How do I make it last?

The primary aim of this toolkit is to offer potential resource options to utilize in the advancement and adoption of a new competency (genomics). Building on the Magnet Hospital experiences, these tools can also be used in an ongoing way to build on the competency foundation that can be measured through an outcome evaluation. Optimizing sustainability of outcomes of the progress made is essential to assure that the investment of time and resources was valuable leading to longer-term beneficial outcomes.

For example, genomic competency information has been included in new nurse orientation. Next steps may include looking at how that content is then used in practice.

• Is the content sufficient or does it need to be expanded?
   
• Has it made a difference to patient outcomes so that ongoing commitment to continue this educational intervention is justified?
   

Another example, the genomic competency is now an expectation of all nurses in your clinical setting. Leadership has included that expectation in the Nursing Department’s strategic plan, clinical ladder expectations, and policy statements. Leadership voices ongoing support, expectation, and recognition of competency achievement.

Factors that influence successful initial program implementation are not necessarily the same as those that enable long-term sustainability. Identified characteristics determined to influence the extent of sustainability of a competency initiative include:

• whether such a program can be modified over time
   
• a “champion” is present
   
• the program “fits” with its organization’s mission and procedures
   
• benefits to staff members and/or clients are readily perceived
   
• stakeholders in other organizations provide support
   

Reference: Scheirer, M.A., Is Sustainability Possible? A Review and Commentary on Empirical Studies of Program Sustainability. American Journal of Evaluation, 2005. 26(3): p. 320-347

It is recommended that a Sustainability Action Plan be developed that:

• identifies new and continuing target areas
   
• allow tracking of progress of identified goals
   
• determine potential new and ongoing challenges that may affect success.

• Specifying additional personal development needs, policy and education strategies, objectives, methods to achieve and/or sustain aims, and timeline allocated to accomplish tasks can help guide ongoing efforts.
   
• Determine within your organization the frequency and contact person(s) for Action Plan submission and review to guide and receive continued support for the team’s plans.
   
• Depending on what interventions were initially used and accomplishments achieved, determination of next steps may require additional funds, methods, and supporters.
   
• Competing demands and emerging priorities that require focus and time of the initial Champions may necessitate the gathering of new supporters for ongoing competency efforts.
   
• Succession planning is key to assuring continued success with genomic competency efforts.

Sustainability Action Plan