Edwards et al. (2007) assessed the sustainability of the Partnerships for Quality (PFQ) projects funded by the Agency for Healthcare Research and Quality (AHRQ). The PQF program funded partnerships of health care professionals and other organizations to facilitate the translation of research into practice, especially in the areas of patient safety and quality improvement (Evaluation of AHRQ's Partnerships for Quality Program, 2006). Edwards et al. convened a work group to review the literature and develop a conceptual framework of sustainability that drew from Rogers’ framework (as cited in Edwards et al., 2007) that includes four elements of sustainability.
The four elements of sustainability are infrastructure, incentives, incremental opportunities for participation, and integration. Infrastructure refers to the resources necessary to bring about and sustain improvements. Incentives can be used to maintain partnerships and key outcomes or practices. Incremental opportunities are activities that facilitate participation from key partners and enable them to experience a sense of ownership. Finally, integration involves aligning the goals of the partnership with the strategic goals of the organization using rewards and measures.
Five goals for sustainability were selected by the work group for the PFQ framework: a partnership’s capacity to collaborate, outcomes, project processes and practices, values, and community capacity. The goals are the attributes of the partnership and the partnership’s activities that are being sustained.
The two-dimensional framework, shown in Exhibit 4.3, is composed of the elements of sustainability and the goals of the program (i.e., what is being sustained?). While this model is highly specific to partnerships pursuing patient safety and quality improvement objectives, it is useful because it shows that there are a number of attributes that can be sustained—the partnership’s ability to collaborate, outcomes, practices, values, and community capacity efforts. Additionally, this model also shows that sustainability is affected by four key elements (infrastructure, incentives, incremental opportunities for participation, and integration).
Exhibit 4.3: Sustainability Framework
Reprinted from Edwards et al. (2007).
Exhibit 4.3 This exhibit shows a two-dimensional framework that includes the elements of sustainability including infrastructure, incentives, incremental opportunities for participation, and integration, as well as the goals of what is being sustained (the partnership’s ability to collaborate, outcomes, practices, values, and community capacity efforts).