Spreading and scaling up innovation and improvement

Greenhalgh, Trisha; Papoutsi, Chrysanthi

doi:10.1136/bmj.l2068

Cited by 394Health Policy Implementation ScienceHealth Sciences Research and EducationHealth Services Management and Policy

Spreading and scaling up innovation and improvement

Open access

Greenhalgh, Trisha, Papoutsi, Chrysanthi·2019·BMJ

DOI 10.1136/bmj.l2068PMC PMC6519511

Open this paper in CoChat — free account Open PDF

Abstract

Disseminating innovation across the healthcare system is challenging but potentially achievable through different logics: mechanistic, ecological, and social, say Trisha Greenhalgh and Chrysanthi Papoutsi

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1136/bmj.l2068

Cites

24 of 24 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Scaling up innovations in health care systems is complex and requires both structure and local adaptability, aided by participatory culture, distributed leadership, transparent outcome assessment, collective learning, and adaptation.
“the successful spread and scaling up of innovations in health care systems is complex, and necessitates both structure and adaptability to the local context, benefitting from a participatory culture, distributed leadership, transparent assessment of outcomes, collective learning, and adaptation.10”
From Feasibility of Ultra-Rapid Exome Sequencing in Critically Ill Infants and Children With Suspected Monogenic Conditions in the Australian Public Health Care System (2020) · cites this paper as [10]
Sustainability requires ongoing effort, so it is essential to build local capacity to adapt to constant change.
“Given that sustainability requires ongoing effort, it is essential to build local capacity to adapt to constant change [14, 54].”
From Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members (2022) · cites this paper as [54]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995 · see citing works
Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations
GREENHALGH, T., ROBERT, G., MACFARLANE, F., BATE, P., & KYRIAKIDOU, O. (2004) · The Milbank Quarterly · doi:10.1111/j.0887-378x.2004.00325.x · Cited by 7,448 · see citing works
Self-citation
Making sense of implementation theories, models and frameworks
Nilsen, P. (2015) · Implementation Science · doi:10.1186/s13012-015-0242-0 · Cited by 4,447 · see citing works
Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies
Greenhalgh, T., Wherton, J., Papoutsi, C., Lynch, J., Hughes, G., A'Court, C., Hinder, S., Fahy, N., Procter, R., & Shaw, S. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.8775 · Cited by 2,887 · see citing works
Self-citation
Experience-based design: from redesigning the system around the patient to co-designing services with the patient
Bate, P., & Robert, G. (2006) · Quality and Safety in Health Care · doi:10.1136/qshc.2005.016527 · Cited by 1,081 · see citing works
Studying complexity in health services research: desperately seeking an overdue paradigm shift
Greenhalgh, T., & Papoutsi, C. (2018) · BMC Medicine · doi:10.1186/s12916-018-1089-4 · Cited by 962 · see citing works
Self-citation
When complexity science meets implementation science: a theoretical and empirical analysis of systems change.
Braithwaite, J., Churruca, K., Long, J. C., Ellis, L. A., & Herkes, J. (2018) · BMC Medicine · doi:10.1186/s12916-018-1057-z · Cited by 845 · see citing works
Scale up of services for mental health in low-income and middle-income countries
Eaton, J., McCay, L., Semrau, M., Chatterjee, S., Baingana, F., Araya, R., Ntulo, C., Thornicroft, G., & Saxena, S. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60891-x · Cited by 698 · see citing works
Explaining Michigan: Developing an Ex Post Theory of a Quality Improvement Program
DIXON-WOODS, M., BOSK, C. L., AVELING, E. L., GOESCHEL, C. A., & PRONOVOST, P. J. (2011) · Milbank Quarterly · doi:10.1111/j.1468-0009.2011.00625.x · Cited by 603 · see citing works
Beyond “implementation strategies”: classifying the full range of strategies used in implementation science and practice
Leeman, J., Birken, S. A., Powell, B. J., Rohweder, C., & Shea, C. M. (2017) · Implementation Science · doi:10.1186/s13012-017-0657-x · Cited by 544 · see citing works
A framework for scaling up health interventions: lessons from large-scale improvement initiatives in Africa
Barker, P. M., Reid, A., & Schall, M. W. (2015) · Implementation Science · doi:10.1186/s13012-016-0374-x · Cited by 400 · see citing works
Explaining Matching Michigan: an ethnographic study of a patient safety program
Dixon-Woods, M., Leslie, M., Tarrant, C., & Bion, J. (2013) · Implementation Science · doi:10.1186/1748-5908-8-70 · Cited by 291 · see citing works
How complexity science can inform scale-up and spread in health care: Understanding the role of self-organization in variation across local contexts
Lanham, H. J., Leykum, L. K., Taylor, B. S., McCannon, C. J., Lindberg, C. C., & Lester, R. T. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.05.040 · Cited by 206 · see citing works
Pathways for scaling up public health interventions
Indig, D., Lee, K., Grunseit, A. C., Milat, A., & Bauman, A. E. (2017) · BMC Public Health · doi:10.1186/s12889-017-4572-5 · Cited by 202 · see citing works
Patient and Public Involvement in Healthcare Quality Improvement: How organizations can help patients and professionals to collaborate
Renedo, A., Marston, C., Spyridonidis, D., & Barlow, J. G. (2014) · Public Management Review · doi:10.1080/14719037.2014.881535 · Cited by 156 · see citing works
Effective strategies for scaling up evidence-based practices in primary care: a systematic review
Charif, A. B., Zomahoun, H. T. V., LeBlanc, A., Langlois, L., Wolfenden, L., Yoong, S. L., Williams, C. M., Lépine, R., & Légaré, F. (2017) · Implementation Science · doi:10.1186/s13012-017-0672-y · Cited by 139 · see citing works
“If We Build It, Will It Stay?” A Case Study of the Sustainability of Whole‐System Change in London
Greenhalgh, T., Macfarlane, F., BARTON‐SWEENEY, C., & Woodard, F. (2012) · Milbank Quarterly · doi:10.1111/j.1468-0009.2012.00673.x · Cited by 111 · see citing works
Self-citation
Role of routines in collaborative work in healthcare organisations
Greenhalgh, T. (2008) · BMJ · doi:10.1136/bmj.a2448 · Cited by 109 · see citing works
Self-citation
Sharing leadership for diffusion of innovation in professionalized settings
Currie, G., & Spyridonidis, D. (2018) · Human Relations · doi:10.1177/0018726718796175 · Cited by 98 · see citing works
Action Schools! BC implementation: from efficacy to effectiveness to scale-up
McKay, H. A., MACDONALD, H. M., Nettlefold, L., Mâsse, L. C., Day, M., & Naylor, P. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-093361 · Cited by 96 · see citing works
Scaling up complex interventions: insights from a realist synthesis
Willis, C. D., Riley, B., Stockton, L. D., Abramowicz, A., Zummach, D., Wong, G., Robinson, K. L., & Best, A. (2016) · Health Research Policy and Systems · doi:10.1186/s12961-016-0158-4 · Cited by 78 · see citing works
Studying Scale-Up and Spread as Social Practice: Theoretical Introduction and Empirical Case Study
Shaw, J., Shaw, S. E., Wherton, J. P., Hughes, G., & Greenhalgh, T. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7482 · Cited by 67 · see citing works
Self-citation
Widespread focused improvement: lessons from international health for spreading specific improvements to health services in high-income countries
Øvretveit, J. (2011) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzr018 · Cited by 38 · see citing works
Scaling up improvements more quickly and effectively
Øvretveit, J., Garofalo, L., & Mittman, B. S. (2017) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzx147 · Cited by 17 · see citing works

Flagged first, then by citations

Sorted by citations

Video consultations for covid-19
Greenhalgh, T., Wherton, J., Shaw, S., & Morrison, C. (2020) · BMJ · doi:10.1136/bmj.m998 · Cited by 866 · see citing works
Self-citation
COVID 19: Disruptive impacts and transformative opportunities in undergraduate nurse education
Carolan, C. M., Davies, C. L., Crookes, P. A., McGhee, S., & Roxburgh, M. (2020) · Nurse Education in Practice · doi:10.1016/j.nepr.2020.102807 · Cited by 282 · see citing works
Feasibility of Ultra-Rapid Exome Sequencing in Critically Ill Infants and Children With Suspected Monogenic Conditions in the Australian Public Health Care System
Australian Genomics Health Alliance Acute Care Flagship, Lunke, S., Eggers, S., Wilson, M., Patel, C., Barnett, C. P., Pinner, J., Sandaradura, S. A., Buckley, M. F., Krzesinski, E. I., et al. (2020) · JAMA · doi:10.1001/jama.2020.7671 · Cited by 239 · see citing works
Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework
James, H. M., Papoutsi, C., Wherton, J., Greenhalgh, T., & Shaw, S. E. (2021) · Journal of Medical Internet Research · doi:10.2196/23775 · Cited by 164 · see citing works
Self-citation
Putting the social back into sociotechnical: Case studies of co-design in digital health
Papoutsi, C., Wherton, J., Shaw, S., Morrison, C., & Greenhalgh, T. (2021) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa197 · Cited by 126 · see citing works
Self-citation
Quality improvement made simple
(2021) · doi:10.37829/hf-2021-i05 · Cited by 121 · see citing works
Systematic review of social prescribing and older adults: where to from here?
Percival, A., Newton, C., Mulligan, K., Petrella, R. J., & Ashe, M. C. (2022) · Family Medicine and Community Health · doi:10.1136/fmch-2022-001829 · Cited by 87 · see citing works
First episode rapid early intervention for eating disorders (FREED): From research to routine clinical practice
Allen, K. L., Mountford, V. A., Brown, A., Richards, K. L., Grant, N., Austin, A., Glennon, D., & Schmidt, U. H. (2020) · Early Intervention in Psychiatry · doi:10.1111/eip.12941 · Cited by 77 · see citing works
Tools for assessing the scalability of innovations in health: a systematic review
Charif, A. B., Zomahoun, H. T. V., Gogovor, A., Samri, M. A., Massougbodji, J., Wolfenden, L., Ploeg, J., Zwarenstein, M., Milat, A., Rhéault, N., et al. (2022) · Health Research Policy and Systems · doi:10.1186/s12961-022-00830-5 · Cited by 71 · see citing works
A systems approach to scale-up for population health improvement
Koorts, H., & Rutter, H. (2021) · Health Research Policy and Systems · doi:10.1186/s12961-021-00679-0 · Cited by 68 · see citing works
Making implementation science more real
Sarkies, M., Francis‐Auton, E., Long, J. C., Pomare, C., Hardwick, R., & Braithwaite, J. (2022) · BMC Medical Research Methodology · doi:10.1186/s12874-022-01661-2 · Cited by 66 · see citing works
Live video from bystanders’ smartphones to medical dispatchers in real emergencies
Linderoth, G., Lippert, F. K., Østergaard, D., Ersbøll, A. K., Meyhoff, C. S., Folke, F., & Christensen, H. C. (2021) · BMC Emergency Medicine · doi:10.1186/s12873-021-00493-5 · Cited by 65 · see citing works
What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care
Finucane, A., Swenson, C., MacArtney, J. I., Perry, R., Lamberton, H., Hetherington, L., Graham‐Wisener, L., Murray, S. A., & Carduff, E. (2021) · BMC Palliative Care · doi:10.1186/s12904-020-00700-3 · Cited by 61 · see citing works
Understanding implementation context and social processes through integrating Normalization Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR)
Schroeder, D. M., Luig, T., Finch, T. L., Beesoon, S., & Campbell-Scherer, D. L. (2022) · Implementation Science Communications · doi:10.1186/s43058-022-00264-8 · Cited by 60 · see citing works
Mapping the role of patient and public involvement during the different stages of healthcare innovation: A scoping review
Cluley, V., Ziemann, A., Feeley, C., Olander, E. K., Shamah, S., & Stavropoulou, C. (2022) · Health Expectations · doi:10.1111/hex.13437 · Cited by 57 · see citing works
From spreading to embedding innovation in health care: Implications for theory and practice
Scarbrough, H., & Kyratsis, Y. (2021) · Health Care Management Review · doi:10.1097/hmr.0000000000000323 · Cited by 53 · see citing works
Achieving Spread, Scale Up and Sustainability of Video Consulting Services During the COVID-19 Pandemic? Findings From a Comparative Case Study of Policy Implementation in England, Wales, Scotland and Northern Ireland
Shaw, S. E., Hughes, G., Wherton, J. P., Moore, L., Rosen, R., Papoutsi, C., Rushforth, A., Morris, J. H., Wood, G. W., Faulkner, S. D., et al. (2021) · Frontiers in Digital Health · doi:10.3389/fdgth.2021.754319 · Cited by 53 · see citing works
Self-citation
Rapid molecular tests for tuberculosis and tuberculosis drug resistance: a qualitative evidence synthesis of recipient and provider views
Engel, N., Ochodo, E., Karanja, P. W., Schmidt, B., Janssen, R., Steingart, K. R., & Oliver, S. R. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd014877.pub2 · Cited by 53 · see citing works
Early experiences of integrating an artificial intelligence-based diagnostic decision support system into radiology settings: a qualitative study
Farič, N., Hinder, S., Williams, R., Ramaesh, R., Bernabéu, M. O., van Beek, E. J. R., & Cresswell, K. M. (2023) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocad191 · Cited by 53 · see citing works
Challenges of Research on Person-Centered Care in General Practice: A Scoping Review
Burgers, J. S., van der Weijden, T., & Bischoff, E. W. M. A. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.669491 · Cited by 52 · see citing works
How can we adapt complex population health interventions for new contexts? Progressing debates and research priorities
Evans, R., Moore, G. F., Movsisyan, A., & Rehfuess, E. A. (2020) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2020-214468 · Cited by 51 · see citing works
Implementation Reporting Recommendations for School-Based Mindfulness Programs
Baelen, R. N., Gould, L. F., Felver, J. C., Schussler, D. L., & Greenberg, M. T. (2022) · Mindfulness · doi:10.1007/s12671-022-01997-2 · Cited by 49 · see citing works
Innovating for improved healthcare: Sociotechnical and innovation systems perspectives and lessons from the NHS
Marjanovic, S., Altenhofer, M., Hocking, L., Chataway, J., & Ling, T. (2020) · Science and Public Policy · doi:10.1093/scipol/scaa005 · Cited by 46 · see citing works
Towards a Framework for Evaluating the Safety, Acceptability and Efficacy of Ai Systems for Health: An Initial SynthesisPreprint
Morley, J., Morton, C. E., Karpathakis, K., Taddeo, M., & Floridi, L. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3826358 · Cited by 46 · see citing works
Scaling up public health interventions: engaging partners across multiple levels
Leeman, J., Boisson, A., & Go, V. (2022) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-052020-113438 · Cited by 45 · see citing works
Conditions and barriers for quality improvement work: a qualitative study of how professionals and health centre managers experience audit and feedback practices in Swedish primary care
Arvidsson, E., Dahlin, S., & Anell, A. (2021) · BMC Family Practice · doi:10.1186/s12875-021-01462-4 · Cited by 45 · see citing works
Siloed mentality, health system suboptimization and the healthcare symphony: a Canadian perspective
Lau, R. S., Boesen, M. E., Richer, L. P., & Hill, M. D. (2024) · Health Research Policy and Systems · doi:10.1186/s12961-024-01168-w · Cited by 45 · see citing works
Implementation of Food is Medicine Programs in Healthcare Settings: A Narrative Review
Houghtaling, B., Short, E., Shanks, C. B., STOTZ, S. A., Yaroch, A. L., Seligman, H. K., Marriott, J. P., Eastman, J., & Long, C. R. (2024) · Journal of General Internal Medicine · doi:10.1007/s11606-024-08768-w · Cited by 44 · see citing works
The CFIR Card Game: a new approach for working with implementation teams to identify challenges and strategies
Piat, M., Wainwright, M., Sofouli, E., Albert, H., Casey, R., Rivest, M.-P., Briand, C., Kasdorf, S., Labonté, L., LeBlanc, S., et al. (2021) · Implementation Science Communications · doi:10.1186/s43058-020-00099-1 · Cited by 42 · see citing works
Overcoming Pilotitis in Digital Medicine at the Intersection of Data, Clinical Evidence, and Adoption
Egermark, M., Blasiak, A., Remus, A., Sapanel, Y., & Ho, D. (2022) · Advanced Intelligent Systems · doi:10.1002/aisy.202200056 · Cited by 38 · see citing works
Evidence on Scaling in Health and Social Care: An Umbrella Review
Corôa, R. D. C., Gogovor, A., Charif, A. B., Hassine, A. B., Zomahoun, H. T. V., McLean, R. K. D., Milat, A., Plourde, K. V., Rhéault, N., Wolfenden, L., et al. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12649 · Cited by 38 · see citing works
Digital health and capability maturity models—a critical thematic review and conceptual synthesis of the literature
Liaw, S., & Godinho, M. A. (2022) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocac228 · Cited by 37 · see citing works
Approaches to Spread, Scale-Up, and Sustainability
Papoutsi, C., Greenhalgh, T., & Marjanovic, S. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009326049 · Cited by 37 · see citing works
Self-citation
Models and approaches for building knowledge translation capacity and capability in health services: a scoping review
King, O., West, E. C., Alston, L. V., Beks, H., Callisaya, M. L., Huggins, C. E., Murray, M., Namara, K. M., Pang, M., Payne, W. R., et al. (2024) · Implementation Science · doi:10.1186/s13012-024-01336-0 · Cited by 37 · see citing works
Shared decision making: why the slow progress? An essay by Neal Maskrey
Maskrey, N. (2019) · BMJ · doi:10.1136/bmj.l6762 · Cited by 37 · see citing works
Evaluating a digital sepsis alert in a London multisite hospital network: a natural experiment using electronic health record data
Honeyford, K., Cooke, G., Kinderlerer, A. R., Williamson, E., Gilchrist, M. J., Holmes, A. H., Room, T. S. B., Glampson, B., Mulla, A., & Costelloe, C. (2019) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocz186 · Cited by 36 · see citing works
Co-designing, measuring, and optimizing innovations and solutions within complex adaptive health systems
de Plaza, M. A. P., Yadav, L., & Kitson, A. A. (2023) · Frontiers in Health Services · doi:10.3389/frhs.2023.1154614 · Cited by 36 · see citing works
Pain management in people with severe mental illness: an agenda for progress
Onwumere, J., Stubbs, B., Stirling, M., Shiers, D., Gaughran, F., Rice, A. S. C., C de C Williams, A., & Scott, W. (2022) · Pain · doi:10.1097/j.pain.0000000000002633 · Cited by 35 · see citing works
Integrating environmental considerations in digital health technology assessment and procurement: Stakeholders’ perspectives
Alami, H., Rivard, L., Lehoux, P., Ahmed, M. A. A., Fortin, J., & Fleet, R. P. (2023) · Digital Health · doi:10.1177/20552076231219113 · Cited by 34 · see citing works
Exploring the experiences of changes to support access to primary health care services and the impact on the quality and safety of care for homeless people during the COVID-19 pandemic: a study protocol for a qualitative mixed methods approach
Howells, K., Burrows, M., Amp, M., Brennan, R., Yeung, W.-L., Jackson, S., Dickinson, J., Draper, J., Campbell, S., Ashcroft, D. M., et al. (2021) · International Journal for Equity in Health · doi:10.1186/s12939-020-01364-4 · Cited by 32 · see citing works
Scaling up sexually transmissible infections point-of-care testing in remote Aboriginal and Torres Strait Islander communities: healthcare workers’ perceptions of the barriers and facilitators
Lafferty, L., Smith, K. S., Causer, L. M., Andrewartha, K., Whiley, D. M., Badman, S. G., Donovan, B. J., Anderson, L., Tangey, A., Mak, D. B., et al. (2021) · Implementation Science Communications · doi:10.1186/s43058-021-00232-8 · Cited by 32 · see citing works
Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
Howells, K., Amp, M., Burrows, M., Brown, J., Brennan, R., Dickinson, J., Jackson, S., Yeung, W.-L., Ashcroft, D. M., Campbell, S., et al. (2022) · British Journal of General Practice · doi:10.3399/bjgp.2021.0596 · Cited by 32 · see citing works
Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study
Gremyr, A., Andersson Gäre, B., Greenhalgh, T., Malm, U., Thor, J., & Andersson, A.-C. (2020) · Journal of Medical Internet Research · doi:10.2196/15521 · Cited by 31 · see citing works
Self-citation
Effect of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-wedge design randomised controlled trial
Lenguerrand, E., Winter, C., Siassakos, D. M., MacLennan, G., Innes, K., Lynch, P., Cameron, A., Crofts, J. F., McDonald, A. M., McCormack, K., et al. (2019) · BMJ Quality & Safety · doi:10.1136/bmjqs-2018-008625 · Cited by 31 · see citing works
We're implementing AI now, so why not ask us what to do? – How AI providers perceive and navigate the spread of diagnostic AI in complex healthcare systems
Gillner, S. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116442 · Cited by 30 · see citing works
NHS cancer services and systems—ten pressure points a UK cancer control plan needs to address
Aggarwal, A. K., Simcock, R., Price, P., Rachet, B., Lyratzopoulos, G., Walker, K., Spencer, K. L., Roques, T. W., & Sullivan, R. J. (2024) · The Lancet Oncology · doi:10.1016/s1470-2045(24)00345-0 · Cited by 30 · see citing works
Implementation strategies within a complex environment: A qualitative study of a shared decision‐making intervention during childbirth
Spigel, L., Plough, A. C., Paterson, V. J., West, R. L., Jurczak, A., Henrich, N. J., Gullo, S., Corrigan, B., Patterson, P., Short, T., et al. (2022) · Birth · doi:10.1111/birt.12611 · Cited by 30 · see citing works
Factors influencing the utilisation of free-standing and alongside midwifery units in England: a qualitative research study
Walsh, D. J., Spiby, H., McCourt, C., Grigg, C. P., Coleby, D., Bishop, S., Scanlon, M., Culley, L. A., Wilkinson, J., Pacanowski, L., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033895 · Cited by 29 · see citing works
Patient feedback for safety improvement in primary care: results from a feasibility study
Hernan, A. L., Giles, S. J., Beks, H., Namara, K. M., Kloot, K., Binder, M. J., & Versace, V. L. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-037887 · Cited by 28 · see citing works
Integrating socially accountable health professional education and learning health systems to transform community health and health systems
Wood, B., Fitzgerald, M., Kendall, C., & Cameron, E. (2021) · Learning Health Systems · doi:10.1002/lrh2.10277 · Cited by 28 · see citing works
Creating Value Through Learning Health Systems
Wasylak, T., Benzies, K., McNeil, D. A., Zanoni, P., Osiowy, K., Mullie, T., & Chuck, A. W. (2022) · Nursing Administration Quarterly · doi:10.1097/naq.0000000000000552 · Cited by 27 · see citing works
Evaluation of the routine implementation of pulse oximeters into integrated management of childhood illness (IMCI) guidelines at primary health care level in West Africa: the AIRE mixed-methods research protocol
Hedible, K. G. B., Louart, S., Neboua, D., Catala, L., Anago, G., Sawadogo, A., Kargougou, G. D., Meda, I. B., Kolié, J. S., Hema, A., et al. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08982-4 · Cited by 27 · see citing works
Digital care at home: Exploring the role of smart consumer devices
Reid, L., & Sisel, G. (2023) · Health & Place · doi:10.1016/j.healthplace.2022.102961 · Cited by 27 · see citing works
Capturing implementation knowledge: applying focused ethnography to study how implementers generate and manage knowledge in the scale-up of obesity prevention programs
Conte, K. P., Shahid, A., Grøn, S., Loblay, V., Green, A. S., Innes‐Hughes, C., Milat, A., Persson, L., Williams, M., Thackway, S. V., et al. (2019) · Implementation Science · doi:10.1186/s13012-019-0938-7 · Cited by 27 · see citing works
Commercialization potential of PET (polyethylene terephthalate) recycled nanomaterials: A review on validation parameters
Kumar, V., Sharma, N., Umesh, M., Sharma, R., Sharma, M., Sharma, D., Sharma, M., Sondhi, S., Thomas, J., Kumar, D., et al. (2024) · Chemosphere · doi:10.1016/j.chemosphere.2024.141453 · Cited by 26 · see citing works
Enhancing translational team effectiveness: The Wisconsin Interventions in Team Science framework for translating empirically informed strategies into evidence-based interventions
Rolland, B., Hohl, S. D., & Johnson, L. J. (2021) · Journal of Clinical and Translational Science · doi:10.1017/cts.2021.825 · Cited by 26 · see citing works
Pharmacist dispensing of the abortion pill in Canada: Diffusion of Innovation meets integrated knowledge translation
Munro, S. B., Wahl, K., Soon, J. A., Guilbert, É., Wilcox, E., Leduc-Robert, G., Ansari, N., Devane, C., & Norman, W. V. (2021) · Implementation Science · doi:10.1186/s13012-021-01144-w · Cited by 25 · see citing works
What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study
Ament, S. M. C., van den Broek, L. M., Everdingen, M. H. J. V. D. B.-V., Boyne, J. J., Maessen, J. M. C., Bekkers, S. C. A. M., Bellersen, L., Rocca, H. B., Engels, Y., & Janssen, D. J. A. (2022) · BMC Palliative Care · doi:10.1186/s12904-021-00896-y · Cited by 25 · see citing works
Building engagement to support adoption of community-based substance use prevention initiatives
Halsall, T., Mahmoud, K., Pouliot, A., & Iyer, S. N. (2022) · BMC Public Health · doi:10.1186/s12889-022-14496-9 · Cited by 25 · see citing works
Bridging the ‘Two Cultures’ of Research and Service: Can Complexity Theory Help? Comment on "Experience of Health Leadership in Partnering With University-Based Researchers in Canada – A Call to ‘Re-imagine’ Research"
Greenhalgh, T. (2019) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2019.89 · Cited by 25 · see citing works
Self-citation
Tensions and Paradoxes of Scaling Up: A Critical Reflection on Physical Activity Promotion
Koorts, H., Bauman, A. E., Edwards, N. C., Bellew, W., Brown, W. J., Duncan, M. J., Lubans, D. R., Milat, A., Morgan, P. J., Nathan, N., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192114284 · Cited by 24 · see citing works
Essential items for reporting of scaling studies of health interventions (SUCCEED): protocol for a systematic review and Delphi process
Gogovor, A., Zomahoun, H. T. V., Charif, A. B., McLean, R. K. D., Moher, D., Milat, A., Wolfenden, L., Prévost, K., Aubin, E., Rochon, P. A., et al. (2020) · Systematic Reviews · doi:10.1186/s13643-019-1258-3 · Cited by 24 · see citing works
Barriers to Implementing a Quality Improvement Program in Low- and Middle-Income Countries: Adequacy of Resources
Pain, D., MacDuffie, E., Martei, Y. M., Kassick, M. E., Ikeda, D. J., Shulman, L. N., Salazar, L. M. L., Diaz, D. A., Nag, S. M., & Grover, S. (2024) · JCO Global Oncology · doi:10.1200/go.24.00114 · Cited by 23 · see citing works
Adult mental health service engagement with patients who are parents: Evidence from 15 English mental health trusts
Dunn, A., Startup, H. M., & Cartwright‐Hatton, S. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12330 · Cited by 23 · see citing works
Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010–2023
McGowan, J. G., Attal, B., Kuhn, I. L., Hinton, L., Draycott, T. J., Martin, G. P., & Dixon‐Woods, M. (2023) · BMJ Quality & Safety · doi:10.1136/bmjqs-2023-016606 · Cited by 23 · see citing works
Evaluating the dissemination and scale-up of two evidence-based parenting interventions to reduce violence against children: study protocol
Shenderovich, Y., Ward, C. L., Lachman, J. M., Wessels, I. M., Sacolo-Gwebu, H., Okop, K., Oliver, D., Ngcobo, L. L., Tomlinson, M., Fang, Z., et al. (2020) · Implementation Science Communications · doi:10.1186/s43058-020-00086-6 · Cited by 23 · see citing works
Systems approaches to scaling up: a systematic review and narrative synthesis of evidence for physical activity and other behavioural non-communicable disease risk factors
Koorts, H., Ma, J., Swain, C. T. V., Rutter, H., Salmon, J., & Bolton, K. A. (2024) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-024-01579-6 · Cited by 22 · see citing works
The what, why and when of adapting interventions for new contexts: A qualitative study of researchers, funders, journal editors and practitioners’ understandings
Copeland, L., Littlecott, H., Couturiaux, D., Hoddinott, P., Segrott, J., Murphy, S., Moore, G. F., & Evans, R. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254020 · Cited by 23 · see citing works
Primary-level palliative care national capacity: Pallium Canada
Pereira, J. L., Chary, S., Faulkner, J., Tompkins, B., & Moat, J. B. (2021) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2021-003036 · Cited by 22 · see citing works
Teamwork in clinical genomics: A dynamic sociotechnical healthcare setting
Best, S., Brown, H. L., Stark, Z., Long, J. C., Ng, L., Braithwaite, J., & Taylor, N. J. (2021) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13573 · Cited by 22 · see citing works
Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design
Riggs, E., Yelland, J. S., Mensah, F. K., Gold, L. H., Szwarc, J., Kaplan, I., Small, R. E., Middleton, P., Krastev, A. H., McDonald, E. A., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-048271 · Cited by 22 · see citing works
Do learners implement what they learn? Commitment-to-change following an interprofessional palliative care course
Pereira, J. L., Meadows, L. M., Kljujic, D., & Strudsholm, T. (2022) · Palliative Medicine · doi:10.1177/02692163221081329 · Cited by 22 · see citing works
Health and Social Care Reform in Scotland – What Next?
Hendry, A., Thompson, M., Knight, P., McCallum, E., Taylor, A., Rainey, H., & Strong, A. (2021) · International Journal of Integrated Care · doi:10.5334/ijic.5633 · Cited by 21 · see citing works
Facilitating future implementation and translation to clinical practice: The Implementation Planning Assessment Tool for clinical trials
Kowalski, C. P., Kawentel, L. M., Kyriakides, T. C., Davis, L. L., Bowersox, N. W., Kilbourne, A. M., Huang, G. D., & Nevedal, A. (2022) · Journal of Clinical and Translational Science · doi:10.1017/cts.2022.467 · Cited by 21 · see citing works
Diffusion dynamics of electronic health records: A longitudinal observational study comparing data from hospitals in Germany and the United States
Esdar, M., Hüsers, J., Weiß, J.-P., Rauch, J., & Hübner, U. (2019) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2019.103952 · Cited by 21 · see citing works
Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members
Morgan, D., Kosteniuk, J., O’Connell, M. E., Seitz, D., Elliot, V., Bayly, M., Chow, A. F., & Cameron, C. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07550-0 · Cited by 20 · see citing works
Development of a Framework for Scaling Up Community-Based Health Promotion: A Best Fit Framework Synthesis
Weber, P., Birkholz, L., Kohler, S., Helsper, N., Dippon, L., Rütten, A., Pfeifer, K., & Semrau, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19084773 · Cited by 20 · see citing works
Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme?
Bångsbo, A., Dunér, A., Dahlin‐Ivanoff, S., & Lidén, E. (2022) · International Journal of Integrated Care · doi:10.5334/ijic.6005 · Cited by 20 · see citing works
Upscaling of climate services – What is it? A literature review
Guentchev, G. S., Palin, E. J., Lowe, J. A., & Harrison, M. (2023) · Climate Services · doi:10.1016/j.cliser.2023.100352 · Cited by 20 · see citing works
Service delivery interventions to improve maternal and newborn health in low- and middle-income countries: scoping review of quality improvement, implementation research and health system strengthening approaches
Mianda, S., Todowede, O. O., & Schneider, H. M. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-10202-6 · Cited by 20 · see citing works
Evaluating Large-Scale Integrated Care Projects: The Development of a Protocol for a Mixed Methods Realist Evaluation Study in Belgium
Goderis, G., Colman, E., Irusta, L. A., Hecke, A. V., Pétré, B., Devroey, D., Deun, E. V., Faes, K., Charlier, N., Verhaeghe, N., et al. (2020) · International Journal of Integrated Care · doi:10.5334/ijic.5435 · Cited by 20 · see citing works
Health and social care integration: fixing a fixed service ecosystem for value co-creation
Strokosch, K., & Roy, M. J. (2024) · Public Management Review · doi:10.1080/14719037.2024.2375566 · Cited by 19 · see citing works
The beginnings of health system transformation: How Ontario Health Teams are implementing change in the context of uncertainty
Embuldeniya, G., Gutberg, J., Sibbald, S., & Wodchis, W. P. (2021) · Health Policy · doi:10.1016/j.healthpol.2021.10.005 · Cited by 19 · see citing works
Organizational perspectives on outdoor talking therapy: Towards a position of ‘environmental safe uncertainty’
Cooley, S. J., Jones, C. R., Moss, D., & Robertson, N. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12315 · Cited by 18 · see citing works
Scale-up influences and definitions of scale-up ‘success’: evidence from globally scaled interventions
Koorts, H., Ma, J., Cassar, S., Bauman, A. E., Lawrence, M. A., Rutter, H., & Salmon, J. (2024) · Translational Behavioral Medicine · doi:10.1093/tbm/ibae063 · Cited by 17 · see citing works
Primary healthcare clinicians’ positive perceptions of the implementation of telehealth during the COVID-19 pandemic using normalisation process theory
Ervin, K. E., Newton, J., & Phillips, J. (2021) · Australian Journal of Primary Health · doi:10.1071/py20182 · Cited by 17 · see citing works
How to embed qualitative research in trials: insights from the feasibility study of the SAFER trial programme
Powell, A. E., Hoare, S. E., Modi, R. N., Williams, K. M., Dymond, A., Chapman, C., Griffin, S. J., Mant, J., & Burt, J. (2022) · Trials · doi:10.1186/s13063-022-06308-7 · Cited by 17 · see citing works
Mobilizing pilot-based evidence for the spread and sustainability of innovations in healthcare: The role of innovation intermediaries
Scarbrough, H., Sanfilippo, K. R. M., Ziemann, A., & Stavropoulou, C. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116394 · Cited by 17 · see citing works
A conceptualisation of scale-up and sustainability of social innovations in global health: a narrative review and integrative framework for action
Niang, M., Alami, H., Gagnon, M., & Dupéré, S. (2023) · Global Health Action · doi:10.1080/16549716.2023.2230813 · Cited by 16 · see citing works
Dancing for Parkinson’s Disease Online: Clinical Trial Process Evaluation
Morris, M. E., McConvey, V., Wittwer, J. E., Slade, S. C., Blackberry, I., Hackney, M. E., Haines, S. J., Brown, L., & Collin, E. (2023) · Healthcare · doi:10.3390/healthcare11040604 · Cited by 16 · see citing works
Evaluating co-design approaches with parents in paediatric healthcare: a systematic review
Suna, J. M., Tanti, D., Merlo, G., Bryant, P. A., McMullan, B. J., Hall, L., & the HOMEFREE Study Group (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13495-x · Cited by 15 · see citing works
Making it personal – population health management and the NHS
McShane, M., & Kirkham, K. (2020) · Journal of Integrated Care · doi:10.1108/jica-01-2020-0002 · Cited by 15 · see citing works
Facilitators and “deal breakers”: a mixed methods study investigating implementation of the Goal setting and action planning (G-AP) framework in community rehabilitation teams
Scobbie, L., Duncan, E., Brady, M., Thomson, K., & Wyke, S. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05651-2 · Cited by 15 · see citing works
Strategies for involving patients and the public in scaling-up initiatives in health and social services: protocol for a scoping review and Delphi survey
Charif, A. B., Plourde, K. V., Guay-Bélanger, S., Zomahoun, H. T. V., Gogovor, A., Straus, S. E., Beleno, R., Kastner, K., McLean, R. K. D., Milat, A., et al. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01597-6 · Cited by 15 · see citing works
Foundation Level Barriers to the Widespread Adoption of Digital Solutions by Care Homes: Insights from Three Scottish Studies
Johnston, L., Koikkalainen, H., Anderson, L., Lapok, P., Lawson, A., & Shenkin, S. D. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127407 · Cited by 15 · see citing works
Isn’t there enough evidence on the benefits of patient navigation?
Paskett, E. D., Battaglia, T. A., Calhoun, E. A., Chappell, M., Dwyer, A. J., Fleisher, L. G., Greenwald, J., & Wells, K. J. (2023) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21805 · Cited by 15 · see citing works
Views and Uses of Sepsis Digital Alerts in National Health Service Trusts in England: Qualitative Study With Health Care Professionals
Lazzarino, R., Borek, A., Honeyford, K., Welch, J., Brent, A., Kinderlerer, A. R., Cooke, G., Patil, S., Gordon, A. C., Glampson, B., et al. (2024) · JMIR Human Factors · doi:10.2196/56949 · Cited by 14 · see citing works
Seeking consent for organ donation: Process evaluation of implementing a new Specialist Requester nursing role
McLaughlin, L., Neukirchinger, B., Monks, J., Duncalf, S., & Noyes, J. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14601 · Cited by 14 · see citing works
The role of trained champions in sustaining and spreading nutrition care improvements in hospital: qualitative interviews following an implementation study
Laur, C. V., Bell, J., Valaitis, R. F., Ray, S., & Keller, H. (2021) · BMJ Nutrition Prevention & Health · doi:10.1136/bmjnph-2021-000281 · Cited by 14 · see citing works
PROMPT Wales project: national scaling of an evidence-based intervention to improve safety and training in maternity
Renwick, S., Hookes, S., Draycott, T. J., Dey, M., Hodge, F., Storey, J., Winter, C., Sengupta, N., & Benjamin, F. (2021) · BMJ Open Quality · doi:10.1136/bmjoq-2020-001280 · Cited by 14 · see citing works

Authors: Greenhalgh, T., & Papoutsi, C.
Affiliations: University of Oxford (GB)
Corresponding author: Greenhalgh, Trisha
ORCID: Greenhalgh, Trisha
Papoutsi, Chrysanthi
Venue: BMJ
Publisher: BMJ
Published: 2019-05-10
Volume: 365
Pages: l2068
ISSN: 1756-1833 (ISSN-L)
0959-8138
DOI: 10.1136/bmj.l2068
PMC: PMC6519511
OpenAlex: W2944295219
Cited by: 382
References: 24
Citations by year: 2026: 35 · 2025: 46 · 2024: 88 · 2023: 60 · 2022: 50 · 2021: 63 · 2020: 33 · 2019: 7
FWCI: 52.12
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: Wellcome Trust (104830/Z/14/Z)
National Institute for Health and Care Research (HS&DR-13/59/26, 13/59/26)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
Keywords: innovation dissemination, scale-up, healthcare innovation, social diffusion
MeSH terms: Delivery of Health Care, Diffusion of Innovation, Health Services Research, Humans, Organizational Innovation, Quality Improvement

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Spreading and scaling up innovation and improvement

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks