page.tpl.php
NODE.TPL.PHP

Sustainability

The best way to ensure your disparities intervention will be sustainable is to plan for sustainability from the start.

Sustainability may feel like the last step of your plan to reduce disparities: let’s start something, then we’ll figure out how to keep it going. This is an all-too-common approach that may limit how sustainable your intervention will be.

In fact, you should think about sustainability throughout the process of creating a culture of equity, conducting a root cause analysis, designing an intervention, and securing buy-in. The Road Map to Reduce Disparities includes many tips for enhancing the sustainability of your intervention. Here, we discuss some of the important take-home messages.

1. Build a strong culture of equity. If your organization has a generalized commitment to equity, and is willing to prioritize activities that promote it, it will be easier to get the resources you need to start and sustain your intervention, such as funding and protected time.

HOW DO WE DO THAT? Finding Answers has lots of tips to create a culture of equity: it’s Step 2 of the Road Map. All of those strategies will create an environment that supports and sustains your disparities intervention for the long run.

2. Integrate equity into organizational values and activities. Because equity is a cross-cutting component of quality, it needs to be a cross-cutting component of your organization’s plans for quality. Even the most well-intentioned equity program is less likely to succeed if it operates in isolation from the rest of the organization. The more your intervention is integrated into the organization, the easier it will be to sustain it.

HOW DO WE DO THAT? Add equity to your organization’s mission and value statements. Think about your current activities and ask yourself: how can I make equity a part of these programs?

3. Pick the low-hanging fruit. Addressing disparities in your organization is not a small task. It can be tempting to take on a big goal right away. But start by choosing a simple and attainable goal. When you achieve it, you’ll build momentum and help avoid staff burnout. And when you show a “quick win” to leadership, it will foster confidence in your program and in your ability to get things done.

HOW DO WE DO THAT? Find a goal that’s feasible but relevant to your identified disparities. A priority matrix can help you determine what goal might be a good choice. While this goal might not have an immediate impact on health outcomes, it helps your team start conversations and practice PDSA cycles. Be sure to report back to all your stakeholders—especially leadership—to celebrate the improvements you achieve.

4. Get patients’ buy-in. If patients buy-in to your program, it will influence their willingness to pay for services related to the initiative—and that will impact the financial feasibility of the program. For example, if patients don’t buy-in to meeting with a diabetes educator, they may not be willing to go if a co-pay is required.

HOW DO WE DO THAT? If you work with patients throughout the process of creating a culture of equity, conducting a root cause analysis, and designing an intervention, the intervention should be a natural fit, and patients’ buy-in should be easy to secure. Finding Answers has compiled several strategies to secure patients’ buy-in. These are summarized in Step 5 of the Road Map.

5. Collect data to make your case. A sound investment is based on sound data. Think carefully about what your leadership (or a funding agency) will want to know when you ask for resources. Design your intervention so you can collect that data, and practice collecting it when you pilot-test.

HOW DO WE DO THAT? Understanding how to collect data and measure your change is covered in Step 6 of the Road Map. Be sure to talk to stakeholders about the kinds of results you expect when. For example, you’re likely to see changes in process measures before any health outcomes move. In addition, sometimes patient satisfaction values will drop as patients’ expectations increase, and then improve over time.

6. Make your team sustainable, too. Nothing stalls a project like absent staff. Secure your leadership’s buy in to supporting the team’s time, and plan ahead to keep you team intact during times of change.

HOW DO WE DO THAT? Prioritize getting protected time to work on the project. Plan for staff turnover by cross-training staff and documenting institutional knowledge. Incorporate intervention training into staff orientation and refresher courses. When appropriate, include program responsibilities in job descriptions, and assess interest in the intervention among candidates for leadership positions.

“Achieving sustainability” may feel like a daunting task. But if you plan for it from the beginning, your project is much more likely to be institutionalized. Keep sustainability in the back of your mind, with every decision you make about implementation and evaluation.