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Defining and measuring implementation climate: a scoping review and concept analysis.

Daniel N Elakpa1,2, Aliki Thomas3,4,5, Sylvie Lambert3

  • 1Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada. daniel.elakpa@mail.mcgill.ca.

Implementation Science Communications
|March 20, 2026
PubMed
Summary
This summary is machine-generated.

Implementation climate, the shared staff perception of an evidence-based intervention (EBI) as a priority, is key for healthcare quality. Strengthening this climate improves intervention adoption and workforce outcomes.

Keywords:
Evidence-based practiceImplementation climateImplementation scienceOrganizational culturePublic health

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Area of Science:

  • Healthcare Management
  • Organizational Psychology
  • Implementation Science

Background:

  • Implementation climate significantly influences the adoption, fidelity, and sustainability of evidence-based interventions (EBIs) in healthcare settings.
  • Existing definitions are inconsistent, often conflated with organizational culture or readiness, and assessed using measures of unclear scope.
  • Clarifying the concept of implementation climate is crucial for effective healthcare quality improvement.

Purpose of the Study:

  • To define implementation climate in healthcare, identify its attributes, antecedents, and consequences.
  • To delineate implementation climate from related constructs.
  • To synthesize quantitative and qualitative measurement approaches for implementation climate.

Main Methods:

  • A Joanna Briggs Institute (JBI) scoping review combined with Walker and Avant's concept analysis.
  • Searches of CINAHL, Embase, MEDLINE, and PsycINFO, supplemented by citation tracking and grey literature.
  • Inductive synthesis of 39 empirical and theoretical sources to derive definitions, attributes, antecedents, consequences, boundaries, and measurement indicators.

Main Results:

  • A synthesized definition of implementation climate: shared staff perception of an EBI as an organizational priority, supported by resources and HR processes, reinforced by incentives, and aligned with values/workflows.
  • Seven key attributes identified: clear expectations, tangible support, incentives, workflow compatibility, high priority, tension for change, and supportive HR practices.
  • Stronger implementation climates correlate with improved EBI reach, fidelity, staff retention, and reduced burnout; transformational leadership and resource allocation are key antecedents.

Conclusions:

  • Implementation climate is a modifiable organizational factor crucial for enhancing quality improvement and implementation initiatives.
  • Leaders can improve implementation climate by setting clear expectations, providing resources, aligning incentives, and ensuring workflow integration.
  • Further research should refine and adapt implementation climate measures across diverse contexts and explore objective indicators alongside perceived measures.