DNP 835 Sustainability Worksheet

Sample Answer

Sustainability Plan Worksheet

An improvement team needs to consider the long-term sustainability of an improvement effort. This worksheet will help you outline the elements needed for a sustainability plan for your proposed evidenced-based quality and/or safety program design by taking you through a series of questions.

By answering these questions, you will be able to develop a plan to ensure the longevity of the expected improvements from your proposed quality and/or safety program stick long-term.

For each category, use the questions provided to help you draft the necessary components that will be needed in a sustainability plan. Use one or two concise sentences to inform on each bullet point/question. Provide scholarly and peer-reviewed support accordingly.

Areas for Consideration Detailed Plan

Measurement

After project completion

• What will you continue to measure?
  
• What will you stop measuring?
  
• What will you do if you see a negative effect?
  
• What will you do if you see clinical significance, but not statistical significance? •

Among the aspects that will be measured even after the project’s completion are the incidences of pressure ulcers among the admitted patients (Lavallée et al.,2019)

The project entails reducing the incidences of pressure ulcers, so as part of the plan, one of the aspects which will not be measured is the rate of project acceptability.

In case there is a negative effect, then the project will be stopped. The stop time will be used to review what could have led to the negative effect and take appropriate measures to correct it if necessary and appropriate.

Clinical significance and statistical significance are both key in research and patient care (McShane et al.,2019). In the cases where there is clinical significance but no statistical significance, then the intervention will still be used since such an observance means that the intervention can be helpful to patients

Ownership

• Who will own the new process that was implemented?
  
• How will you tell if the person is engaged and onboard with the improvement process?

The new process will be implemented at the facility. As such, while the project is owned by the investigator, it will be owned by the facility upon implementation. The organization’s leaders will see to it that the project’s aspects are accurately used to ensure that the benefits are optimized.

Onboarding and engagement with the project are key to the project’s chances of success (Carrigan et al.,2018). As such, it is important to explore if individuals are engaged and on board with the improvement process. Therefore, the people’s commitment and willingness to participate in every step of implementation will be observed.

Communication

How will you communicate about the change, and who will be the messenger?

• When will communication take place?
  
• How will you support individuals in the new process?
  
• What type of training will you use after project completion?
  
• Who will be responsible for that training?

Communicating the change intentions is important to enhance the chances of buy-in and project success.

Therefore, various strategies will be used to communicate about the change, including official channels of communication such as email. Another aspect will be face-to-face meetings. The emails will be sent through the organization’s official communication channels.

While the first communication will take place at the begging of the project, it is important to ensure that there is constant communication throughout the project to ensure that people remain focused on the project’s aim, objectives, and focus (Palinkas et al.,2018).

Support to individuals is key to ensuring focus and commitment to the project’s goals and objectives. Individuals will be supported through training, especially the aspects of the new bundle care.

Offering training is key. Hence it will also be offered even after the project’s completion. One such training will take the form of refreshing the memory and knowledge of the nursing team regarding the use of the new bundle. Training will also be offered to new nurses who will join the facility after implementation. This will ensure that they have a grasp of how to use the new pressure ulcer bundle.

The training will be offered by the senior nursing staff who have experience with pressure ulcer control as well as skills in training and educating staff.
Change Management

• How will you respond to resistance/barriers to change (“But this is how we have always done things.”)
• How would you use your evidence-based change model to ensure adoption and sustainability?
• How will you standardize the process so that it is easy to do the “new” right thing?

Resistance to change management can derail the chances of the project succeeding. Therefore, it is important to put in place appropriate measures for responding to such resistance or barriers (Tucker & Gallagher-Ford, 2019).

One aspect is to use timeous communication to let individuals know of the planned change, which will reduce the chances of resistance. The other strategy is to offer training and increase the individual’s knowledge regarding the use of pressure bundles. The next strategy is to approach the individuals and discuss with them why they are resisting the proposed change and help them understand the project’s intention.

Evidence-based change models are key in ensuring adoption and sustainability. Lewin’s change stages will be key. The third phase will particularly be used to enhance adoption and sustainability, where the staff will be supported to use the new system and rewarded for excellent execution (Hussain et al.,2018).

The standardization will be accomplished by writing the requirements of new bundle care. The guidelines will ensure that individuals are always capable of accessing the required standards of care if need be.

Workload

Is the change increasing the overall workload to the system?

• If so, how can you decrease the workload?
  
• If not, how will you communicate about what is changing and not changing?

The proposed change will not increase the workload since it will just involve the use of a bundle care approach to reduce the rates and incidences of pressure ulcers.

Such an aspect will be communicated officially to the nursing staff. Apart from paper documentation, such communication will also be accomplished through emails so that the individuals know what is changing and what is not changing. Adapted from “Sustainability Planning Worksheet” by the Institute for Healthcare Improvement (2019).

References

• Carrigan, T. M., & Livesay, S. (2018). Mapping a Strategy for Success A Case Study in Nursing Engagement as a Strategic Imperative at a Comprehensive Stroke Center. Nurse Leader, 16(2), 112-117. https //doi.org/10.1016/j.mnl.2017.12.010
  
• Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https //doi.org/10.1016/j.jik.2016.07.002
  
• Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle a feasibility study. Health & Social Care In the Community, 27(4), e417-e427. https //doi.org/10.1111/hsc.12742
  
• McShane, B. B., Gal, D., Gelman, A., Robert, C., & Tackett, J. L. (2019). Abandon statistical significance. The American Statistician, 73(sup1), 235-245. https //doi.org/10.1080/00031305.2018.1527253
  
• Palinkas, L. A., Garcia, A., Aarons, G., Finno-Velasquez, M., Fuentes, D., Holloway, I., & Chamberlain, P. (2018). Measuring collaboration and communication to increase implementation of evidence-based practices the cultural exchange inventory. Evidence & Policy, 14(1), 35-61. https //doi.org/10.1332/174426417X15034893021530
  
• Tucker, S. J., & Gallagher-Ford, L. (2019). EBP 2.0 From strategy to implementation. AJN The American Journal of Nursing, 119(4), 50-52. 10.1097/01.NAJ.0000554549.01028.af