More Than a Checklist: Building Better Implementation Plans
By Dr. Julia E. Moore, Executive Director
4-min read
Implementation plans are fascinating. In some ways, we all make implementation plans on a regular basis. I’m in the process of making plans for summer. My husband has been building us a barn for years, and he has constant implementation plans. Even my 11-year-old has been coming home with homework that involves creating an implementation plan for writing a story.
However, not all implementation plans are created equal. Fortunately, there are different aspects we can consider to improve our implementation plans.
Implementation plans are everywhere—but are they incorporating what they need to?
Recently, I had a wonderful conversation with members of an organization that has enthusiastically embraced implementation science as their “new way of working” over the past few years. They invited me to review their implementation plans for various exciting programs and initiatives, and it was truly inspiring to see how much they’ve evolved.
They maintained implementation plans in the past, but before fully integrating implementation science, these were largely focused on operational aspects, such as resources and accountability. What struck me was how they’ve recognized how much these plans have transformed! They’ve moved away from merely administrative components to incorporating a thoughtful approach that values core elements while remaining adaptable. This shift is remarkable, as it emphasizes meeting people and organizations where they are and meaningfully highlights the principles of implementation science.
Common oversights in implementation planning
What is fascinating about implementation science is that it’s very intuitive and, simultaneously, often not instinctual. Let me give you a couple of examples.
Example of overlooked elements of implementation planning – Readiness.
When people hear that one of the major reasons that organizations fail to implement new initiatives is that those organizations are not ready, they’re rarely surprised. Anyone who has been part of or supported implementation across several organizations has probably had some version of this experience. And yet, our natural inclination is not necessarily to assess readiness across sites. When we do, we might tend to pick and prioritize more ready sites rather than figure out how to meet the sites that need help the most where they are.
Example of overlooked elements of implementation planning – Sustainability.
Sustainability is such a beautiful example because it seems obvious and yet is not how we approach the world. The research shows that planning for sustainability early and often increases the likelihood of sustainability. I say this sentence several times a month, and no one is surprised by that finding. And yet sustainability planning is very rarely part of our implementation plans, especially early on. In fact, we often experience pushback against planning for sustainability too early because people say they want to know that something is working well before planning for sustainability. Except if you wait until you know if it works well, it’s often no longer the optimal time to plan for sustainability.
What should underpin an implementation plan?
Wouldn’t it be amazing if our implementation plans were underpinned by the science of what we know works in implementing and supporting implementation? Many of these elements come naturally to us and are already embedded in how we think about implementation plans, but not all of them. And it’s fascinating which ones are different or new for various groups.
When creating an implementation plan, we like to start with a process model. Process models outline the steps or stages in a process, like the implementation process. There are several different process models out there. In this case, we want to focus on a process model that helps us plan for implementationinstead of a process model that helps us design the THING we’re implementing.
Examples of process models that help us plan for implementation include:
The last two have four overarching steps that really seem to resonate with people. Whether you use those process models or not, we’ve been finding that people like categorizing Implementation across these four phases:
Exploration
Preparation
Implementation
Full implementation/sustainability
*Note: Technically, EPIS refers to sustainment rather than sustainability, which we understand is an important distinction for implementation researchers. In our experience, implementation practitioners prefer to use the term sustainability instead.
Identifying key implementation activities
After selecting a process model, we then find it helpful to identify and consider the different implementation activities that typically fall under these different phases. Where exactly activities land varies based on the initiative and the context, but we like to take a starting place and adapt from there. This helps us identify key activities that should be embedded in our implementation plans. For example:
Creating an implementation team
Engaging appropriate people
Assessing the need/gap
Selecting change (or implementation) strategies
Assessing readiness of the context
Planning for sustainability
Assessing implementation quality (or fidelity)
Evaluating outcomes
We’ve started using this implementation checklist as a starting point for these conversations. For every initiative, we’ve been adapting and moving elements around, but it’s a great way to get everyone on the same page about the kinds of elements we need to consider.
Embedding Frameworks and Theories in Implementation Planning
One of the most important aspects of developing a great implementation plan isn’t just to have these activities listed but to ensure that appropriate frameworks or theories underpin the different activities in each phase. For example, if you’re assessing the context, you don’t just want to ask people what the context is; you want to be using a really appropriate contextual framework that will help you think about elements of the context that maybe you wouldn’t have thought of initially or maybe that people wouldn’t have brought up as potential issues or facilitators.
Similarly, there are so many great sustainability planning tools out there. When sustainability planning uses an existing tool backed by a framework (instead of just saying that someone is going to plan for sustainability), it can set people up to approach sustainability much more holistically.
We repeatedly hear that approaching implementation plans this way helps people identify a few key elements that they hadn’t thought of. This is not entirely reinventing the wheel; it identifies a couple of activities or factors that may have been overlooked before and could have a pivotal role in making implementation run more smoothly.
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