Making sense of complexities: building the foundation for evaluating implementation in CLAHRCs
Prof Jo Rycroft‐Malone Dr Joyce Wilkinson Bangor University
Aim of study • To determine the impact of one of the key functions of the CLAHRCs – implementing research into clinical practice • Implementing research through CLAHRCs: “What works for whom and in what circumstances?”
Research implementation • Using research is complex and multi‐faceted
• Involves social processes which are influenced by a number of other factors and mediated by context
Context & Complexity in CLAHRCS
Contexts have shared features…
…but are often quite different
Looking at context and complexity in CLAHRCs from different perspectives
Study Design • Realistic Evaluation: context + mechanisms = outcomes – CLAHRCS are ‘broken down’ so we can identify what it is about them (mechanisms) that might produce a change (impact/outcomes) and which conditions (context) are necessary to have an impact
• Longitudinal case studies of 3 CLAHRCs, focussing on tracer issues • Stakeholder involvement is a key aspect of the evaluation
Realistic Evaluation Cycle Phase 1
Determining theoretical constructs/concept mapping Mechanism Contexts Outcomes
M C O
Theory Phase 2 &3 What works, for Whom, how & in what circumstances
Phase 1 contd Specification
Hypotheses
Observations Phase 2 Assessing the relationships between different mechanisms (M) in different contexts (C) with what outcomes (O) arising, through multi-method data collection & analysis
Identifying what might work, for whom, how & in what circumstances - Theory development
Study design 3 phases to the evaluation 1. Developing an evaluation framework and CMOs of what might work in implementation 2. Evaluating the impact and process of research implementation in the case study CLAHRCs over time through a focus on tracer issues 3. Testing the wider applicability of emerging theories about what works (and what does not work), where and why
Phase One: developing the framework Literature on implementation CLAHRC documentation (e.g.) Implementation models (PARIHS & K2A) What we know already are important factors What we need to know more about e.g CoPs, user involvement, mechanisms, boundary objects… • Range of impacts and different types of ‘use’ of research, not just instrumental use
• • • • •
Evaluation framework (a work in progress) Knowledge e.g. Different types of knowledge
CLAHRC activities e.g. primary research Knowledge use & impacts
Temporality e.g the age of CLAHRC
Context
Facilitation e.g. formal & Informal roles
Knowledge Utilisation and translation through CLAHRCs Actors/Agents e.g. key stakeholders & key players
Geography e.g. geographical barriers to implementation
User involvement e.g. Impacts for users from Involvement with CLAHRCS
Knowledge Sharing e.g. sharing Knowledge other than research
Next Steps • Developing MCOs and hypotheses, for example……knowledge brokers working as link agents between researcher and practitioners who are credible and respected(mechanism), across care boundaries (context) improve information flow (intended outcome)
• Meet with key stakeholders in CLAHRCS and evaluation user group • Identifying ‘tracer issues’ with CLAHRCs
Thank you!
j.rycroft‐
[email protected] [email protected]