The updated CFIR (Damschroder, Reardon, Widerquist, et al. 2022) divides formal leadership roles into two levels: High-level Leaders and Mid-level Leaders (see Individuals: Roles: Mid-level Leaders).
High-level Leaders include leaders with the authority to dedicate resources and to make decisions about whether to adopt, implement, and or/sustain the innovation (see Individuals: Characteristics: Opportunity) (Dy et al. 2015). The involvement of leaders and managers (Klein et al. 2001; VanDeusen Lukas et al. 2007; Moretto et al. 2019) is often critical to implementation success (see Individuals: Characteristics: Motivation). Different levels of leadership may have differential effects on implementation success.
Commitment of individuals (see Individuals: Characteristics: Motivation) in formal leadership roles at multiple levels is a significant and frequently assessed determinant of implementation outcomes (Kirk et al. 2015). Commitment, involvement, and accountability (see Individuals: Characteristics: Motivation and Opportunity) of leaders and managers have a significant influence on the success of implementation (Klein et al. 2001; P. W. Meyers et al. 1999; VanDeusen Lukas et al. 2007). Leadership support in terms of commitment and active interest leads to a stronger implementation climate which is related to implementation effectiveness; this association is strengthened with more users being required to work together to implement (Helfrich, Weiner, et al. 2007; Klein et al. 2001). Committed leaders have managerial patience (taking a long- vs. short-term view) to allow time for reduction in productivity until full adoption of the innovation (Klein et al. 2001). Leaders can be important conduits to help persuade other individuals via interpersonal channels and by modeling norms (see Inner Setting Culture: Learning-Centeredness) associated with implementing an innovation (Leeman et al. 2007). Leaders are important for their ability to network (see Inner Setting: Relational Connections), negotiate for resources (see Inner Setting: Available Resources), allocate time (see Individuals: Characteristics: Opportunity), and demonstrate priority (see Inner Setting: Relative Priority).