Carrying out or accomplishing the implementation according to plan.  

Quality of execution may consist of the degree of fidelity of implementation to planned courses of action [1], intensity (quality and depth) of implementation [2], timeliness of task completion, and degree of engagement of key involved individuals (e.g., implementation leaders) in the implementation process. There is not a consensus in the literature about how to assess fidelity – especially how to do so in a standardized way across studies and settings; it may not be appropriate to do so. Pearson et al. defined fidelity in terms of the extent to which hard core components of the intervention were implemented and also, quality and depth of implementation (together comprising intensity of implementation) [2]. The latter dimension (intensity) was subjectively determined based on organizational documents, meetings, communications, and other study materials. Execution of an implementation plan can be organic with no obvious or formal planning which makes this construct challenging to assess. However, in addition to a well developed plan, three general approaches increase the likelihood of success. Dry runs are simulations or practice sessions that allow team members to learn how to use the intervention before going live and help train and prepare users [3]. Pilots or trials of a new intervention also allow users to test procedures, gain confidence, and build an environment of psychological safety as members are encouraged to take on new behaviors, and make adjustments [3]. More complex interventions may lead to incremental interventions [4][5][6]. Breaking down the intervention into manageable parts that can be adopted incrementally has a positive relationship with adoption [4] because incremental implementation allows people to feel that they have enough time to do their work and to learn new skills associated with the shift to the new intervention [7]. Successes in early increments of the implementation help increase confidence, give an opportunity to make adjustments, and gain new “believers.”

Inclusion Criteria

Include statements that demonstrate how implementation occurred with respect to the implementation plan.

Note: Executing is coded very infrequently due to a lack of planning. However, some studies have used fidelity measures to assess executing, as an indication of the degree to which implementation was accomplished according to plan.

Exclusion Criteria

Currently no criteria are listed; as we become aware of criteria, we will post them here. Please contact us with updates.

Check out SIRC’s Instrument Review project and published systematic review protocol, which has cataloged over 400 implementation-related measures. 

Note: As we become aware of measures, we will post them here. Please contact us with updates.

  1. Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S: A conceptual framework for implementation fidelity. Implement Sci 2007, 2:40.
  2. Pearson ML, Wu S, Schaefer J, Bonomi AE, Shortell SM, Mendel PJ, Marsteller JA, Louis TA, Rosen M, Keeler EB: Assessing the implementation of the chronic care model in quality improvement collaboratives. Health Serv Res 2005, 40:978-996.
  3. Edmondson AC, Bohmer RM, Pisana GP: Disrupted routines: Team learning and new technology implementation in hospitals. Adm Sci Q 2001, 46:685-716.
  4. Damanpour F: Organizational Innovation: A Meta-Analysis of Effects of Determinants and Moderators. The Academy of Management Journal 1991, 34:555-590.
  5. Grossman JB: The Supreme Court and Social Change: A Preliminary Inquiry. Am Behav Sci 1970, 13:535-551.
  6. Normann R: Organizational Innovativeness: Product variation and reorientation. Adm Sci Q 1971, 16.
  7. Helfrich CD, Weiner BJ, McKinney MM, Minasian L: Determinants of implementation effectiveness: adapting a framework for complex innovations. Med Care Res Rev 2007, 64:279-303.