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Abstract

Realist evaluation has become widespread partly because of its sensitivity to the influence of contexts on policy implementation. In many such evaluations, the range of contexts considered relevant nevertheless remains disparate and under-conceptualised. This article uses findings from a realist evaluation of English Patient Safety Collaboratives during 2015–2018 to develop a realist taxonomy of contexts, differentiating contexts according to how they affect the corresponding policy mechanism. By analysing the main context-mechanism-outcome configurations that made up the English Patient Safety Collaboratives, we derive a taxonomy of the contexts that affected implementation and outcomes. The categories of context were structural (network, hierarchy, market and organisational contexts); resource-based (actors, material, financial); motivational (receptivity, outcome headroom), and temporal (continuity, history and convergence). To the categories found in previous studies, this study adds the three temporal contexts.

Publication Date

2021-04-11

Publication Title

Evaluation

Volume

27

Issue

2

ISSN

0090-4449

Acceptance Date

2020-09-21

Deposit Date

2020-09-21

Embargo Period

2021-05-28

Funding

The authors all declare that they have no conflict of interest in the publication of this research. The study was funded by the Department of Health (England) Policy Research Programme, grant PR-R11-0914-12002. S. Ball is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula.

Keywords

realist evaluation, context, patient safety collaborative, time, NHS

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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