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The Implementation Gap

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Regardless of your profession the outcome is reliant on how well you execute. All the planning, professional learning, strategy and ingenuity in the world will make no difference if you are unable execute with fidelity. When the rubber hits the road it’s the implementation gap that’s hinders progress.

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When the rubber hits the road it’s the fidelity of the implementation that makes the difference.

We spend a great deal of time and energy trying to determine why some of our initiatives are not making the gains they are intended to and why some are driving forward exceeding expectations. We analyse, hypothesis, review and try to identify the specific strategies that have been successful. Why is it that this one worked and this one was not as successful? In my opinion we sometimes over-complicate our analysis and need to look at one simple but vital question, how well did we implement? Why is it that the plan we formulate is not always the plan that is implemented? You see ideas are easy, execution is more complex.

We know that successful outcomes can be found when they are underpinned by research. Given the global contentedness we have available today there are not many professions that are not awash with research. In short we are generally able to analyse data, draw conclusions, consider a strategy and find some research to back up our plan. For the most part we have access to high quality professional learning, in most instances we are afforded time to participate in professional learning, partake in collaborative discussion and design a plan of action that we believe best meets the needs of the context within which we work. What then happens in many cases is that we return to our individual environments and begin to implement the plan. Now in many cases we have observations, walk throughs, instructional rounds and opportunities to observe and discus how well we execute; however what happens when no-one is watching. What happens when it gets hard and you’re tired and it’s not going to plan? For many of us we revert back to what we know. I often think about going to the gym. I know how to do the exercises. I’ve had a personal trainer show me how to use the equipment. I know what ‘good form’ looks like when I have to execute an exercise movement or a routine, but when I get tired and no-one is watching the first things that goes out the window is my ability to do the exercises precisely as they are intended, my elbows come out, my legs don’t fully extend, I move a little slower. In other words I take short cuts. Strategies and initiatives do not fail on their own. It’s our disciplined attention to implementation that is the most consistent impediment to success.

The main issue for us to overcome with the implementation of any initiative or strategy is the change in behaviour of those tasked with its implementation. Medical research is littered with countless reports of people not following advice provided for treatment of medical issues. How many of us have started a course of antibiotics only to forget to take the last two or three tablets because we felt better. The World Health Organisation reports that 50% of scripts prescribed for treatment of illnesses are not taken correctly and 40% of patients do not adhere to their treatment regimes. Changing behaviour is difficult even when faced with the prospect of your own health. With this in mind it can be increasingly difficult to change behaviour when implementing new skills and knowledge in a profession.

Overcoming behavioural changes will be critical. There are a few strategies that you can implement that can assist. Firstly you need to have a series of short term wins and you need these quickly. It’s no surprise that immediate positive reinforcement of the desired changes to behaviour are more likely to embed the behavioural changes you are seeking. Its basic psychology. This is where side by side and shoulder to shoulder support is so important. To have your peers working alongside you in your context, guiding, supporting and encouraging allows you to trial the new strategy with the confidence that you have a safety net. If it’s not working as intended you have someone there with you to adapt, refocus and try again. Without this safety net it’s easy to think this won’t work and revert back to previous techniques. Having someone there to assist you and share in your successes is a key factor in successful implementation. Creating conditions that allow for this close level of collaboration will be a vital structure when supporting fidelity of implementation.

Another one of the difficulties with implementation is that the landscape is constantly changing and we need to be agile enough to adapt. When we plan we are planning for a static environment, however as soon as we interact the environment changes and we are faced with new elements that we may not have considered. How then do we overcome this? I believe that this is best supported by process. Disciplined attention to detail and sound processes to guide our implementation allow us to review, realign and re-engage. Whatever your process, framework or guidelines are they need to be clearly understood by all members of the team. These are the guiding principles that will assist with fidelity of implementation. How many times have you heard a sportsperson say that when the chips were down they knew that if they stuck to their processes they could overcome any obstacle. It’s the same when we implement, if we have sound, well thought out processes to guide us then there is less of a chance that we miss the mark on implementation. Alignment of processes across disciplines allows our whole context to understand that this is the expectation for how way we work around here.

Implementation is best supported when being implemented in the right conditions. An environment that supports ongoing improvement, trust, collaboration and accountability supports consistency of implementation. I’ve written previously on the power of culture. Understanding our purpose, creating the customs, beliefs, values and attitudes that focus on continuous improvement should be the foundation. Feedback loops and sound processes that support the culture you are establishing are critically important. Never underestimate the power of an underlying culture that may be resistant to change. Find the early adopters cultivate their skills, support their implementation and celebrate their success. Establishing the right culture is fundamental to fidelity of implementation.

Effective and consistent implementation is complex and multi-directional being impacted from a range of influences. The gap between theory and practice will never be closed through careful planning alone. It’s the on the ground, shoulder to shoulder support and collaborative practice that will make the difference. To change practice we must change behaviour and to do so we must change mindsets, change skill sets and provide processes that support implementation. This is complex work that requires disciplined attention over an extended period of time. When thinking about how you implement initiatives consider whether your implementation has changed practices, routines and structures in a concrete way on the ground and how you know? What concrete evidence do you have that it has had any impact and that it is being implemented consistently? These a key questions that will assist you with reviewing the way you implement within your context. Remember when the rubber hits the road it’s the fidelity of the implementation that makes the difference.

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