Date of Award

Spring 5-15-2022

Author's School

Graduate School of Arts and Sciences

Author's Department

Public Health

Degree Name

Doctor of Philosophy (PhD)

Degree Type



Every year, millions of children seek health care for acute and emergent needs. However, evidence-based care is not currently delivered to every child. Even when teams implement care discoveries designed to improve outcomes, they are often not sustained over time. All children should receive care that is in accord with current evidence-based guidelines, and those evidence-based practices must be effectively maintained over time. It is imperative to understand how to sustain care improvements in the clinical setting. Sustainability capacity allows us to understand the organizational factors that ensure care delivery over time. While there has been an increased focus on sustainability, the field is still in its infancy. This study contributes to the field of sustainability by addressing three aims: (1) identifying determinants of clinical sustainability, (2) exploring the clinician perspective on sustainability and clinician roles contributing to sustainability, and (3) assessing the communication structures of antimicrobial stewardship teams and their influence on sustainability. Results highlight the validity of the sustainability capacity measure and highlight important contextual determinants of sustainability capacity. Future research should continue to focus on the factors that determine sustainability as well as transition to understanding interventions to improve sustainability of evidence-based care.


English (en)

Chair and Committee

Douglas A. Luke

Committee Members

Enola K. Proctor


Update embargo

Included in

Public Health Commons