Obstetrician–gynecologist, Tiffany Moore Simas, MD, MPH, MEd, FACOG, and perinatal psychiatrist Nancy Byatt, DO, MS, MBA, DFAPA, FACLP, from UMass Chan Medical School/UMass Memorial Health provide an overview of steps seven through ten, which involve implementation and sustainment. In order, steps seven through ten are training obstetric care clinicians and other staff, implementing changes based on goals and workflow, evaluating progress towards goals, and revising procedures based on lessons learned.