Requirements for sustainability

Having implemented new changes, organisations need to establish a range of practices to ensure that the change becomes the new way of doing things. Without a focus on standardisation, documentation, training, measurement and resources, workers will find it easy to resort to the old way of doing things.


Standardisation is an approach which outlines agreed policies and practices, providing clear and explicit guidance for a process. These are generally documented in the form of “standards”, “standard operating procedures” (SOPs) or “best practices”.


The term “documentation” carries some negative connotations and can make people think “more paper - more work”.However, documentation of the change is crucial in highlighting the learning during implementation and serves as a consistent approach for all.It also provides a record of what the organisation has invested throughout the process of change.


Ongoing and visible measurement of the process is a useful approach to ensure that the changes are being carried out consistently. Information and learning can be gleaned from measurement during and after implementation.Some measures used in testing and implementation cycles may be used after implementation to demonstrate sustained improvement.


Before implementing a change, consideration must be given to training requirements. Some form of training is usually required and will be influenced by the scale and complexity of the change.Training required for testing a change is minimal. A broader, longer-term approach is required to support implementation.Adopting a PDSA approach to the development of training will help to address the needs of the trainees, fostering a culture where trainees are motivated to learn and change.


All the above need to be considered at the very outset to develop a clear idea of the resources required.PDSA cycles should be designed during the implementation phase to assess the resources required to maintain the change.Careful planning for the implementation phase is therefore required from the outset.