Overview of the Stages of Implementation

Conducting stage-appropriate implementation activities is necessary for successful service and systems change.

Implementation is not an event.  It is a mission-oriented process that takes 2-4 years involving multiple decisions, actions and corrections.  The implementation process includes four “Stages” which will lead to the sustainability of a new EBP/EII in the context of a changing world. Stages are not linear and do not have a crisp beginning or end. For example, there are occasions when the organization will move to earlier stages due to changes in staff, funding, or unsuccessful attempts at employing the EBP/EII with high fidelity. There are key components and processes to pay attention to during each of the stages that can guide the systematic and intentional approach for managing system change and building sustainability for the new EBP/EII.

 

Exploration Stage

The goal of the Exploration stage  is allow time to assess the potential match between community needs, the new EBP or EII  requirements, and community resources and to make a decision to proceed (or not). In addition, potential barriers to implementation are assessed (e.g., relating to funding, staffing, referrals, and system changes). During this stage, champions are identified and engaging stakeholders for feedback occurs. The result of the Exploration Stage is a clear implementation plan with tasks and time lines to facilitate the installation and initial implementation of the program.

Installation Stage

After a decision is made to begin installing a new EBP/EII, there are activities which need to be accomplished before the change in practice begins. These activities define the Installation Stage of implementation. Resources are being consumed in active preparation for actually doing things differently in keeping with the tenets of the new EBP/EII.  Resources are being consumed, and there is no change in implementer behavior at this time. It takes time and talent to ensure structural supports are put in place, materials and supports are organized and system components are reorganized. These include ensuring the availability of funding streams and human resource strategies, policy and procedure development and creating reporting frameworks for expected outcomes.  These activities and their associated “start-up costs” are necessary first steps to begin any implementation of a new practice or innovation in an educational setting.

Initial Implementation Stage

This stage is known as the “awkward stage”. After working though the Installation Stage, the outcome is an Implementation Action plan for the first generation implementers to begin this new work.  Even the best laid out plans offer opportunities for learning and rapid cycle improvement.  The motto is to “get started and then get better”. The support of leadership and Implementation Teams is critical during this stage since new challenges emerge from staff due to fear of change, inertia, and investment in the status quo.  We believe there is a correlation between the time taken in the exploration stage and the push-back that may be experienced during initial implementation. Hand-in-hand with success is the willingness to learn from mistakes and develop system solutions when appropriate, rather than allowing problems to re-emerge and re-occur. 

Full Implementation Stage

Full implementation of an innovation can occur once the new learning becomes integrated into local, district, regional and state practices, policies, and procedures. The EBP/EII has become part of the school, district or State culture and student outcomes (i.e. behavioral, social) are experienced. Over time, the innovation becomes “accepted practice” and a new operationalization of “business as usual” takes its place.  To reach Full Implementation typically takes two to four years, depending on the complexity of the practice and the size of the organization. To prevent “implementation dips” from occurring, it is important for regular assessment of fidelity to the intervention and fidelity to the Implementation processes. Implementation Teams can help ensure that implementation data are used for decision-making, fed forward and back to key stakeholders and new issues are addressed quickly.