A realistic evaluation of fines for hospital discharges: Incorporating the history of programme evaluations in the analysis

Manzano, Ana

doi:10.1177/1356389010389913

Cited by 27 publications

(27 citation statements)

References 25 publications

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“…It must be noted that sampling strategy here is more complicated because information-rich cases (Patton, 2002) will be difficult to guess when our knowledge is still tentative. For example, in a study evaluating a programme to accelerate hospital discharges (Manzano-Santaella, 2011), several formal and informal meetings took place with stakeholders (i.e. ward managers, discharge liaison officers) to discuss how and where to recruit patients with different illnesses that could represent different challenges for the theories to be tested and refined.…”

Section: B) From Whom Choosing and Finding Knowledgeable Intervieweesmentioning

confidence: 99%

“…If the answer is yes, could you tell me the story of that user'). The following extract from a realist interview (Manzano-Santaella, 2011) illustrates how individual cases can be used as prompts to refine general programme theories while exploring unobservable events or thought processes. In this example, the evaluator was trying to explore mechanisms leading to people being transferred into care homes to accelerate hospital discharges.…”

Section: Programme Theory and Phases In Realist Interviewsmentioning

confidence: 99%

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The craft of interviewing in realist evaluation

2016

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Pawson and Tilley suggest a unique strategy for conducting qualitative interviews within realist evaluation studies. Theories are placed before the interviewee for them to comment on with a view to providing refinement. The subject matter of the interview is the researcher's theory and interviewees confirm, falsify, and refine this theory. This relationship-described as a teacherlearner cycle-is integral to realist evaluations. This article provides an overview of how interview techniques have been applied in realist evaluations in the last decade as well as suggesting two guiding principles. The first one relates to the design of realist studies and the second one explains how to ask questions like a realist, and proposes three different phases in realist interviews: theory gleaning, theory refining and theory consolidation. The article aims to contribute to a growing understanding of the practical and epistemological challenges presented by primary data collection in realist evaluation.

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Section: B) From Whom Choosing and Finding Knowledgeable Intervieweesmentioning

confidence: 99%

Section: Programme Theory and Phases In Realist Interviewsmentioning

confidence: 99%

The craft of interviewing in realist evaluation

2016

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“…To document these changes in the intervention is challenging, but this has also been done before in other studies using realist evaluation [57]. Moreover, it has been argued that realist evaluation is well suited for examining the diverse components of a program in a contextualized way [47].…”

Section: Discussionmentioning

confidence: 99%

How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol

et al. 2013

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BackgroundDespite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues—such as IPV management—get integrated into health systems, and that focuses on healthcare teams’ learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services.MethodsThis study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management.DiscussionEvaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.

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“…9 They have also been used in fields as diverse as international development, education, crime prevention and climate change.…”

Section: Fundingmentioning

confidence: 99%

Quality and reporting standards, resources, training materials and information for realist evaluation: the RAMESES II project

Wong

Westhorp

Greenhalgh

et al. 2017

Health Serv Deliv Res

129

124

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Background Many of the problems confronting policy- and decision-makers, evaluators and researchers today are complex, as are the interventions designed to tackle them. Their success depends both on individuals’ responses and on the wider context of people’s lives. Realist evaluation tries to make sense of these complex interventions. It is a form of theory-driven evaluation, based on realist philosophy, that aims to understand why these complex interventions work, how, for whom, in what context and to what extent. Objectives Our objectives were to develop (a) quality standards, (b) reporting standards, (c) resources and training materials, (d) information and resources for patients and other lay participants and (e) to build research capacity among those interested in realist evaluation. Methods To develop the quality and reporting standards, we undertook a thematic review of the literature, supplemented by our content expertise and feedback from presentations and workshops. We synthesised findings into briefing materials for realist evaluations for the Delphi panel (a structured method using experts to develop consensus). To develop our resources and training materials, we drew on our experience in developing and delivering education materials, feedback from the Delphi panel, the RAMESES JISCMail e-mail list, training workshops and feedback from training sessions. To develop information and resources for patients and other lay participants in realist evaluation, we convened a group consisting of patients and the public. We built research capacity by running workshops and training sessions. Results Our literature review identified 152 realist evaluations, and when 37 of these had been analysed we were able to develop our briefing materials for the Delphi panel. The Delphi panel comprised 35 members from 27 organisations across six countries and five disciplines. Within three rounds, the panels had reached a consensus on 20 key reporting standards. The quality standards consist of eight criteria for realist evaluations. We developed resources and training materials for 15 theoretical and methodological topics. All resources are available online (www.ramesesproject.org). We provided methodological support to 17 projects and presentations or workshops to help build research capacity in realist evaluations to 29 organisations. Finally, we produced a generic patient information leaflet for lay participants in realist evaluations. Limitations Our project had ambitious goals that created a substantial workload, leading to the need to prioritise objectives. For example, we truncated the literature review and focused on standards and training material development. Conclusions Although realist evaluation holds much promise, misunderstandings and misapplications of it are common. We hope that our project’s outputs and activities will help to address these problems. Our resources are the start of an iterative journey of refinement and development of better resources for realist evaluations. The RAMESES II project seeks not to produce the last word on these issues, but to capture current expertise and establish an agreed state of the science. Much methodological development is needed in realist evaluation but this can take place only if there is a sufficient pool of highly skilled realist evaluators. Capacity building is the next key step in realist evaluation. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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A realistic evaluation of fines for hospital discharges: Incorporating the history of programme evaluations in the analysis

Cited by 27 publications

References 25 publications

The craft of interviewing in realist evaluation

The craft of interviewing in realist evaluation

How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol

Quality and reporting standards, resources, training materials and information for realist evaluation: the RAMESES II project

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