Unity Health Care is the largest network of community health centers in the District of Columbia, providing a wide range of health services across its practice sites. As part of the Integrated Care DC’s Value-Based Care (VBC) Learning Collaborative, Unity’s behavioral health team members are participating in the Care of Acute and Chronic Conditions track, focusing on preventing potentially avoidable hospitalizations for their patients. Specifically, Unity seeks to demonstrate how behavioral support can positively impact adherence and lifestyle changes like diet and physical activity to reduce the likelihood of congestive heart failure (CHF), resulting in unnecessary emergency room encounters and inpatient days.
Challenge
Sustaining improvements from effective QI projects is a common and often neglected challenge. However, as Richard Bebout, PhD, senior director of behavioral health at Unity, noted, “As with any improvement work in health care, once we understand that an improvement is actually an improvement, we want to plan for its sustainability,”
Approach
To support this goal, the learning collaborative’s track leads conducted a session on the National Health System (NHS) Sustainability Model, which helps organizations identify the 10 key factors contributing to sustainability. Participants learned how to evaluate improvement projects for long-term success and develop strategies to strengthen sustainability efforts.
Following the workshop, Dr. Bebout and his colleagues at Unity used the model to assess their QI project’s readiness for sustainability. The process provided eye-opening insights into areas where their project was faltering. Early success at one site with a 5-star team isn’t predictive of widespread adoption of new best practices.
Lessons Learned
- Sustainability must be intentional—it does not happen on its own.
- Structured sustainability planning is important. After the NHS Sustainability Model session and follow-up webinar, Dr. Bebout said, “The idea that good ideas will magically turn into sustainable actions just because they make sense is fantasy. Shame on us if we don’t use this tool as a frame of reference because things don’t just happen magically. People often say we start so many good things, and they just sort of fizzle out,”
By applying the NHS Sustainability Model, Unity Health Care is now better equipped to sustain and scale its quality improvement efforts, ensuring that valuable initiatives drive positive patient outcomes over time.