Healthy Communities Action Plan - Sustaintool



[Name of Clinical Practice] Sustainability Plan

Practice Vision Statement: [Describe the final long term goal or purpose of the clinical practice.]

Background: [Briefly summarize the history and current state of the practice you wish to sustain.]

Resources: [List any funding sources or key resources for this clinical practice along with their expiration dates.]

Sustainability Results: [Summarize your practice’s strengths and areas for improvement identified in your results from the Clinical Sustainability Assessment Tool.]

Practice Elements to be Sustained: [List the practice elements that your team has decided to sustain. Refer to your evaluation data to see which practice elements are most effective and essential.]

Staff & Partners: [List partners involved in the sustainability assessment and/or creation and implementation of the sustainability plan.]

Time Frame: [Enter the period of time over which the sustainability activities listed below will be implemented.]

|Engaged Staff & Leadership: Having supportive frontline staff and management within the organization |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

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|[Add or delete steps to meet your needs.] | | | | | | | |

|Engaged Stakeholders: Having external support and engagement for the practice |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

| | | | |Q1 |Q2 |Q3 |Q4 |

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|[Add or delete steps to meet your needs.] | | | | | | | |

|Organizational Readiness: Having the internal support and resources needed to effectively manage the practice |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

| | | | |Q1 |Q2 |Q3 |Q4 |

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|[Add or delete steps to meet your needs.] | | | | | | | |

|Workflow Integration: Designing the practice to fit into existing processes, policies, and technologies |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

| | | | |Q1 |Q2 |Q3 |Q4 |

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|[Add or delete steps to meet your needs.] | | | | | | | |

|Implementation & Training: Promoting processes and learning that guide the direction, goals and strategies of the practice |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

| | | | |Q1 |Q2 |Q3 |Q4 |

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|[Add or delete steps to meet your needs.] | | | | | | | |

|Monitoring & Evaluation: Assessing the practice to inform planning and document results |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

| | | | |Q1 |Q2 |Q3 |Q4 |

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|[Add or delete steps to meet your needs.] | | | | | | | |

|Outcomes & Effectiveness: Understanding and measuring practice outcomes and impact |

|Sustainability Objective: [Write an objective that will enable you to increase sustainability capacity in this domain in a way that is important for your practice. The objective should be Specific, Measurable, Attainable, Realistic, and Time Bound (SMART). You may need more than |

|one objective per domain.] |

|Steps to achieve objectives: |Who will do the work? |What does success look like? |What non- financial resources are needed |Due date |

|[Be very specific and include important sub-steps. Anyone should be able to pick |[For every task, there needs to be a |[What metrics will you use to track progress on the completion |for this step? Where will they come from? |[In the appropriate quarter, enter a specific |

|up this document and understand what needs to happen in order to reach your |responsible party/parties. Who will |of each step? How will you know it’s time to move on to the next| |date by which the activity must be completed.] |

|objective.] |ultimately ensure the work gets |step?] | | |

| |finished?] | | | |

| | | | |Q1 |Q2 |Q3 |Q4 |

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|[Add or delete steps to meet your needs.] | | | | | | | |

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