Building Transformative Capacities by Expanding the Academic Mission Across the Care Continuum: A Realist Evaluation

Abstract

This chapter aims to understand how organizational actors in Academic Health Centres (AHCs) mobilize transformative capacities through the process of expanding the academic mission across the care continuum in the enactment of a policy reform. Using a realist evaluation approach, a single qualitative embedded case study was conducted in Quebec, Canada. Empirical data collected through document review and semi-structured interviews with key informants were first categorized as context, intervention, mechanism or outcome, and then sub-categorized as forms of institutional work. This study reveals that the development of transformative capacities through policy reform aiming to expand the academic mission across boundaries is a heterogeneous, nonlinear and relational process. Further research could explore the role of relational work in aligning actors across hierarchical boundaries through large-scale health system transformation.