title: The sustainability of healthcare innovations: a concept analysis.
abstract: OBJECTIVE
  To report on an analysis of the concept of the sustainability of healthcare innovations.
  
  
  BACKGROUND
  While there have been significant empirical, theoretical and practical contributions made towards the development and implementation of healthcare innovations, there has been less attention paid to their sustainability. Yet many desired healthcare innovations are not sustained over the long term. There is a need to increase clarity around the concept of innovation sustainability to guide the advancement of knowledge on this topic.
  
  
  METHODS
  Concept analysis.
  
  
  METHODS
  We included literature reviews, theoretical and empirical articles, books and grey literature obtained through database searching (ABI/INFORM, Academic Search Complete, Business Source Complete, CINAHL, Embase, MEDLINE and Web of Science) from 1996-May 2014, reference harvesting and citation searching.
  
  
  METHODS
  We examined sources according to terms and definitions, characteristics, preconditions, outcomes and boundaries to evaluate the maturity of the concept.
  
  
  RESULTS
  This concept is partially mature. Healthcare innovation sustainability remains a multi-dimensional, multi-factorial notion that is used inconsistently or ambiguously and takes on different meanings at different times in different contexts. We propose a broad conceptualization that consists of three characteristics: benefits, routinization or institutionalization, and development. We also suggest that sustained innovations are influenced by a variety of preconditions or factors, which are innovation-, context-, leadership- and process-related.
  
  
  CONCLUSIONS
  Further conceptual development is essential to continue advancing our understanding of the sustainability of healthcare innovations, especially in nursing where this topic remains largely unexplored.
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
authors.forename: Andrea R
authors.identifier: http://orcid.org/0000-0002-4147-9471
authors.initials: AR
authors.lastname: Fleiszer
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.|Women's Health Mission, McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
authors.forename: Sonia E
authors.initials: SE
authors.lastname: Semenic
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.|Knowledge Translation, Montreal, Quebec, Canada.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Ritchie
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.|McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Richer
authors.affiliation: Ecole nationale d'administration publique (ENAP), Montreal, Quebec, Canada.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Denis
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D009936:Organizational Innovation; D015397:Program Evaluation
keywords: change; concept analysis; innovation; institutionalization; nurses/midwives/nursing; routinization; sustainability