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Can we speed the testing, implementation and spread of management innovations in a systematic way to also contribute to scientific knowledge? Researchers and implementers have developed an approach to test and revise a local version of an innovation during its implementation. The chapter starts with a case example of an application of this combination of implementation and quality improvement sciences and practices (improve-mentation). It then summarizes four examples of this approach so as to help understand what improve-mentation is and how it is different from traditional quality improvement and traditional implementation of evidence-based practices. It considers gaps in knowledge that are hindering both more use of improve-mentation to generate scientific knowledge about spread and implementation, as well as more use of improve-mentation by health care service organizations and researchers. It closes by proposing fruitful research and development that can address these knowledge gaps to speed the implementation, sustainment and spread of care and management innovations.

Sungusungu non-state justice organizations in Tanzania exemplify large-scale cooperation. Sungusungu third-party enforcers protect property and resolve interpersonal disputes for ethnic Sukuma and individuals from other ethnic groups who have joined the hierarchically structured organizations. We use ethnographic and experimental data to highlight the importance of institutional forces when attempting to understand patterns of large-scale cooperation. We acknowledge the usefulness of considering micro-economic theories (e.g. costly signaling theory) to understand Sungusungu, but show that social institutions and a human predisposition to act as a “strong reciprocator” are important mechanisms to explain both the origins and maintenance of Sungusungu cooperation.

Legislative action was historically the means by which U.S. states abolished capital punishment, but such action ceased for decades following the Supreme Court's 1976 Gregg decision that reaffirmed the constitutionality of the death penalty. Despite the fact that several legislatures have considered abolition bills in the modern era, only three states successfully enacted such legislation. It is my purpose in this study to analyze why states are currently struggling to pass abolition legislation and to determine which factors contribute to success. I conduct a comparative, qualitative case study of New Jersey, the first state to legislatively abolish since 1976, and Maryland, a similar state whose abolition effort recently failed. I analyze the content of legislators’ debates about the abolition bills in committee and on the legislature floor, as well as news coverage of the abolition efforts in each state's largest newspapers. I reach two primary conclusions. First, an abolition bill is more likely to be passed by Democrats than Republicans, but unified Democratic control of the government is not a sufficient condition for abolition. Second, arguments about the risk of wrongful executions and the deleterious collateral consequences of the death penalty process on the family members of murder victims are powerful sources of political support for abolition, especially where doubts about the deterrent effect of the death penalty are widespread. This study reaffirms the central importance of the innocence frame in the modern death penalty debate, and it presents the first scholarly analysis of the collateral consequences frame. These findings may help activists in the abolition movement more effectively frame their arguments to appeal to legislators.