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REVIEW article
Front. Health Serv.
Sec. Implementation Science
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1373429
Re-conceptualizing implementation outcomes of health innovations as either modes or attributes: an integrated framework
Provisionally accepted- 1Centre for Healthcare Innovation Research, Cass Business School, City University of London, London, United Kingdom
- 2Faculty of Management, Bayes Business School, City University of London, London, United Kingdom
- 3Department of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, United Kingdom
- 4Department of Social & Policy Sciences, University of Bath, Bath, England, United Kingdom
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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 use a meta-ethnographic approach to enhance our theoretical conceptualization of implementation outcomes. By situating such outcomes within the overall process of implementation, we are 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.
Keywords: Implementation frameworks, outcomes, Conceptualization, innovations, integration, De-implementation, depth, breadth
Received: 19 Jan 2024; Accepted: 11 Apr 2025.
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) or licensor 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.
* Correspondence: Zuhur Balayah, Centre for Healthcare Innovation Research, Cass Business School, City University of London, London, United Kingdom
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.