Clinical process innovations (CPI) are central to the ability of organizations to negotiate the challenges of cost containment and quality improvement, yet many CPI have not met expectations. Perhaps most alarming is that the dissemination and implementation of CPI is not well understood. This is the second of two articles addressing the dissemination and use of CPI in integrated delivery systems. This article discusses those factors that have been identified as either facilitating or impeding the various stages in implementing CPI and suggests some intervention strategies to enhance opportunities for continuous CPI. Identifying the process and the factors driving the implementation of CPI is only part of the challenge. The development of CPI adequate to fully meet current challenges will require managers to re-examine existing paradigms and values influencing their actions to date. Within this context, the necessary staging of the innovation process within the life cycle, developing partnerships both within and outside the organization to gather the necessary resources and support, and multidimensional performance monitoring and feedback can prepare organizations and managers to better face the reality of managing the innovation process.