City Research Online

Abstract

The implementation of innovations in practice is challenging and often produces disappointing outcomes. Although the reasons for this are multifaceted, part of the challenge derives from the lack of consensus on how such implementation outcomes should be conceptualized and measured. In this review, we used a meta-ethnographic approach to enhance our theoretical conceptualization of implementation outcomes. By situating such outcomes within the overall process of implementation, we were able to unpack them analytically as the product of two major components, which we term “modes” and “attributes,” respectively. Modes comprise engagement, active implementation, and integration to foreground focal implementation outcomes. The attributes associated with the modes comprise implementation depth, implementation breadth, implementation pace, implementation adaptation, and de-implementation to indicate the features of the modes of implementation outcomes. Taken together, our analysis based on modes and attributes provides an integrated framework of implementation outcomes. The proposed framework enhances our understanding of the way in which implementation outcomes have been conceptualized in previous literature, enabling us to clarify the relations and distinctions between them in terms of translatability and complementarity. The proposed framework thus extends the conceptualization of implementation outcomes to better align with the complex reality of implementation practice, offering useful insights to researchers, practitioners, and policymakers.

Publication Type:	Article
Additional Information:	Copyright: © 2025 Balayah, Stavropoulou, Scarbrough, Nigam and Ziemann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Publisher Keywords:	breadth, conceptualization, de-implementation, depth, implementation frameworks, innovations, integration, outcomes
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	Bayes Business School Bayes Business School > Management School of Health & Medical Sciences School of Health & Medical Sciences > Healthcare Services Research & Management
SWORD Depositor:	Symplectic Administrator

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