Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A realistic evaluation: the case of protocol-based care | Rycroft-Malone et al. Implementation Science 2010 5 38 http content 5 1 38 IMPLEMENTATION SCIENCE Implementation Science METHODOLOGY Open Access A realistic evaluation the case of protocol-based care Jo Rycroft-Malone 1 Marina Fontenla2 Debra Bick3 and Kate Seers2 Abstract Background Protocol based care was envisioned by policy makers as a mechanism for delivering on the service improvement agenda in England. Realistic evaluation is an increasingly popular approach but few published examples exist particularly in implementation research. To fill this gap within this paper we describe the application of a realistic evaluation approach to the study of protocol-based care whilst sharing findings of relevance about standardising care through the use of protocols guidelines and pathways. Methods Situated between positivism and relativism realistic evaluation is concerned with the identification of underlying causal mechanisms how they work and under what conditions. Fundamentally it focuses attention on finding out what works for whom how and in what circumstances. Results In this research we were interested in understanding the relationships between the type and nature of particular approaches to protocol-based care mechanisms within different clinical settings context and what impacts this resulted in outcomes . An evidence review using the principles of realist synthesis resulted in a number of propositions . context mechanism and outcome threads CMOs . These propositions were then tested through multiple case studies using multiple methods including non-participant observation interviews and document analysis through an iterative analysis process. The initial propositions conjectured CMOs only partially corresponded to the findings that emerged during analysis. From the iterative analysis process of scrutinising mechanisms context and outcomes we were able to draw out some theoretically generalisable features about what works for .
