Despite the best intentions of policy makers and practitioners alike, plans do not always turn out as expected. The “implementation gap” is a phrase that is often used to refer to the difference between what a particular policy promises and what is delivered in practice. This gap (or deficit as it is sometimes called) is both puzzling and challenging to practitioners and researchers. It has provoked pronounced debates of late, partly as a consequence of the rise of movements in evidence-based policy, practice and medicine. The Society for the Study of Organizing in Health Care (SHOC) has had a particular focus on the ways in which this gap manifests in health care and addressed this issue at its biennial international conference in Organisational Behaviour in Health Care (OBHC) in 2010.