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The effectiveness of champions in implementing innovations in health care: a systematic review

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Santos, Wilmer J., Graham, Ian D., Lalonde, Michelle, Demery Varin, Melissa, Squires, Janet E.·2022·Implementation Science Communications
DOI 10.1186/s43058-022-00315-0PMC PMC9308185
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Abstract

Background: Champions have been documented in the literature as an important strategy for implementation, yet their effectiveness has not been well synthesized in the health care literature. The aim of this systematic review was to determine whether champions, tested in isolation from other implementation strategies, are effective at improving innovation use or outcomes in health care. Methods: The JBI systematic review method guided this study. A peer-reviewed search strategy was applied to eight electronic databases to identify relevant articles. We included all published articles and unpublished theses and dissertations that used a quantitative study design to evaluate the effectiveness of champions in implementing innovations within health care settings. Two researchers independently completed study selection, data extraction, and quality appraisal. We used content analysis and vote counting to synthesize our data. Results: After screening 7566 records titles and abstracts and 2090 full text articles, we included 35 studies in our review. Most of the studies (71.4%) operationalized the champion strategy by the presence or absence of a champion. In a subset of seven studies, five studies found associations between exposure to champions and increased use of best practices, programs, or technological innovations at an organizational level. In other subsets, the evidence pertaining to use of champions and innovation use by patients or providers, or at improving outcomes was either mixed or scarce. Conclusions: We identified a small body of literature reporting an association between use of champions and increased instrumental use of innovations by organizations. However, more research is needed to determine causal relationship between champions and innovation use and outcomes. Even though there are no reported adverse effects in using champions, opportunity costs may be associated with their use. Until more evidence becomes available about the effectiveness of champions at increasing innovation use and outcomes, the decision to deploy champions should consider the needs and resources of the organization and include an evaluation plan. To further our understanding of champions’ effectiveness, future studies should (1) use experimental study designs in conjunction with process evaluations, (2) describe champions and their activities and (3) rigorously evaluate the effectiveness of champions’ activities. Registration: Open Science Framework ( https://osf.io/ba3d2 ). Registered on November 15, 2020.

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  • Many factors identified in our analysis reflect established findings on implementation of other innovations and NASSS framework constructs.

    “Many factors identified in our analysis—including context (at system, organization, and service levels), leadership and engagement approaches, technological considerations, use of data, and local capacity and resourcing (e.g., finance, people)–reflect established findings on implementation of other innovations, digital or otherwise,21,27, 28, 29, 30 and NASSS framework constructs.20”

    From Procurement and early deployment of artificial intelligence tools for chest diagnostics in NHS services in England: a rapid, mixed method evaluation (2025) · cites this paper as [28]

    The Results (Description and operationalization of champions; page unavailable) describe champions promoting innovations and taking leadership roles, including acquiring resources. The review also examines technological innovations and organizational uptake, but it does not establish the full set of factors listed in the citing sentence, particularly use of data and context across system, organization, and service levels. The NASSS framework is attributed to a separate citation, not this source. (LLM, conf=0.83)

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Cited by

Sorted by citations

Authors
Santos, W. J., Graham, I. D., Lalonde, M., Demery Varin, M., & Squires, J. E.
Affiliations
University of Ottawa (CA)
Corresponding author
Squires, Janet E.
ORCID
Venue
Implementation Science Communications
Publisher
Springer Science and Business Media LLC
Published
2022-07-22
Volume
3
Issue
1
Pages
80-80
ISSN
2662-2211 (ISSN-L)
DOI
10.1186/s43058-022-00315-0
PMC
PMC9308185
OpenAlex
W4286486503
Cited by
205
References
10
Citations by year
2026: 62 · 2025: 66 · 2024: 57 · 2023: 18 · 2022: 2
FWCI
6.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science Communications (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • University of Ottawa
  • Canadian Institutes of Health Research (FDN# 143237, 143237)
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 › Health Information Management › Healthcare Quality and Management
Keywords
champions, implementation strategies, healthcare innovation, innovation adoption, organizational change, best practices, implementation effectiveness, health care organization

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