About the Assessment
The Clinical Sustainability Assessment Tool (CSAT) is a self-assessment used by both clinical staff and stakeholders to evaluate the sustainability capacity of a clinical practice. When you take the assessment online, you will receive a summary report of your overall sustainability, which can be used to help with sustainability planning. The CSAT was developed with funding from the Center for Dissemination and Implementation at the Institute for Public Health.
- The assessment is made up of 35 questions and takes about 10-15 minutes to finish.
- You will rate your practice activities across 7 clinical sustainability domains.
- The assessment can be used in a wide variety of clinical practice settings (e.g., hospital systems, clinics, pharmacies, community health centers, long-term care facilities, and home healthcare).
- The assessment can be taken as an individual or group.
The CSAT is a tool to help articulate your understanding of a clinical practice. The numbers are a way for you to conceptualize your practice across these domains relative to each other so you can start thinking about where you want to focus your efforts as you work to increase your sustainability capacity. The more honest you can be with your answers, the more helpful the report will be in moving forward with your program’s sustainability planning.
How to access the assessment in other languages
We worked with partners to translate the CSAT so that the tool is valid and reliable in English, Spanish, and Portuguese. You can access the CSAT in English, Spanish, and Portuguese by downloading the assessment as a PDF to administer offline. Currently, only the English version is available to complete online. If you are interested in working with us to translate the CSAT into another language, please contact us.
How to administer a group assessment
When doing a group assessment, we recommend multiple staff and stakeholders assess the same practice. This makes sure many perspectives are included in the final sustainability report. Each individual can participate anonymously and will receive their own personal results. Starting a group assessment allows you to invite others to take the assessment and choose whether to complete an assessment yourself. Only you will have access to the final group sustainability report.
NOTE: You can invite up to 12 people to complete a group assessment for free. If you are interested in assessing more than 12 people, please contact us.
How we developed the Clinical Sustainability Assessment Tool
In working with programs to measure and build sustainability capacity, the Center for Public Health Systems Science (CPHSS) saw a need for better understanding of what factors help sustain clinical practices. Using the PSAT as a template, we wanted to create a new tool that would measure clinical sustainability.
Because sustainability is a major challenge for all kinds of programs, we developed the PSAT in 2010 to provide practitioners and evaluators a tool to assess the sustainability of a wide range of programs. The online tool has been used over 5,000 times to assess different types of programs around the world, 13% of which have been a clinical or behavioral health practice. Yet we found that some of the PSAT language that is common in public health did not translate well to clinical care. In comparison to public health programs, clinical care is:
- Focused on practices and procedures, rather than policies and programs
- Integrated with other clinical practice activities
- Dependent on clinical and frontline staff, and less so on external stakeholders
- Reliant on technical supports
- More likely to have immediately apparent outcomes
The CSAT was designed to address these differences and measure sustainability factors specific to clinical care. To develop the tool, we reviewed the clinical sustainability literature and our prior work designing the PSAT. We also used a Concept Mapping process to define the conceptual structure of clinical sustainability, incorporating the input of 42 experts in implementation research and clinical medicine.
The resulting Clinical Sustainability Framework identified core domains of a conceptual framework for clinical practice capacity for sustainability. The Clinical Sustainability Assessment Tool was created to measure these core sustainability domains.
Read more about creating the Clinical Sustainability Framework and Tool.
How we know the Clinical Sustainability Assessment Tool measures the 7 different sustainability domains
We piloted the CSAT with over 120 individuals assessing a clinical practice, and ran extensive psychometric analyses on the pilot data to improve the framework and assessment. The final Clinical Sustainability Framework and Assessment Tool has been reliability tested and can be used to assess practices in a variety of clinical settings to better understand and plan for sustainability.
The CSAT is a free tool for measuring a clinical practice’s capacity for sustainability. The tool is available along with the following benefits for no cost:
- Free access to the CSAT with the ability to rate your practice across 7 sustainability domains (a 10-15 minute assessment)
- Individual Sustainability Report (see a sample) that summarizes your responses
- Group Sustainability Report (see a sample) that combines responses from up to 12 individuals assessing the same practice. The report can be used to guide sustainability planning
- Free custom profile to create and store your individual and group assessments
In addition to the free services described above, we also offer paid services. These services are designed to help you get the most out of our Clinical Sustainability Framework and Assessment Tool and to guide you in the sustainability planning process. Services available through paid consultation include:
- Customized CSAT for your group
- Webinars on the Clinical Sustainability Framework and Tool
- Workshops on building clinical sustainability capacity
Learn more about these services, or visit the CPHSS Services information.
Frequently Asked Questions
What is the Clinical Sustainability Assessment Tool?
The CSAT is a 35 item self-assessment that clinical team members and stakeholders can take to evaluate the sustainability capacity of a practice. We define clinical sustainability capacity as the ability of an organization to maintain structured clinical care practices over time and to evolve and adapt these practices in response to new information. When you take the assessment online, you will receive an automated summary report of your overall sustainability. You can use these results to engage in sustainability planning.
How do I choose between the PSAT and the CSAT?
First make sure you have clearly defined the set of activities you would like to assess. The CSAT assesses the sustainability capacity of a clinical practice, such as a mental health screening procedure or a hand hygiene process. The PSAT assesses a wide range of programs in public health and other fields (e.g., social services and education), such as a healthy school lunch initiative or an adult literacy program.
If you are still unsure of which tool to use, you can read about and compare the CSAT domains and the PSAT domains. You can also preview the CSAT questions and the PSAT questions. Think about how the domains and questions apply to the set of activities you would like to assess. One tool may stand out as more useful for your purposes.
Is the Clinical Sustainability Assessment Tool reliable and valid?
The CSAT has excellent usability and reliability, and preliminary validation data suggest that the CSAT is able to distinguish among different types of clinical settings.
Who has used the Clinical Sustainability Assessment Tool?
The CSAT was piloted with 120 individuals assessing a clinical practice, including physicians, pharmacists, nurses, administrative and support staff, leadership, and others. The individuals represented a range of clinical settings (e.g., outpatient and inpatient), patients (e.g., adult and pediatric), and environments (e.g., academic medical centers, community hospitals, community health centers, and private practices).
Can I adapt the Clinical Sustainability Assessment Tool?
Yes. The CSAT is licensed under the Creative Commons Attribution-Non Commercial-Share-Alike license. You may adapt the tool, but you must acknowledge Washington University as the original creator of the tool, you may not make a commercial profit off of your adapted tool, and you must share your version under the same terms. You can adapt the tool by changing the phrasing, adding, or dropping questions, etc. Keep in mind that when you make these changes the revised tool may no longer be reliable. If you make changes, please send us a copy of the adapted tool at firstname.lastname@example.org
At what level can the Clinical Sustainability Assessment Tool be used?
The CSAT can be used in a wide variety of clinical practice settings from large health care systems to small clinics.
Who should I invite to take the Clinical Sustainability Assessment Tool?
We recommend that multiple staff and stakeholders take the assessment for a more complete picture of your clinical practice. When you create an account, you have the option to set up a Group Assessment and invite multiple people to individually complete the assessment tool. Results are then averaged together in a Group Sustainability Report.
When identifying participants, choose people who are knowledgeable about the practice and invested in its success. For example, front line staff, volunteers, leadership, and administrative staff could all bring different but valuable perspectives. If community support or partners are essential to the practice, consider involving representatives from these groups too. After you receive your Group Sustainability Report, it is important to discuss differences in opinion over the scores
What kinds of practices should use the Clinical Sustainability Assessment Tool?
The tool was designed to assess a wide range of clinical practices. We define the term ‘practice’ as the set of formal organized activities that you want to sustain over time. This can refer to the activities occurring within a variety of clinical settings. Some examples of clinical practices are: antibiotic stewardship, a new surgical procedure, electronic medical record order sets, or hand hygiene.
How long will it take to complete?
The CSAT is quick and easy to complete; you only need 10-15 minutes!
How was the Clinical Sustainability Assessment Tool developed?
The Clinical Sustainability Framework and Assessment Tool was adapted from the PSAT, and is grounded in a comprehensive literature review and expert-informed Concept Mapping.
Who should use the Clinical Sustainability Assessment Tool?
Clinical staff, leadership, evaluators, partners, and funders are all encouraged to use the CSAT and engage in sustainability planning. In fact, we recommend that multiple staff and stakeholders take the assessment for a more complete picture of your practice.
How many questions are there?
The CSAT has a total of 35 likert scale questions and looks at 7 different sustainability domains.