Chronic Obstructive Pulmonary Disease (COPD) is a primary cause of adult hospitalizations and imposes substantial burdens on patients and healthcare systems. Initiatives that support providers and patients in addressing needs at each stage of this illness are needed. The INSPIRED COPD Outreach Program™ was introduced in 2010 in Halifax, Nova Scotia, Canada to improve care for those with advanced COPD. The huge success of the program led to its expansion to various contexts and geographic locations through a pan-Canadian quality improvement collaborative (QIC). Our study explored early elements of program planning and practice with an aim to understand factors that influence program sustainability. We evaluated the implementation process of 19 teams across Canada; post-collaborative team reports, focus groups, interviews and self-ratings of progress were collected from all teams. Analysis of data revealed three phases important to fostering sustainability (facilitating implementation, keeping the momentum, and securing sustainability) and each phase had unique supporting themes. Not surprisingly, teams that planned for sustainability early in the implementation process were more likely to successfully achieve program sustainability. However, teams also benefited more broadly from sustainability planning; this included being better able to plan for program spread as well as skill retention and knowledge transfer. This was also seen for quality improvement skills introduced early in the program that were more likely to be maintained and used through other contexts when sustainability planning was present. This study highlights that a QIC can be effective in not only influencing program sustainability but also beyond program implementation through improving knowledge and skill acquisition.

慢性阻塞性肺疾病（COPD）是成人住院的主要原因，给患者和医疗保健系统带来沉重负担。需要采取措施支持提供者和患者满足这种疾病各个阶段的需求。INSPIRED COPD Outreach Program™ 于 2010 年在加拿大新斯科舍省哈利法克斯推出，旨在改善对晚期 COPD 患者的护理。该计划的巨大成功导致其通过泛加拿大质量改进协作组织 (QIC) 扩展到不同的环境和地理位置。我们的研究探讨了项目规划和实践的早期要素，旨在了解影响项目可持续性的因素。我们评估了加拿大 19 个团队的实施过程；从所有团队收集协作后团队报告、焦点小组、访谈和进度自我评价。数据分析揭示了促进可持续性的三个重要阶段（促进实施、保持势头和确保可持续性），每个阶段都有独特的支持主题。毫不奇怪，在实施过程的早期就规划可持续性的团队更有可能成功实现项目的可持续性。然而，团队也从可持续发展规划中更广泛地受益；这包括能够更好地规划方案传播以及技能保留和知识转移。这也体现在项目早期引入的质量改进技能，当可持续性规划存在时，这些技能更有可能在其他环境中得到维护和使用。这项研究强调，QIC 不仅可以有效地影响项目的可持续性，而且还可以通过改善知识和技能的获取来有效地影响项目的实施。