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An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.
A critical yet unresolved issue in the field of implementation science is how to conceptualize and evaluate success. Studies of implementation use widely varying approaches to measure how well a new mental health treatment, program, or service is implemented. Some infer implementation success by measuring clinical outcomes at the client or patient level while other studies measure the actual targets of the implementation, quantifying for example the desired provider behaviors associated with delivering the newly implemented treatment.
While some studies of implementation strategies assess outcomes in terms of improvement in process of care, Grimshaw et al. We define implementation outcomes as the effects of deliberate and purposive actions to implement new treatments, practices, and services. Implementation outcomes have three important functions. First, they serve as indicators of the implementation success.
Second, they are proximal indicators of implementation processes. And third, they are key intermediate outcomes Rosen and Proctor in relation to service system or clinical outcomes in treatment effectiveness and quality of care research.
