Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25439
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Collective action for implementation: a realist evaluation of organisational collaboration in healthcare
Authors: Rycroft-Malone, Jo
Burton, Christopher
Wilkinson, Joyce E
Harvey, Gill
McCormack, Brendan
Baker, Richard
Dopson, Sue
Graham, Ian
Staniszewska, Sophie
Thompson, Carl
Ariss, Steven
Melville-Richards, Lucy
Williams, Lynne
Keywords: Implementation
Collaboration
Evidence
Co-production
Knowledge
Realist
Issue Date: 9-Feb-2016
Citation: Rycroft-Malone J, Burton C, Wilkinson JE, Harvey G, McCormack B, Baker R, Dopson S, Graham I, Staniszewska S, Thompson C, Ariss S, Melville-Richards L & Williams L (2016) Collective action for implementation: a realist evaluation of organisational collaboration in healthcare, Implementation Science, 11, Art. No.: 17.
Abstract: Background  Increasingly, it is being suggested that translational gaps might be eradicated or narrowed by bringing research users and producers closer together, a theory that is largely untested. This paper reports a national study to fill a gap in the evidence about the conditions, processes and outcomes related to collaboration and implementation.  Methods  A longitudinal realist evaluation using multiple qualitative methods case studies was conducted with three Collaborations for Leadership in Applied Health Research in Care (England). Data were collected over four rounds of theory development, refinement and testing. Over 200 participants were involved in semi-structured interviews, non-participant observations of events and meetings, and stakeholder engagement. A combined inductive and deductive data analysis process was focused on proposition refinement and testing iteratively over data collection rounds.  Results  The quality of existing relationships between higher education and local health service, and views about whether implementation was a collaborative act, created a path dependency. Where implementation was perceived to be removed from service and there was a lack of organisational connections, this resulted in a focus on knowledge production and transfer, rather than co-production. The collaborations’ architectures were counterproductive because they did not facilitate connectivity and had emphasised professional and epistemic boundaries. More distributed leadership was associated with greater potential for engagement. The creation of boundary spanning roles was the most visible investment in implementation, and credible individuals in these roles resulted in cross-boundary work, in facilitation and in direct impacts. The academic-practice divide played out strongly as a context for motivation to engage, in that ‘what’s in it for me’ resulted in variable levels of engagement along a co-operation-collaboration continuum. Learning within and across collaborations was patchy depending on attention to evaluation.  Conclusions  These collaborations did not emerge from a vacuum, and they needed time to learn and develop. Their life cycle started with their position on collaboration, knowledge and implementation. More impactful attempts at collective action in implementation might be determined by the deliberate alignment of a number of features, including foundational relationships, vision, values, structures and processes and views about the nature of the collaborationandimplementation.
DOI Link: http://dx.doi.org/10.1186/s13012-016-0380-z
Rights: © Rycroft-Malone et al. 2016 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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