happen.
The IHI a few years ago created a guide or a white paper on sustaining improvement.
This was based on their review of literature both theoretical and practical.
And their model focuses on daily work for frontline managers and staff.
Key elements of their model are performing daily huddles of
healthcare workers to discuss tasks that needs to be done.
The use of visual boards at the frontline,
so people can see how they're progressing, problem solving,
and escalation protocols, so that if things are not working,
they can move up to the appropriate level where the problem can be fixed.
And the integration of aims and priorities into the entire plan.
A third model is the trip model that is for translating research into practice.
Perhaps more appropriately these days translating evidence into practice,
since not everything we're doing uses research evidence per se.
You've already heard a little bit about this in an earlier lecture.
Crucial to this model are first of all,
assembling the right team to do the work,
summarizing the available evidence,
understanding barriers that you may confront, planning ahead,
and then for ease, engaging first,
then educating, then executing the plan,
and then evaluating what's occurred.