Table 1.

Understanding the British National Health System Sustainability Index Model

SI Dimension	SI Factor	Measurement Intent of SI Question
Process	Benefits beyond helping patients	Change improves efficiency and makes jobs easier
	Credibility of the Benefits	Evidence supports the benefits change of the change which is obvious to all key stakeholders.
	Adaptability of improved process	Assess staff perceptions that change can continue in the face of changes in staff, leadership, organization structures,
	Effectiveness of the System	Examines the presence of a system to continually monitor the impact of change
Staff	Staff involvement	Focuses on the engagement of staff at the start of the change process and ensuring that training is received for the newly required skills.
	Staff attitudes	Seeks reduce resistance to change through empowerment and belief by staff that the change will be sustained
	Senior Leadership Engagement	Effort and responsibility by management to sustain the change and it involves staff sharing of information about the change process and seeking advice from senior leaders
	Clinical leadership engagement	Similar to senior leadership engagement but the focus is on key clinical leaders
Organization	Fit with organization’s strategic aims & culture	Examines prior history in sustaining change and that improvement goals are consistent with agency goals
	Infrastructure for Sustainability	Explores if resources (staff, facilities, job descriptions, money etc) are available to help sustain change.