Sustainment Sustainability and Spread Study

What is SSaSSy?

In this study we examine the factors that contribute to sustainment, sustainability, and spread following our Safer Care for Older Persons (in residential) Environments (SCOPE) intervention

What was SCOPE?
The SCOPE intervention was a theory and evidence informed intervention TREC implemented in 2018.

SCOPE was implemented in Manitoba, Alberta, and British Columbia. It had many components based on a model of facilitation to improve quality of care and resident outcomes. 

In SCOPE, care aides led small quality improvement teams, and preliminary results suggest that they were successful in improving care for nursing home residents in reducing pain, increasing mobility, and managing responsive behaviours.

The SSaSSy study examines the best ways to support and sustain the work of the care aide-led quality improvement teams over the long term - from one to two years after the original implementation of SCOPE took place. The study also examines how the practices and approaches learned through SCOPE are spread to other groups in a home.

Quick Facts

British Columbia

Logomakr_6fb18l.pngLength of Project
3 year study

Logomakr_1NbR52.pngFacilities Involved
4 facilities in Manitoba
Up to 13 facilities in Alberta
Up to 16 facilities in British Columbia

Logomakr_172HmD.pngTarget Audience
Care aides
LTC facility management

"The results of SSaSSy stand to contribute significantly to our understanding of the post-implementation stages of an intervention. This can help us learn how to improve the sustainability of evidence-informed practice innovations in healthcare settings."
Whiteney Berta - SSaSSy Principal InvestigatorDr Whitney Berta, SSaSSy Principal Investigator

What is involved?

In SSaSSy we examine the different support conditions needed to sustain the SCOPE intervention following the traditional research period. The study is conducted in nursing homes approximately one year after the SCOPE intervention ends in those homes.

SSaSSy will last for 3 years and will have two phases:

  • Phase 1: SSaSSy Booster Pilot (Year 1) - Manitoba
  • Phase 2: Exploratory Evaluation of SSaSSy Boosters (Years 2 & 3) - Alberta and British Columbia

What exactly are Boosters?

We will implement support conditions we are calling “Boosters”. These Boosters will be developed and refined during the pilot phase and tested in the exploratory phase. Boosters consist of support from our research team. They are delivered through a Learning Congress, in-person meetings, email, and teleconferences. The Boosters also differ from one another by how often teams receive support.

SSaSSy Aims

Here is a more academic explanation of the the main aims of SSaSSy:

  1. To explore the relative effects of Booster conditions on sustainment, sustainability, and spread of the SCOPE intervention; specifically with respect to:
    • sustained improvement in resident outcomes
    • sustained changes in staff behaviours
    • sustained improvements to staff work attitudes
    • sustained changes to senior leadership support behaviours
    • indications of spread to other units
  2. To determine the role that adaptation/contextualization plays in sustainment, sustainability and spread of the SCOPE intervention
  3. To compare cost of each post-implementation support condition 


Results of this work will support the development of a scale-up strategy for SCOPE across the nursing home sector in Canada.

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