Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: A realist evaluation protocol

McHugh, Sheena M.; Tracey, Marsha L.; Riordan, Fiona; O'Neill, Kate N.; Mays, N.; Kearney, Patricia M.

Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: A realist evaluation protocol

dc.contributor.author	McHugh, Sheena M.
dc.contributor.author	Tracey, Marsha L.
dc.contributor.author	Riordan, Fiona
dc.contributor.author	O'Neill, Kate N.
dc.contributor.author	Mays, N.
dc.contributor.author	Kearney, Patricia M.
dc.contributor.funder	Health Research Board
dc.contributor.funder	Centre for Ageing Research and Development in Ireland
dc.date.accessioned	2017-06-22T13:55:52Z
dc.date.available	2017-06-22T13:55:52Z
dc.date.issued	2016-07-28
dc.description.abstract	Background: Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. Methods/design: This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme’s resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. Discussion: This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative feedback for the NDP while also supporting the refinement and revision of initial theories about how the programme is being implemented in the dynamic and unstable context of the Irish healthcare system.	en
dc.description.sponsorship	Health Research Board (Research Leader Award (RL/2013/7)	en
dc.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	107
dc.identifier.citation	McHugh, S., Tracey, M. L., Riordan, F., O’Neill, K., Mays, N. and Kearney, P. M. (2016) 'Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol', Implementation Science, 11, 107 (13pp). doi: 10.1186/s13012-016-0464-9	en
dc.identifier.doi	10.1186/s13012-016-0464-9
dc.identifier.endpage	13
dc.identifier.issn	1748-5908
dc.identifier.journaltitle	Implementation Science	en
dc.identifier.startpage	1
dc.identifier.uri	https://hdl.handle.net/10468/4164
dc.identifier.volume	11
dc.language.iso	en	en
dc.publisher	BioMed Central	en
dc.relation.uri	https://implementationscience.biomedcentral.com/articles/10.1186/s13012-016-0464-9
dc.rights	© 2016, McHugh et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.	en
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	en
dc.subject	Realist evaluation	en
dc.subject	Protocol	en
dc.subject	Diabetes	en
dc.subject	Implementation	en
dc.title	Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: A realist evaluation protocol	en
dc.type	Article (peer-reviewed)	en