Resource Details

Resource Name:The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change
File:click to download: Dynamic_Sustainability_Framework,_Chambers_et_al.pdf
Resource Type:Peer-reviewed publication
Short Desc:The authors examine the development of concepts of sustainability, and respond to two frequent assumptions— ‘voltage drop,’ whereby interventions are expected to yield lower benefits as they move from efficacy to effectiveness to implementation and sustainability, and ‘program drift,’ whereby deviation from manualized protocols is assumed to decrease benefit. They posit that these assumptions limit opportunities to improve care, and instead argue for understanding the changing context of healthcare to continuously refine and improve interventions as they are sustained. Sustainability has evolved from being considered as the endgame of a translational research process to a suggested ‘adaptation phase’ that integrates and institutionalizes interventions within local organizational and cultural contexts. These recent approaches locate sustainability in the implementation phase of knowledge transfer, but still do not address intervention improvement as a central theme. They propose a Dynamic Sustainability Framework that involves: continued learning and problem solving, ongoing adaptation of interventions with a primary focus on fit between interventions and multi-level contexts, and expectations for ongoing improvement as opposed to diminishing outcomes over time.
Resource Date:02-Oct-13
Contact Person:Eric Sarriot
Related Topics:  Track 1: Sustain. in Community Health
 Track 3: Complex Systems
 Health systems strengthening
 Organizational Capacity
 Organizational Viability