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Service Delivery

Program Implementation

What are key ingredients in successful implementation?

Successful implementation of a program or policy can be very challenging, particularly if it requires considerable change in existing practice or relationships within or between organizations. A vital first step is establishing or assessing the design or plan for the program of interest. This plan should be a detailed document that spells out specifically what is to be done, who is to do it, and when it must be completed. Specifically, the program plan should[1]:

• Clearly identify the target group for the program, or individuals who are the intended focus of the program

• Specify the program’s goal(s) or the desired outcome of the program

• List program objectives, meaning specific measures that can be used as means for assessing whether the goal(s) have been achieved

• Identify detailed strategies (activities) for achieving the program objectives or goals

• Prioritize and set target dates for accomplishing tasks that must be completed to put the program’s strategies in place and maintain their operation

• Assign tasks to specific individuals or groups who have adequate authority and resources to accomplish them

• Specify a plan for ongoing monitoring of program implementation and outcome evaluation.

Even with a very well-designed program and carefully written program plan, successful implementation of the plan is difficult. One of the primary challenges is ensuring that adequate resources are available to enact the plan. If sufficient funds and staff are not committed to the program, there can be little hope of successful implementation. In fact, inadequate resources have been identified as one of the leading causes of implementation failure [2]. In addition to resource allocation, other factors are key to achieving successful implementation. Of particular importance, and related to adequate resource allocation, is gaining the support of organizational management for the program goals, objectives, and strategies. In addition, administrative processes (such as procedures, paperwork, and requirements) must be reviewed and adjustments made in a way that accommodates the needs of the new program. Also, establishing local ownership or buy-in of staff responsible for implementing the program is critical [3]. RAND researchers have outlined several ways to encourage this type of commitment by key staff members [4].

• Use opinion leaders, or well-respected and effective leaders who are committed to the process of designing and executing the program plan.

• Educate staff about all the facets of the program, including why it is necessary, its specific goals and objectives, how the goals and objectives will be achieved, and how success will be measured.

• Focus on local implications, how the implementation process will impact day to day activities, and solicit input from staff on their concerns about implementation of the program.

• Include staff at all levels in the implementation process who will have some direct or indirect role in establishing or maintaining the program

• Use data to the greatest extent possible to demonstrate the need for the program.

• Focus staff attention on program goals and how successfully establishing the program will accomplish those goals.

More Information

Here are some additional sources of information about achieving successful implementation:

• New!  The RAND Corporation hands-on manual Getting To Outcomes 2004: Promoting Accountability Through Methods and Tools for Planning, Implementation, and Evaluation highlights ten questions related to accountability that should be answered in the course of planning, implementing, and evaluating prevention programs. Although the manual specifically addresses prevention of substance use and abuse among youth, the approach can be applied to all types of prevention programs. The manual features examples from a community-based effort to develop, implement, and evaluate a program to eliminate alcohol, drug, and tobacco use among school-age youth. Worksheets contained in the manual provide a way for readers to answer the ten accountability questions, and a web-based companion tool called iGTO is currently being developed to facilitate this process. The full manual is available at www.rand.org/pubs/technical_reports/TR101/index.html.

• The Office of Juvenile Justice and Delinquency Prevention created a series of how-to reports on topics related to program development, implementation, and evaluation. The series is primarily intended to provide instructions on fundamentals for youths interested in delinquency and crime prevention programming, but the bulletins are broadly applicable to any type of social program. One bulletin, called "Planning a Successful Crime Prevention Project," discusses program implementation issues www.ncjrs.org. The entire how-to series is also available online at www.ojjdp.ncjrs.org.

• The Center for Substance Abuse Prevention (CSAP) produced this technical assistance document, Finding the Balance: Program Fidelity and Adaptation in Substance Abuse Prevention (PDF file). The report discusses the extent to which a proven program can be adapted to fit the needs and circumstances of local communities without decreasing its effectiveness. CSAP has a second report, Achieving Outcomes: A Practitioner's Guide to Effective Prevention (PDF file), that discusses the process for implementing programs that achieve prevention outcomes.

• Researchers at Virginia Tech produced a report that examines issues related to implementation of a large number of projects funded by the U.S. Department of Agriculture. The projects addressed the needs of at-risk children, youths, and families. The researchers point out several areas that, if not properly addressed, can lead to poor program implementation. www.ext.vt.edu

• RAND researchers produced a report on the implementation of welfare reform in the state of California. In this report, the researchers discuss some key issues that can influence program implementation. This report is available free online. Specifically, see the section entitled "A Theoretical Perspective on the Implementation Process," beginning on page 4 of the report www.rand.org/publications.

• New!  The Colorado Trust produced the report Bringing Research to Scale: The Nurse-Family Partnership Program, which provides a case study of how an intervention program can be scaled up from demonstration to community-wide implementation. The Nurse-Family Partnership, a home visitation program, has been proven to improve women and children's health outcomes, reduce participants' reliance on welfare and food stamps, and reduce their contact with the criminal justice system, among other benefits. The report describes the key ingredients in successfully scaling up the program's implementation, which include development of a research-based program model that demonstrates established replicable evidence-based outcomes; adequate initial funding; a person or an organization in the community that will strongly advocate for the program's implementation and obtain buy-in from communities, stakeholders, and potential funders; and legislative support that translates into funding to sustain and expand the program. Contact the Colorado Trust for a copy of the full report. The Nurse-Family Partnership program is a Proven program on PPN. Read the program review at www.promisingpractices.net/program.asp?programid=16.