Neonatal Abstinence Syndrome

Priority 9: Sustainability

NAS SustainabilityEvaluation workplans help organizations think systematically about their improvement initiatives and continually evaluate all of their tests of change. They should be created at the outset of the initiative to focus the team’s vision of which drivers will be tackled first. The evaluation plan helps  keep goals, process and outcome measures front-of-mind and assigns responsibilities for tasks.

The workplan should be considered a living document that is continually evaluated and updated to align with the iterative findings of this work.

Evaluation measures should be linked to the larger goal of standardized screening and referral to services.  They should help identify barriers that impede change such as fear, need for training, inadequate staffing levels, lack of technology, outdated organizational policies or other system issues that could stall an initiative. Performance metrics may include outcomes, process or balancing measures.

Outcome measures speak to how change impacts patients, their health and wellbeing. Process measures, the parts in the system, aid in tracking efforts to improve screening and referral. Balancing measures are chosen to understand whether changes to improve one part of the system are causing new problems in other areas.

Creating a balanced scorecard with complementary metrics will aid in tracking the effectiveness of this [work Communication] also is key to the success of any program. Communication reinforces the results of positive change, builds credibility among leaders and fosters an environment where improvement is embedded in the culture.

Communication should not be limited to staff – sharing with patients and families encourages transparency in two-way communication and ensures that everyone is engaged in the process and its success.


  • Create an evaluation workplan that includes specific, measurable, applicable, realistic and timely steps toward change.
  • Implement small tests of change that you think will lead to improvement over a short period of time.
  • Refine and broaden approaches, leveraging generated learning to plan for scaling the changes.
  • Establish standardized templates and educate stakeholders on their use.
  • Agree to standardized application guidance and share across all stakeholder communities.
  • Create continual evaluation and feedback mechanisms to ensure consistency in design, application and practice.

For more information on NJHA’s activities to improve maternal and child health,