Outcomes

The success of implementation is evaluated through implementation outcomes, which are distinct from service system and clinical treatment outcomes. However, successful attainment of implementation outcomes is seen as necessary to subsequent attainment of service system and clinical outcomes. This chapter discusses implementation outcomes, draws key conceptual distinctions from other types of outcomes, and addresses progress in the field to advance the rigour of their measurement. It presents a taxonomy of eight conceptually distinct implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration and sustainability) along with their definitions. It also provides information about a growing base of resources to support their measurement. Advances in our ability to conceptualize and measure implementation outcomes is crucial to understanding implementation processes and roadblocks to such processes. Most critically, robust tests of comparative effectiveness studies of implementation strategies requires rigor in the measurement or implementation outcomes.