Quality Improvement Zone

An implementation checklist is a tool that helps teams plan how to make successful changes part of everyday practice. Once a change has been tested under different conditions and shown to lead to improvement, the checklist helps ensure the change can be implemented consistently, sustained over time and become part of normal working practice.

Testing and implementation are not the same thing. Testing is about learning whether a change works and refining it through PDSA cycles. Implementation is about making a successful change the standard way of working. This often requires additional planning, training, documentation, measurement and resources to ensure the change is sustained over time.

The implementation checklist provides a structured approach to preparing for implementation through five key areas:

• standardisation
• documentation
• measurement
• education
• resources

Successful changes do not automatically become sustainable. Without careful planning, improvements can become dependent on specific individuals, and old ways of working may gradually return.

The implementation checklist helps teams move from successful testing to sustainable implementation by ensuring the systems, processes and support mechanisms needed for long-term success are in place.

Using the implementation checklist can help you:

• make successful changes part of everyday practice
• reduce reliance on individual people or champions
• clarify roles and responsibilities
• support staff training and onboarding
• ensure improvements continue to be measured and monitored
• identify the resources required to maintain the change over time
• increase the likelihood that improvements will be sustained

The implementation checklist can be used once you have confidence that your change leads to improvement and you are ready to make it part of routine practice. Work through each of the five areas to identify what needs to be in place before implementation.

1. Standardisation

Identify all of the processes, activities and tasks required to maintain the change. Consider who is responsible for each activity and ensure roles and responsibilities are clearly defined. This may include developing or updating standard operating procedures, protocols, guidelines or other supporting processes.

2. Documentation

Document how the new process will operate in practice and ensure this information is easily accessible to those who need it. Consider who is responsible for maintaining and updating documentation as the process evolves.

3. Measurement

Ongoing measurement helps teams understand whether improvements are being maintained over time. Identify the measures that will be used for quality control and sustainability monitoring.

Consider:

• what will be measured
• how data will be collected
• how often measurement will take place
• who is responsible for collecting and reviewing the data

Use clear operational definitions so that measures are collected consistently over time.

4. Education

Consider what knowledge and skills people need to successfully adopt the new process. This may include training, guidance materials, coaching or other support mechanisms. Think about how new staff members will be introduced to the new way of working and who will be responsible for maintaining training materials.

5. Resources

Identify any resources needed to sustain the change over time. This may include equipment, technology, staffing, funding, time or specialist support. Consider where these resources will come from and how they will be maintained.

Reviewing each area of the checklist can help ensure your change is implemented consistently, embedded into everyday practice and sustained over time.