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Related Concept Videos

Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

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Related Experiment Videos

A realistic evaluation: the case of protocol-based care.

Jo Rycroft-Malone1, Marina Fontenla, Debra Bick

  • 1Centre for Health Related Research, School of Healthcare Sciences, Bangor University, Ffriddoedd Road, Bangor, UK. j.rycroft-malone@bangor.ac.uk.

Implementation Science : IS
|May 28, 2010
PubMed
Summary

This study applied realistic evaluation to understand how protocol-based care works in different settings. It found that context significantly influences the effectiveness of standardized care approaches.

Related Experiment Videos

Area of Science:

  • Health Services Research
  • Implementation Science
  • Evaluation Methodology

Background:

  • Policy makers envisioned 'protocol-based care' to improve healthcare services in England.
  • Realistic evaluation is a growing methodology, yet underrepresented in implementation research.
  • This study addresses this gap by applying realistic evaluation to protocol-based care.

Purpose of the Study:

  • To describe the application of realistic evaluation in studying protocol-based care.
  • To share findings on standardizing care through protocols, guidelines, and pathways.
  • To understand the interplay of context, mechanism, and outcomes in protocol implementation.

Main Methods:

  • Utilized realist evaluation principles, focusing on 'what works, for whom, how, and in what circumstances'.
  • Conducted an evidence review to develop context-mechanism-outcome (CMO) propositions.
  • Tested propositions through multiple case studies using observation, interviews, and document analysis.

Main Results:

  • Initial CMO propositions were refined through iterative analysis.
  • Identified theoretically generalizable features of effective standardized care approaches.
  • Demonstrated how context influences the success of protocol-based care.

Conclusions:

  • Realistic evaluation proved a suitable framework for implementation research, particularly for understanding context's influence.
  • The approach facilitated sense-making of complex, multi-factorial implementation processes.
  • Provided an interpretive framework for developing explanatory theory on standardized care in practice.