Using a Complex Systems Perspective to Achieve Sustainable Health Care Practice Change

Abstract

Background: There has been a surge of interventions at health care settings to achieve practice change, but sustaining these new practices remains challenging. The purpose of the study is to use the Legacy Sustainability Model, a framework grounded in complexity science, to examine the implementation and sustainability of an interprofessional (IP) collaboration intervention in health care. The model considers the six factors communication, connections, coherence, continuous assessment, commitment and constructs essential to building capacity for sustainability.Methods and Findings: Three health care settings in Alberta implemented IP practice interventions over a six-month period. After three and six months, we interviewed participants at each site about the progress of the IP intervention and emerging challenges. We examined the interview data for emergence of the six factors of the Legacy Sustainability Model. Conclusions: Our analysis showed distinct contextual differences between the three sites as represented by the strengths of the six factors at the outset of the IP interventions and the way the factors evolved throughout the project. Using a complex systems lens may be valuable for examining contextual factors that might affect the success of a practice intervention and for monitoring progress towards capacity building for lasting practice change.