Debate
Measuring persistence of implementation: QUERI Series
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* Corresponding author: Candice C Bowman candybowman@gmail.com
1 Health Services Research & Development, VA San Diego Healthcare System, San Diego, California, USA
2 Department of Anthropology, San Diego State University, San Diego, California, USA
3 Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
4 Center for Health Quality, Outcomes, and Economic Research, VA New England Healthcare System, Bedford, Massachusetts, USA
Implementation Science 2008, 3:21 doi:10.1186/1748-5908-3-21
Published: 22 April 2008Abstract
As more quality improvement programs are implemented to achieve gains in performance, the need to evaluate their lasting effects has become increasingly evident. However, such long-term follow-up evaluations are scarce in healthcare implementation science, being largely relegated to the "need for further research" section of most project write-ups. This article explores the variety of conceptualizations of implementation sustainability, as well as behavioral and organizational factors that influence the maintenance of gains. It highlights the finer points of design considerations and draws on our own experiences with measuring sustainability, framed within the rich theoretical and empirical contributions of others. In addition, recommendations are made for designing sustainability analyses.
This article is one in a Series of articles documenting implementation science frameworks and approaches developed by the U.S. Department of Veterans Affairs Quality Enhancement Research Initiative (QUERI).