7.3 Sustainability

Sustainability means improvement gains continue over time, even as staff turns over, leadership changes, and new or competing priorities emerge.

Key Strategies

• Intuitive design and human factors: Make the right thing the easy thing. A screening tool embedded in the triage workflow is more reliable than one requiring navigation to a separate module.
• System-embedded practices: Move from memory-based to structurally supported behaviors (see Reliability Levels, Module 6).
• Audit + engagement: Data audits tell you whether the behavior is occurring. Engagement (observation, conversations, feedback) tells you why. Both are needed.