Original ArticlesStages in the Implementation of Innovative Clinical Programs in Complex OrganizationsROSENHECK, ROBERT M.D.1Author Information 1VA Northeast Program Evaluation Center and Yale Departments of Psychiatry and Public Health, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, Connecticut 06516. Send reprint requests to Dr. Rosenheck. This paper was presented in part as the Carl Taube Award Lecture at the American Public Health Association Annual Meeting, Boston, MA, November 13, 2000. Paul Errera, M.D., Thomas Horvath, M.D., Laurent Lehmann, M.D., Gay Koerber, M.A., and William Van Stone, M.D., provided national leadership for the VA mental health programs described here. NEPEC Project Directors who participated in design, implementation, and evaluation of these projects include Rani Desai, Ph.D., Alan Fontana, Ph.D., Linda Frisman, Ph.D., Wes Kasprow, Ph.D., Alvin Mares, Ph.D., Michael Neale, Ph.D., and Catherine Seibyl, M.S.N., M.P.H. Gregory Greenberg, Ph.D., made helpful comments on an earlier draft. The Journal of Nervous and Mental Disease: December 2001 - Volume 189 - Issue 12 - p 812-821 Buy Abstract Organizational processes can have an important impact on the introduction of innovative treatments into practice. Conceptual frameworks from organization theory and experiences implementing several hundred specialized mental health programs in the Department of Veterans Affairs (VA) over the past 15 years are used to illustrate stages and processes in the implementation of new treatment models. Four phases in the implementation of new treatments in complex organizational settings are described: a) the decision to implement, b) initial implementation, c) sustained implementation, and d) termination or transformation. Key strategies for moving research into practice include constructing decision-making coalitions, linking new initiatives to legitimate goals and values, quantitative monitoring of implementation and performance, and the development of self-sustaining communities of practice as well as learning organizations. Effective dissemination of new treatment methods requires different organizational strategies at different phases of implementation. © 2001 Lippincott Williams & Wilkins, Inc.