Table 1 Implementation outcomes and strategies
Implementation outcome | Definitiona |
Acceptability | Perception among implementation stakeholders that a given treatment, service, practice, or innovation is agreeable, palatable, or satisfactory |
Adoption | Intention, initial decision, or action to try or employ an innovation or evidence-based practice |
Appropriateness | Perceived fit, relevance, or compatibility of the innovation or evidence based practice setting, provider, or consumer; and/or perceived fit of innovation to address a particular issue |
Penetration | Integration of a practice within a service setting and its subsystems; number of eligible persons who use a service, divided by the total number of persons eligible for the service; number of providers who deliver a given service or treatment, divided by the total number of providers trained in or expected to deliver the service |
Feasibility | Extent to which a new treatment, or an innovation, can be successfully used or carried out within a given agency or setting |
Fidelity | Degree to which an intervention was implemented as it was prescribed in the original protocol or as it was intended by the program developers |
Sustainability | Extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations |
Implementation cost | Cost impact of an implementation effort |
Implementation strategy | Definitiona |
Plan • Gather information • Build buy-in • Initiate leadership • Develop relationships | Help stakeholders gather data, select strategies, build buy-in, initiate leadership, and develop the relationships necessary for successful implementation |
Educate • Develop materials • Inform and influence stakeholders | Inform a range of stakeholders about the innovation and/or implementation effort |
Finance • Modify incentives • Facilitate financial support | Incentivize the use of clinical innovations and provide resources for training and ongoing support. |
Restructure | Facilitate implementation by altering staffing, professional roles, physical structures, equipment, and data systems |
Quality management | Put data systems and support networks in place to continually evaluate and enhance quality of care, and ensure that clinical innovations are delivered with fidelity |
Attend to policy context | Encourage the promotion of clinical innovations through accrediting bodies, licensing boards, and legal system |