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Measuring persistence of implementation: QUERI Series

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Candice C Bowman*1, Elisa J Sobo2, Steven M Asch3, Allen L Gifford4 for the HIV/Hepatitis Quality Enhancement Research Initiative Address: 1Health Services Research & Development, VA San Diego Healthcare System, San Diego, California, USA, 2Department of Anthropology, San Diego State University, San Diego, California, USA, 3Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA and 4Center for Health Quality, Outcomes, and Economic Research, VA New England Healthcare System, Bedford, Massachusetts, USA Email: Candice C Bowman* - candybowman@gmail.com; Elisa J Sobo - esobo@mail.sdsu.edu; Steven M Asch - steven.asch@va.gov; Allen L Gifford - agifford@bu.edu. | Implementation Science BioMed Central Open Access Measuring persistence of implementation QUERI Series Candice C Bowman 1 Elisa J Sobo2 Steven M Asch3 Allen L Gifford4 for the HIV Hepatitis Quality Enhancement Research Initiative Address 1Health Services Research Development VA San Diego Healthcare System San Diego California USA 2Department of Anthropology San Diego State University San Diego California USA 3Center for the Study of Healthcare Provider Behavior VA Greater Los Angeles Healthcare System Los Angeles California USA and 4Center for Health Quality Outcomes and Economic Research VA New England Healthcare System Bedford Massachusetts USA Email Candice C Bowman - candybowman@gmail.com Elisa J Sobo - esobo@mail.sdsu.edu Steven M Asch - steven.asch@va.gov Allen L Gifford - agifford@bu.edu Corresponding author Published 22 April 2008 Received 28 July 2006 Implementation Science 2008 3 21 doi 10.1186 1748-5908-3-21 Accepted 22 April 2008 This article is available from http www.implementationscience.cOm content 3 1 21 2008 Bowman et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http creativecommons.org licenses by 2.0 which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract As more quality improvement programs are implemented to achieve gains in performance the need to evaluate their lasting effects has become increasingly evident. However such long-term follow-up evaluations are scarce in healthcare implementation science being largely relegated to the need for further research section of most project write-ups. This article explores the variety of conceptualizations of implementation sustainability as well as behavioral and organizational factors that influence the maintenance of gains. It highlights the finer points of design considerations and draws on our own experiences with measuring .