Framework 2: Implementation Stages

Implementation is not an event.  Implementation is “a specified set of activities designed to put into practice an activity or program” (Fixen, Naoom, Blase, Friedman, & Wallace, 2005). These activities occur over time in stages that overlap and that are revisited as needed.  

An implementation stages diagram portayed as four overlapping circles, reading left to rightImplementation involves multiple decisions, actions, and corrections to change the structures and conditions necessary to implement and sustain new practices and programs successfully. The required decisions and actions are accomplished through a set of Implementation Stages. 

Research shows achieving intended outcomes through implementing a well-constructed, well-defined, well-researched program can be expected to take 2 to 4 years The timeline for achieving outcomes (if at all) drastically increases for programs that are not well constructed or well defined. There is substantial agreement that planned change is a recursive process that happens in discernible stages.  (Bierman et al., 2002; Fixsen, Blase, Timbers, & Wolf, 2001; Panzano & Roth, 2006; Prochaska & DiClemente, 1982; Solberg, Hroscikoski, Sperl-Hillen, O’Conner, & Crabtree, 2004).  Conducting stage-appropriate implementation activities is necessary for successfully utilizing new practices and for organizations and systems to change to support new ways of work. 

There are four functional Implementation Stages: Exploration, Installation, Initial Implementation, Full Implementation. Stages of implementation do not cleanly end as another begins. Instead, stages overlap with activities related to one stage still occurring as activities for the next stage begin. Likewise, it is often necessary to revisit previous stages when circumstances change (e.g., change in staff/leadership, data identifies an area where changes are required). 

The following section describes each of the four stages in more detail.

Implementation Stages

An implementation stages diagram with the stages "exploration", "installation", "initial implementation" and "full implementation" listed

 

SISEP Video Series: Implementation Stages

When a decision is made to begin implementing a new initiative, is your first reaction often excitement with a side of panic? Do you already feel behind before you even started? Have you ever wondered if there is a way to be proactive about implementation instead of reactive? Check out this video for an overview of implementation stages and the purpose of intentionally working through each stage.  Click to Tweet

Implementation in Context: Stages 

Mia jumps in. 

Let’s consider the importance of stages through an example. Mia wants to change her personal health habits by including a new fitness routine to her weekly schedule. To accomplish this, Mia decides to get a membership to the gym closest to her house and go six days a week for an hour. After the first week, Mia realizes that she can’t make it to the gym that many days a week. To make matters worse, that gym does not have equipment she feels comfortable using nor does it have any group classes. Needless to say, Mia has not managed to change her personal health habits. 

What went wrong? It certainly helps to check out the equipment in a fitness center before joining, but there’s quite a bit more that Mia could do to implement her new habits. We will walk through the stages of implementation looking at Mia’s fitness goal.