BACKGROUND:
Population aging has increased the prevalence of Major Neurocognitive Disorders (MNDs), highlighting the need for innovative care in Quebec[1-3]. In response, the CONSTELLATIONS Living Lab developed a quality improvement program with reflective practice workshops to improve care transitions and co-create solutions with patients, caregivers, and professionals[4]. Since 70% of effective innovations fail to last[5], this study explored factors supporting sustainability and scale-up.

METHODS:
A sequential mixed-methods design evaluated the innovation, combining three tools: the Continuing Professional Development (CPD) theoRy-basEd instrument to assess the impACT of continuing professional development activities on professional behavIOr chaNge (Reaction) questionnaire[6], the National Health Service Sustainability Model (NHS SM)[7], and the Questionnaire auto-administré sur le potentiel de mise à l'échelle des innovations en santé et en services sociaux, version 4.0 (ISSaQ-4.0)[8]. Data were collected from workshop participants and project leaders through questionnaires and semi-structured interviews. CPD Reaction results were analyzed using the Capability, Opportunity, Motivation–Behavior model[9] and the Theoretical Domains Framework[10] to assess participants’ intention to implement new practices. The NHS SM and ISSaQ-4.0 results were analyzed through neo-institutional[11-12] and structuration theory[13] lens to identify sustainability and scale-up factors.

RESULTS:
Despite limited statistical power, qualitative findings supported quantitative results. Participants (N=45 for CPD Reaction; N=38 for NHS Sustainability Model/ISSaQ-4.0) from three settings valued the workshops for increasing awareness and collaboration but noted a lack of immediate impact on care transitions. They identified barriers: limited resources, systemic disorganization, poor communication, insufficient prioritization, and restricted data access. Suggested improvements included role clarification, improving communication, and ongoing evaluation.

CONCLUSIONS:
The initiative was deemed relevant and promising, but success depends on preparation of implementation settings. The study questions resource allocation and the ability of local champions to translate intent into action, while emphasizing integrated research as a lever to enhance system efficiency.