Fixsen and his colleagues reviewed the literature on implementation science (Fixsen, et al (2005) Implementation Research: A Synthesis of the Literature) and suggested that implementation tends to follow four discrete stages. These stages have been estimated to take between 2-4 years and emphasise that program implementation is a process rather than an event. .

Exploration and Adoption

Teams may engage in exploration for a wide range of reasons such as a wish to improve effectiveness or to ensure a better fit between community needs (the client group) and the skills and resources of the team or service. The process may be guided by feedback from staff around training needs and service managers exploring different training opportunities for their staff teams.

Program Installation

This stage involves organisations ensuring that all the components of the program are properly installed and supported. This is likely to include staff training, organisational changes and basic systems such as IT.

Initial Implementation

This has been described as 'the initial awkward stage' of implementation. The organisation will probably experience considerable anxieties about adopting new methods and leaders and supervsiors may lack confidence in sustaining new methods during this period. Many implementation projects end during this phase.

Full Operation

The new method of working becomes firmly established and it becomes 'business as usual'. Staff have become more confident in the methods and experienced in handling common challenges to the adopted method of working.