Designing for sustainability: an 8-year mixed methods evaluation of a timely drug administration initiative

BACKGROUND: Sustaining improvements from large-scale quality initiatives in hospital settings remains a persistent challenge. When such improvements fade, patient safety risks may re-emerge. Despite their importance, long-term post-implementation evaluations of large-scale hospital initiatives are scarce. AIM: This study aimed to identify long-term insights into the sustainability of a large-scale hospital initiative designed to improve timely drug administration. METHODS: A mixed methods case study was conducted on an Australian hospital-wide initiative implemented in 2014-2015. Quantitative data included rates of unintentional drug omissions before, during, and after the initiative. Qualitative data were collected through 13 individual semi-structured interviews with stakeholders, including implementation team members, hospital staff, and managers. Thematic analysis was conducted inductively and then categorized deductively using an evidence-based sustainability framework.…