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At this point, you have tested change ideas through your PDSA cycles and determined which were successful. Now you will formally implement these changes into practice in your unit or department, and once implemented, you will spread the change to other units or departments.

Key activities include:

• Formalizing and standardizing the changes, and documenting the new processes
• Communicating the new processes widely among staff
• Generating buy-in by sharing the improvement story and the impact on patients and staff
• Using your measurement plan to monitor adoption and improvement
• Collecting data and displaying it visually using run charts and control charts to understand variations in performance
• Creating a spread plan
• Using your measurement plan to monitor adoption and improvement

Tools and resources

• Implementing and Sustaining Changes Guide
  Learn about stakeholder engagement, how to communicate change, standardize change, provide training, and more.
• Sustainability Planner
  Identify how you will support the seven key factors that will help sustain the change.
• Spread Guide
  Learn about spread in QI, the “seven spreadly sins,” and a framework for spreading change.
• Spread Tool
  Outline what change is being spread and how, the resources required, and how progress will be communicated.