Systematic approaches to practice change should include plans to monitor and evaluate, maintain and reinforce positive changes, and identify any ongoing issues with poor-quality practice. This may include periodic, scheduled re-evaluation. Donabedian principals suggest that evaluation should focus on the impact of changes to the structures or processes of care, as well as the outcomes, in order to identify clinically important improvements to the quality of care and patient outcomes. Successful evaluation depends on how well the evaluation methods account for changes in practice and is a key component for sustaining any progress made over time. 

Drawing on existing models and theories about change management and knowledge translation, the evidence implementation wedge of the JBI Model of Evidence-based Healthcare seeks to ensure that this process is informed by and relevant to local culture and context, and builds capacity (internal facilitation) by supporting a culture of practice improvement.

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