The original CFIR (Laura J. Damschroder et al. 2009) stated that the need to compete with and/or imitate external peer entities can drive implementation and/or delivery of an innovation (T. Greenhalgh, Robert, et al. 2004); peer entities refers to any outside entity with which the Inner Setting feels some degree of affinity or competition (e.g., market competitors, other settings in the same network, a highly regarded institution). In competitive markets, Inner Settings may be more likely to implement new innovations (Frambach and Schillewaert 2001).
The pressure to implement can be particularly strong for late adopters (Walston, Kimberly, and Burns 2001). If competitors or colleagues are all using an innovation, individuals and settings may feel compelled to do so too. This is referred to as “mimetic pressure” or “inter-organizational norm-setting” (T. Greenhalgh, Robert, et al. 2004). This pressure directly influences adoption decisions but can also trickle down to implementation if individuals are attuned to practices of outside entities.