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Implementing large-system, value-based healthcare initiatives: a realist study protocol for seven natural experiments
Mitchell N Sarkies1, Emilie Francis-Auton2, Janet C Long2
1Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, Australia Mitchell.sarkies@mq.edu.au.
This realist study explores how implementation strategies impact value-based healthcare initiatives in New South Wales. Findings will guide sustainable health system transformation by detailing what works for whom and under which circumstances.
Area of Science:
- Health Services Research
- Implementation Science
- Health Systems Strengthening
Background:
- Value-based healthcare (VBH) models are crucial for addressing health system pressures and patient needs.
- Implementing VBH initiatives at scale presents significant challenges requiring contextual understanding.
- Realist studies offer nuanced insights into VBH implementation beyond simple effectiveness.
Purpose of the Study:
- To conduct a realist study on the implementation of seven large-scale VBH initiatives in New South Wales, Australia.
- To understand how diverse implementation strategies and processes influence the uptake, adoption, fidelity, and adherence of VBH initiatives.
- To elucidate contextual factors that enable sustainable impacts of VBH initiatives.
Main Methods:
- An exploratory, sequential, mixed-methods realist study adhering to RAMESES II reporting standards.
- Programme theories formulated from literature, documents, and interviews (Stage 1).
- Theories tested and refined using interviews, evaluation data, administrative systems, and surveys (Stage 2); generalizable theories synthesized (Stage 3).
Main Results:
- (Study ongoing, results pending publication)
Conclusions:
- (Study ongoing, conclusions pending publication)
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