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This thesis deals with the conditions and factors influencing the implementation outcome of top management decisions. The thesis presents an implementation model, which describes, and to a certain extent explains, the factors influencing the implementation efficiency of decisions made by top executives in complex profit-driven, Swedish organizations. The model is developed from a literature review and tested in an empirical study with both qualitative and quantitative approaches. The implementation efficiency is estimated as the sum of implementation process efficiency and decision goal satisfaction. The empirical study is carried out in the perspective of both the executives and the implementers. All types of decisions have been studied. The respondents have described how a specific decision is handled in the implementation phase (the qualitative part of the study). They have also estimated the performance of specific variables on a six-grade scale for the same decision (the quantitative part of the study). The analysis of the empirical data is carried out not only as comparisons of the opinions of respondents for each decision identifying similarities and differences, but also by using Qualitative Comparative Analysis, QCA, and a simultaneous equation model, LISREL. The analysis results show that the preliminary implementation model satisfactorily explains basic correlations between implementation conditions and implementation efficiency. The implementation efficiency is positively correlated with a simple implementation context and an evident implementation profile as well as decisions with only internal consequences, operational decisions and recognized decisions. The implementation efficiency is on average about 65%, with great variation between companies and between decisions, indicating a huge potential for improvements. There are differences between decision makers and the implementers in terms of perceived implementation conditions and implementation efficiency. It is also observed that decision makers engage themselves to a very limited extent in the implementation of their decisions. The preliminary implementation model has been developed with complementary variables as a result of the study. Furthermore, it has been possible to design a preliminary model describing the critical moment of transformation of the implementation task. Both models require further empirical tests.