Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review

Abstract

IntroductionThe sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system.Methods and analysisThe protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies.Ethics and disseminationAs no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems.

Implementation of Situational Awareness in the Pediatric Oncology Setting. Does a ‘huddle’ Work and Is it Sustainable?

“…One of our main outcomes was the sustainability of the huddle, we intended to conceive and build an intervention that was sustainable over time. Sustainability in healthcare settings is poorly defined (Braithwaite et al, 2017). Huddles are well known as being sustainable in HROs (Reiter-Palmon, Crowe, & Scott, 2018) however, it is hard to sustain an intervention within the complex nature of the healthcare system particularly when the intervention has a quality focus rather than directly related to patient care.…”

Bibliometric Review of the Knowledge Base on Healthcare Management for Sustainability, 1994–2018

“…Greenhalgh and Robert authored two highly co-cited papers (not tabled): 'Diffusion of innovations in service organizations: Systematic review and recommendations' [11] and 'Diffusion of innovations in health service organizations: A systematic literature review' [53]. These papers examined how the The 'sustainable change in health care services' (red cluster) is the largest school of thought consisting of 53 scholars [49][50][51][52][53][54][55][56][57][58][59][60]. Key scholars associated with this school include Robert with 77 co-citations [11,51,52], Greenhalgh with 72 co-citations [12,49,50], and Radnor with 53 co-citations.…”

“…Recent literature in this school of thought has broadened the scope of change implementation by focusing on business transformation strategies designed to improve operational processes and outcomes for health care organizations. For example, authors such as Radnor, Baithwaite, Smith and Berwick have explored the potential and effects of implementing business processes designed to reduce waste and improve the quality of care [57][58][59][60][61][62]. Evidence-based practices and implementation have been studied within the scholarly literature in this discipline [11,20].…”

Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

“…Accordingly, to make services sustainable, healthcare professionals are endeavoring to optimize the quality of care for those with complex clinical needs [5]. The increased demand for both ambulatory and long-term care, triggered by demographic change, requires planning and collaboration between health system stakeholders, including policymakers, healthcare staff, insurers, and patients [6,7]: Healthcare systems do not have the capacity to accommodate errors.…”