Dear Joanne,

 

Thanks for sharing about your PhD Thesis. I share the same challenge – trying to teach myself and then communicate realist methods to my supervisors who have not used this routinely in their previous research projects.

 

Even though your request was for literature or ideas on how to introduce “facilitatory strategies” without adding to the confusion, I will like to take a look at your CMOC and share a few ideas in the hope that you find it useful.

 

This is your current CMOC:

Context – Location – remotely located

Mechanism Resources –  limited knowledge/understanding/communication

Mechanism Response –  Trust not likely to exist

Outcome – Patient Discharge delayed

 

You have a separate term titled - “facilitatory strategies”

 

An option you may consider:

 

Context – Location – remotely located, limited trust among health service providers.

Mechanism Resources –  facilitatory strategies aimed at improving existing relationships

Mechanism Response –  change in the level of knowledge, understanding, communication (as proximal outcomes) and trust among health service providers.

Outcome – Patient Discharge (rates) - delayed/improved/no change, other untoward effects.

 

Of course this program theory may change as you collect data.

 

Wishing you success on your project and as a newbie to realist methods as well, I would like to learn alongside with you.

 

Regards.

 

Yakubu.

 

Kenneth Yakubu | MB.BS, FWACP (Fam Med), FMCFM, MBA-HUM, MPhil (Fam Med)
PhD Student

The George Institute for Global Health | AUSTRALIA
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From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]> On Behalf Of Joanne Howe
Sent: Friday, 13 December 2019 1:41 AM
To: [log in to unmask]
Subject: Re: Advice over terminology for "facilitatory strategies"

 

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Thanks Janet,

 

Hope you are well!

 

I definitely get the sense that co-location offers opportunities for collaborative working practices – simply because opportunity is present where as in remote locations opportunities need to be created. This collaboration gives rise to inter-service trust and  assists in the smooth and timely transfer of patients across organisational boundaries

 

I’ve got three services which have different locations to their referring units– One is fully embedded (no organisational boundary exists), one is co-located in the same hospital building and one is remote. “Trust” as described by stakeholders seems to exist in lesser degrees depending on location.  I haven’t previously given much thought to the definition of Trust and will do so now…

 

However, as my services have been in existence for some time they have implemented these facilitatory strategies to strengthen their inter-service relationships and build up trust… these seem to concentrate around inter-service education and collaborative inter-service team working

 

I would be very interested in reading more of your work on this matter – especially as it will be relevant from a healthcare perspective. It sounds really interesting, have you published anything from the work as yet?

 

I’ve just been reading Justin’s paper  an RE of community-based participatory research… - which has also been thought provoking too

 

Thanks for taking the time to reply

 

Jo