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Evaluating impact of clinical guidelines using a realist evaluation framework
Author(s) -
Reddy Sandeep,
Wakerman John,
Westhorp Gill,
Herring Sally
Publication year - 2015
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12482
Subject(s) - suite , context (archaeology) , government (linguistics) , adaptation (eye) , medical education , health care , medicine , nursing , knowledge management , process management , psychology , computer science , engineering , political science , paleontology , linguistics , philosophy , neuroscience , law , biology
Rationale, aims and objectives The Remote Primary Health Care Manuals ( RPHCM ) project team manages the development and publication of clinical protocols and procedures for primary care clinicians practicing in remote A ustralia. The Central Australian Rural Practitioners Association Standard Treatment Manual, the flagship manual of the RPHCM suite, has been evaluated for accessibility and acceptability in remote clinics three times in its 20‐year history. These evaluations did not consider a theory‐based framework or a programme theory, resulting in some limitations with the evaluation findings. With the RPHCM having an aim of enabling evidence‐based practice in remote clinics and anecdotally reported to do so, testing this empirically for the full suite is vital for both stakeholders and future editions of the RPHCM . Methods The project team utilized a realist evaluation framework to assess how, why and for what the RPHCM were being used by remote practitioners. A theory regarding the circumstances in which the manuals have and have not enabled evidence‐based practice in the remote clinical context was tested. The project assessed this theory for all the manuals in the RPHCM suite, across government and aboriginal community‐controlled clinics, in three regions of A ustralia. Conclusion Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation.