Sustainability of Partnership Projects: A Conceptual Framework and Checklist

Background: There is growing recognition that the health care delivery system in the United States must make major changes. Intervention projects focusing on quality and patient safety offer the potential for reshaping the future of medicine. Sustainability of the Partnerships for Quality (PFQ) projects and other patient safety and quality improvement projects that provide evidence of effectiveness is essential if progress is to be made. Methods: For the purposes of these projects, a conceptual framework and a checklist for sustainability were developed. The framework consists of two dimensions: (1) the goals-what is to be sustained- and (2) elements for sustainability-infrastructure, incentives, incremental opportunities for involvement, and integration. The checklist is designed to trigger planning for sustainability early in a project's design. Specific questions about each of the elements can cue planners and project leaders to build in the goals for sustainability and change processes. Results: A pilot test showed that the framework and checklist are relevant and helpful across a variety of projects. Discussion and Conclusion: Two extended examples of planning and action for sustainability from the PFQ projects are described. It is too early to claim sustainability for these projects. However, continued monitoring for at least three years with the checklist could result in valuable national data with which to design and implement future projects.