How do oilcloth sessions work? A realist evaluation approach to exploring ripple effects in an implementation strategy.

IF 1.7 4区医学 Q3 HEALTH POLICY & SERVICES

Journal of Health Organization and Management Pub Date : 2024-05-27 DOI:10.1108/JHOM-01-2023-0022

Jeanette Wassar Kirk, Nina Thorny Stefansdottir, Ove Andersen, Mette Bendtz Lindstroem, Byron Powell, Per Nilsen, Tine Tjørnhøj-Thomsen, Marie Broholm-Jørgensen

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引用次数: 0

Abstract

Purpose: To explore the mechanisms of the implementation strategy, "oilcloth sessions" and understand and explain the ripple effects of oilcloth sessions as a strategy to implement a new emergency department.

Design/methodology/approach: A qualitative design was used whereby data were collected using field notes from an ethnographic study of the oilcloth sessions and follow-up semi-structured interviews with staff, managers and key employees who participated in the oilcloth sessions. The data analysis was inspired by the realist evaluation approach of generative causality proposed by Pawson and Tilley.

Findings: The primary ripple effect was that the oilcloth sessions were used for different purposes than the proposed program theory, including being used as: (1) a stage, (2) a battlefield, (3) a space for imagination and (4) a strategic management tool influencing the implementation outcomes. The results bring essential knowledge that may help to explain why and how a well-defined implementation strategy has unplanned outcomes.

Originality/value: Unintended outcomes of implementation strategies are an underexplored issue. This study may help implementation researchers rethink the activities required to reduce unintended negative outcomes or explore potential unplanned outcomes and, in this way, hinder or enhance outcomes, effectiveness and sustainability. Future studies within implementation research should incorporate attention to unintended outcomes to fully understand the impact of implementation strategies.

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油布会议如何发挥作用？以现实主义评估方法探讨实施战略中的涟漪效应。

目的：探讨 "油布会议 "这一实施策略的机制，并了解和解释油布会议作为新急诊科实施策略的连锁反应：采用定性设计，通过对油布会议的人种学研究进行实地记录，并对参与油布会议的员工、管理人员和主要雇员进行后续半结构化访谈来收集数据。数据分析受到了 Pawson 和 Tilley 提出的现实主义因果关系评估方法的启发：主要的涟漪效应是，油布会议的用途与所提出的计划理论不同，包括被用作以下用途(1) 舞台；(2) 战场；(3) 想象空间；(4) 影响实施结果的战略管理工具。研究结果带来了重要的知识，可能有助于解释为什么以及如何定义明确的实施战略会产生计划外的结果：原创性/价值：实施战略的意外结果是一个未得到充分探讨的问题。这项研究可能有助于实施研究人员重新思考减少意外负面结果或探索潜在意外结果所需的活动，从而阻碍或加强结果、有效性和可持续性。未来的实施研究应关注意外结果，以充分了解实施战略的影响。

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来源期刊

Journal of Health Organization and Management HEALTH POLICY & SERVICES-

CiteScore

3.20

自引率

7.10%

发文量

期刊介绍： ■International health and international organizations ■Organisational behaviour, governance, management and leadership ■The inter-relationship of health and public sector services ■Theories and practices of management and leadership in health and related organizations ■Emotion in health care organizations ■Management education and training ■Industrial relations and human resource theory and management. As the demands on the health care industry both polarize and intensify, effective management of financial and human resources, the restructuring of organizations and the handling of market forces are increasingly important areas for the industry to address.