Table 3 Middle managers’ roles identified in included studies

Mediating between strategy and day-to-day activities

Addressing concerns raised by frontline employees and enabling them to fulfill their implementation-related responsibilities by overcoming barriers, holding them accountable, and coaching them.

“Leaders needed to be committed to addressing the administrative, adaptive, and enabling behaviors to find a solution to the adaptive challenge” [28].

Diffusing information

Using media to provide comprehensive and relevant information to stakeholders.

“Provide short training courses to keep staff up to date with skills for performance enhancement” [29].

Selling implementation

Present, convince and encourage stakeholders to participate in implementation of an innovation.

“Actively provide encouragement and positive feedback” [12].

Synthesizing information

Form, combine, interpret, and explain different elements to synthesize a cohesive and comprehensive piece of information.

“Determine QI priorities after analysis of available information such as key performance indicators, patient feedback, and review of organizational strategic directions” [16].

Shaping implementation climate

The extent to which EBP implementation is rewarded, supported, and expected in an organization [30]

“Prioritize the implementation of EBP and resource management” [31].