Phase 4: Sustainment
Normalise acupuncture and acupressure into routine hospital practice so the intervention persists beyond the implementation team.
It is common that an implementation is not sustained once the implementation team has left or dissolved. Whether an implementation can be sustained is largely related to if it can be normalised into routine practice; and if the needs can be met. This requires a number of inner or internal factors and outer or external factors. Not all factors are relevant to all implementations. At a local level, often inner factors are more important and have direct impact on the success of implementation.
Outer Factors
Leadership
Concerns external leadership input, such as government support.
Link to other organisations
References pressure from external entities (e.g., other hospitals implementing similar practices).
Funding
Addresses implementation costs and available resources.
- Considers whether acupuncture/acupressure is cost-neutral
- Examines potential reductions in anti-emetic use and recovery time
Inner Factors
Leadership
- Requires organizational support from leadership
- Recommends engaging leadership from initial phases
- Suggests regular audit reports to leadership
- Advises aligning outcomes with organizational missions
Fidelity
- Questions whether practices maintain intended standards
- Example: SeaBand displacement below proper PC6 location
- Recommends onsite monitoring and staff feedback
- Proposes visible, accessible education materials
- Suggests regular education sessions matching routine practice protocols
Staffing / Support Coaching
- Emphasizes continuous staff support through education and resources
- Recommends identifying enthusiastic champions per work unit
- Proposes manager reminders to staff
- Advocates visible, accessible education materials
Phase 4 Resources
Last reviewed: April 2026