Sustained knowledge use refers to the continued implementation of innovations over time.
Sustained knowledge use depends on the ability of workers and organizations to adapt to change.
Tension exists between the routinization of one innovation and the receptiveness to subsequent newer innovations.
Key factors found to influence sustainability include:
Relevance of the topic:
Is there a well-defined need and priority for the knowledge that is being implemented?
Is there consensus about what knowledge needs to be sustained and what is needed to create conditions for sustainability?
How does the new knowledge fit with current priorities?
Benefits:
What are the anticipated outcomes of knowledge implementation from a biological, economic, psychological, organizational, social, political, or other perspective?
How are these benefits meaningful to the various stakeholders?
Attitudes:
What are the attitudes (i.e., potential resistance) of the patient/client, their family, the public, health care providers, and relevant decision-makers toward the innovation?
Networks:
What teams or groups can be engaged to facilitate the sustainability of knowledge use?
Are there people who can be engaged to cross disciplines, settings, or sectors of the health care system (e.g., interprofessional collaborative practice, academic programs, health care organizations, community-based care)?
Leadership:
What actions might leaders and managers at all levels of involvement take to support the sustainability of knowledge use?
Are there champions for the change?
Who is responsible for continued implementation of the innovation and for making modifications as new knowledge is brought forward?
Who will be responsible for ensuring that relevant outcomes are met?
Policy articulation and integration:
How will the fit between new knowledge and existing policies be assessed?
How might the knowledge be integrated in relevant policies, procedures, regulatory and documentation systems (e.g., electronic clinical decision support systems)?
Financial:
What funding is required to implement, sustain, and scale up knowledge?
What flexibility in funding is necessary and available for reimbursement?
Can cost-effective strategies be used?
Political:
Who are the stakeholders and what power or support might be leveraged?
