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Table 1 Development of Normalisation Process Theory

From: Implementation, context and complexity

Theoretical focus Theoretical content Research questions Empirical focus
1 Users’ interactions with objects in implementation processes (2006) Analysis of mechanisms of collective action (interactional workability, relational integration, skill set workability, contextual integration) [22, 23]. What factors promote or inhibit the routine incorporation of complex interventions in practice? How do they affect implementation processes and outcomes? How complex interventions are operationalised by their users.
2 Agency within implementation processes (2009) Analysis of mechanisms of agents’ contributions to implementation processes (sense-making, cognitive participation, collective action, reflexive monitoring) [24, 25]. What factors promote or inhibit the implementation, embedding and integration of practices? How do they affect implementation processes and outcomes? The work people do when they implement a new technique, technology or organisational intervention.
3 Resource mobilisation in implementation processes (2013) Analysis of social structural resources (roles, rules, norms and material resources) and social cognitive resources (potential and commitment) available to agents as they invest in implementation [26, 27]. What factors promote or inhibit the mobilisation of structural and cognitive resources for implementation? How do they affect implementation processes and outcomes? How implementation processes work over time.
4 Implementation as adaptive self-organising in complex systems (this paper) Analysis of properties of interventions as events in systems (plasticity and elasticity) and adaptive responses to emergence (normative and relational restructuring). What factors promote or inhibit adaptation and self-organisation in complex systems? How do they affect implementation processes and outcomes? How implementation processes differ between settings.