Sustaining System Change

Full implementation of a new initiative can take from 2 to 4 years. Critical to the process overall is for the agency to ensure sustainability. Planning for long-term sustainability must begin during the strategic planning stage and continue throughout the process. Agency leadership should ensure that funding streams remain available, that staff, external stakeholders, and consumers continue to be involved, that goals are being appropriately worked toward, that all sites are maintaining fidelity to the intervention’s design, and that there is progress toward meeting goals.

Articulating the connections between new behaviors and improved outcomes can be a powerful tool in assuring staff and partners of progress. For example, if moves of children in care are diminishing due to more frequent and better quality worker/child/caregiver visits, as anticipated, support and enthusiasm from staff and partners involved in the innovation will be bolstered.

The innovation, in all its various stages, will need to be fully integrated into the State’s systems. This includes ongoing training, regulations, policies and procedures, and, most importantly, the agency-wide continuous quality improvement (CQI) system. The new practice should be incorporated into the case record review process and data system. Bi-directional stakeholder communication, or feedback loops, should then continue through the CQI process, as should ongoing analysis, assessments, and improvements. The emphasis of CQI on data, expedient diffusion of best practices, and ongoing, cyclical improvement can then continue to guide and strengthen the implementation of the agency’s various initiatives.