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Table 1 Procedures and outputs for each stage of the evaluation

From: A multistage mixed methods study protocol to evaluate the implementation and impact of a reconfiguration of acute medicine in Ireland’s hospitals

Stage

Procedures

Outputs

1. Theory Conceptualisation

1. Elicit the programme’s theory and depict it in a logic model using:

a. Documentary review

b. Key informant interviews

c. Discussions with NAMP programme staff

1. Logic model depicting the programme’s mechanisms of change, desired outcomes, and programme components

2. Description of the organisational structures, processes and resources to be implemented

2. Assessing Implementation

1. Work with the NAMP team to design a survey for sites to assess ‘fidelity’ to the NAMP model of care based on the description of organisational structures, processes and resources be implemented from Stage 1

2. Measure programme reach - (Unit utilisation and conditions seen) using secondary administrative data

1. Quantification of what organisational functions have been implemented at each site

2. Measure of programme reach-utilisation of the Units and clinical conditions managed

3. Identifying factors influencing implementation and operation of the programme

1. Purposively sample eight sites based on their level of utilisation

2. Undertake semi-structured interviews with clinical staff at these sites

3. Import interview transcripts and documents into NVivo, code deductively using CFIR (and inductively) using Framework Analysis

4. Rate the CFIR constructs at each site to reflect their influence on implementation

5. Construct a matrix of cross case comparison; identify constructs that can possibly differentiate implementation

1. Descriptive memo of each case

2. Rating of the influence of each construct at each site

3. List of constructs that can successfully differentiate implementation

4. Evaluating impact

1. Clarify the expected programme outcomes and impact using the logic model

2. Create analytical datasets using secondary/administrative data

3. Estimate programme impact on reducing lengths of stay, and potentially avoidable admissions using interrupted time series

1. Estimation of programme effectiveness in reducing overnight emergency admissions for potentially avoidable medical conditions and reducing lengths of hospital stay and bed days used by medical patients

5. Integrating findings

1. Integrate qualitative findings from the each stage of the study

1. Comprehensive account of what has been implemented and what has been achieved and the factors that are influencing both of these