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. 2013 Feb 13:8:18.
doi: 10.1186/1748-5908-8-18.

Towards a general theory of implementation

Carl May  1
Affiliations

Towards a general theory of implementation

Carl May. Implement Sci. .

Abstract

Understanding and evaluating the implementation of complex interventions in practice is an important problem for healthcare managers and policy makers, and for patients and others who must operationalize them beyond formal clinical settings. It has been argued that this work should be founded on theory that provides a foundation for understanding, designing, predicting, and evaluating dynamic implementation processes. This paper sets out core constituents of a general theory of implementation, building on Normalization Process Theory and linking it to key constructs from recent work in sociology and psychology. These are informed by ideas about agency and its expression within social systems and fields, social and cognitive mechanisms, and collective action. This approach unites a number of contending perspectives in a way that makes possible a more comprehensive explanation of the implementation and embedding of new ways of thinking, enacting and organizing practice.

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Figures

Figure 1
Figure 1
How higher level and middle-range theories are assembled to support the proposed General Theory.
Figure 2
Figure 2
Concepts, Constructs and Dimensions of the General Theory.
Figure 3
Figure 3
Resources and possibilities for agents’ contributions to implementation processes.
See this image and copyright information in PMC

References

    1. Latour B. Reassembling the Social: An Introduction to Actor Network Theory. Oxford: Oxford University Press; 2005.
    1. May C. Mobilizing modern facts: Health Technology Assessment and the politics of evidence. Sociol Health Ill. 2006;28(5):513–532. - PubMed
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    1. Shippee ND, Shah N, May CR, Mair F, Montori VM. Workload, capacity, and burden: a model of cumulative patient complexity. J Clin Epidemiol. 2012;65(10):1041. 1051. - PubMed
    1. Eccles MP, Mittman BS. Welcome to implementation science. Implement Sci. 2006;1:1.

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