Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework

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,...

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Main Authors: Zuhur Balayah, Charitini Stavropoulou, Harry Scarbrough, Amit Nigam, Alexandra Ziemann
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1373429/full
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author Zuhur Balayah
Zuhur Balayah
Charitini Stavropoulou
Charitini Stavropoulou
Harry Scarbrough
Harry Scarbrough
Amit Nigam
Amit Nigam
Alexandra Ziemann
Alexandra Ziemann
author_facet Zuhur Balayah
Zuhur Balayah
Charitini Stavropoulou
Charitini Stavropoulou
Harry Scarbrough
Harry Scarbrough
Amit Nigam
Amit Nigam
Alexandra Ziemann
Alexandra Ziemann
author_sort Zuhur Balayah
collection DOAJ
description 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.
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spelling doaj-art-fd39073a19d04454becfe1609eb8c5fd2025-08-20T01:55:33ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-05-01510.3389/frhs.2025.13734291373429Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated frameworkZuhur Balayah0Zuhur Balayah1Charitini Stavropoulou2Charitini Stavropoulou3Harry Scarbrough4Harry Scarbrough5Amit Nigam6Amit Nigam7Alexandra Ziemann8Alexandra Ziemann9Centre for Healthcare Innovation Research (CHIR), City St George's, University of London, London, United KingdomFaculty of Management, Bayes Business School, City St George's, University of London, London, United KingdomCentre for Healthcare Innovation Research (CHIR), City St George's, University of London, London, United KingdomDepartment of Health Services Research and Management, School of Health and Psychological Sciences, City St George's, University of London, London, United KingdomCentre for Healthcare Innovation Research (CHIR), City St George's, University of London, London, United KingdomFaculty of Management, Bayes Business School, City St George's, University of London, London, United KingdomCentre for Healthcare Innovation Research (CHIR), City St George's, University of London, London, United KingdomFaculty of Management, Bayes Business School, City St George's, University of London, London, United KingdomCentre for Healthcare Innovation Research (CHIR), City St George's, University of London, London, United KingdomDepartment of Social and Policy Sciences, University of Bath, Bath, United KingdomThe 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.https://www.frontiersin.org/articles/10.3389/frhs.2025.1373429/fullimplementation frameworksoutcomesconceptualizationinnovationsintegrationde-implementation
spellingShingle Zuhur Balayah
Zuhur Balayah
Charitini Stavropoulou
Charitini Stavropoulou
Harry Scarbrough
Harry Scarbrough
Amit Nigam
Amit Nigam
Alexandra Ziemann
Alexandra Ziemann
Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework
Frontiers in Health Services
implementation frameworks
outcomes
conceptualization
innovations
integration
de-implementation
title Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework
title_full Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework
title_fullStr Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework
title_full_unstemmed Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework
title_short Re-conceptualizing implementation outcomes of health innovations as modes or attributes: an integrated framework
title_sort re conceptualizing implementation outcomes of health innovations as modes or attributes an integrated framework
topic implementation frameworks
outcomes
conceptualization
innovations
integration
de-implementation
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1373429/full
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