Full implementation of an innovation occurs once the new learning becomes integrated into practitioner, organizational, and community practices, policies, and procedures. Over time, the innovation becomes “standard practice” and a new operationalization of “business as usual” takes its place in the setting (e.g., Faggin, 1985). During Full Implementation vigilance over site practices and data reviews continue as more staff members participate, turnover occurs, and improvement cycles continue.
Full Implementation is reached when 50% or more of the intended practitioners, staff, or team members are using an effective innovation with fidelity and good outcomes. For example, if there are 10 teachers who are attempting to use an innovative approach for math instruction, 5 of the teachers would need to be using the innovation as intended as measured by a performance (fidelity) assessment. Full Implementation is difficult to achieve and sustain without the necessary implementation supports described herein (Fixsen, Blase, Timbers, & Wolf, 2001; U.S. Department of Education, 2011).
In the Full Implementation Stage the new ways of providing services are now the standard ways of work where practitioners and staff routinely provide high quality services and the implementation supports are part of the way districts and schools carry out their work. Implementation Teams are built into organization structures and are essential contributors to the ongoing success of using the evidence-based program. Staff, administrators, and leaders come and go and each new person needs to develop the competencies to effectively carry out the innovation and its implementation supports. Managers and administrators come and go and need to continually adjust organizational supports to facilitate the work of practitioners. Systems continue to change and impact organizations and practitioners. Evidence-based programs continue to be developed and programs already in place continue to be improved. The work of Implementation Teams is to ensure that the gains in the use of effective practices are maintained and improved over time and through transitions of leaders and staff.
The Implementation Team will continue to look at each of the Implementation Drivers during this Stage to monitor their effectiveness in “full throttle” mode. Continuous quality improvement of the Implementation Drivers is a hallmark of Full Implementation. Has there been turnover in staff on the Implementation Team? Are new staff members on board who need orientation and training? Are new staff members getting increased coaching compared to staff who are meeting fidelity? Is coaching being provided to all staff? Is coaching contributing to staff satisfaction and improvements in fidelity? Are the data systems providing timely, actionable, reliable, and valid data? Are data regularly used for decision-making? How are the stakeholders reacting to the widespread use of these practices?
Policy changes/development for sustainability
When Full Implementation has been achieved and is being sustained, people sometimes forget that changes in policy and procedures can adversely impact use of the innovation as intended. Throughout the life of the innovation the Implementation Team together with leadership pays attention to the degree to which policies and procedures help or hinder implementation and outcomes. Have you paid attention to the changes needed in policy and procedures with ongoing active use of the improvement cycles? It can take some time to change policies even after the Implementation Team recognizes the need to do so. There may be future innovations which will require the same type of changes in policy as the current one. Now is the time to get comfortable with ‘institutionalizing’ the use of improvement cycles to strengthen the infrastructure so you are ready to go next time!
Fidelity scores signal full implementation. Fidelity measures are identified and/or developed during Exploration and Installation. Fidelity measures are used during Initial Implementation to improve the competency of new Implementation Team members as they support teacher and staff learning and use of innovations. When 50% of the practitioners meet fidelity criteria, it is likely that organizations and sites have changed and are providing routine support for the full use of innovations. Does the criterion of 50% seem low to you? That mark is actually challenging to meet and sustain given staff and leadership turnover. Implementation Teams are essential to assuring the supports to reach Full Implementation and sustain that level of excellence for successive cohorts of students and staff.
Evaluation for expected outcomes
When 50% of the staff are using the innovation fully and effectively, it is legitimate to anticipate robust recipient outcomes. At this point, there is no doubt that the innovation is in place and is being used as intended across a site. Full Implementation creates the opportunity to see if the innovations/practices/systems are producing the anticipated outcomes. During this Stage, it is appropriate to analyze the results from the selected or created assessments for individual outcomes coupled with implementation fidelity checks. Based on the results of this evaluation process, action plans are created or updated (e.g., reporting to stakeholders, celebrations, re-examination of drivers). Sustainability requires tenacity. First, you got started, then you got better. Now may be your biggest challenge – maintaining the quality over time and across staff through purposeful use of the Implementation Drivers and Improvement Cycles. The goal is to have the use of these frameworks become second nature.
Share your Success!
A great deal of hard work has gotten you this far. Celebration is motivation! When it becomes clear from your assessments that staff are implementing with fidelity and consumers benefitted from these efforts, be sure to spread the word! Success will encourage everyone involved to maintain the innovation(s).