Developing New Methods for Person-Centred Approaches to Adjudicate Context-Mechanism-Outcome Configurations in Realist Evaluation.

Seán Paul Teeling,Jan Dewing,Deborah Baldie

doi:10.3390/ijerph19042370

Abstract

Realist evaluation provides a general method of evaluating the application of interventions including policy, legislation, projects, and new processes in social settings such as law enforcement, healthcare and education. Realist evaluation focuses on what about interventions works, for whom, and in what circumstances, and there is a growing body of work using realist evaluation to analyse interventions in healthcare organizations, including those using Lean Six Sigma improvement methodologies. Whilst realist evaluation facilitates the analysis of interventions using both qualitative and quantitative research, there is little guidance given on methods of data collection and analysis. The purpose of this study is to address this lack of guidance through detailing the use of innovative person-centred methods of data collection and analysis in a realist evaluation that enabled us to understand the contribution of Lean Six Sigma to person-centred care and cultures. This use of person-centred principles in the adjudication of identified program theories has informed novel methods of collecting and analysing data in realist evaluation that facilitate a person-centred approach to working with research participants and a way of making the implicit explicit when adjudicating program theory.

Highlights

As part of our research into the influence of Lean Six Sigma (LSS) on person-centredness, in a recent realist evaluation [1], we addressed whether, to what extent, and in what ways the process improvement methodologies of Lean and Six Sigma in healthcare contributed to person-centred care and cultures
Public Health 2022, 19, 2370 paper does not repeat the findings of our study [1] but rather outlines how we addressed the problem of applying new methods of collecting and analysing data within realist evaluation that facilitated person-centred ways of working with research participants
We detail how we addressed the problem of applying new methods of collecting and analysing data within realist evaluation that facilitated person-centred ways of working with research participants

Summary

Introduction

As part of our research into the influence of Lean Six Sigma (LSS) on person-centredness, in a recent realist evaluation [1], we addressed whether, to what extent, and in what ways the process improvement methodologies of Lean and Six Sigma in healthcare contributed to person-centred care and cultures. We were able to understand how healthcare staff who were LSS practitioners and had undertaken a university LSS education and training program understood and experienced, in their specific contexts of practice, the contribution of the application of LSS learning and practice to person-centred care and cultures. The realist evaluation was undertaken at a university teaching hospital in Dublin Ireland, a major centre for medical, nursing, and allied health professional training and a teaching partner to University College Dublin (UCD) since its foundation.

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Discussion

Conclusion