A case study evaluation of implementation of a care pathway to support normal birth in one English birth centre: anticipated benefits and unintended consequences

AbstractSystematic case studies are often placed at the low end of evidence-based practice (EBP) due to lack of critical appraisal. This paper seeks to attend to this research gap by introducing a novel Case Study Evaluation-tool (CaSE). First, issues around knowledge generation and validity are assessed in both EBP and practice-based evidence (PBE) paradigms. Although systematic case studies are more aligned with PBE paradigm, the paper argues for a complimentary, third way approach between the two paradigms and their ‘exemplary’ methodologies: case studies and randomised controlled trials (RCTs). Second, the paper argues that all forms of research can produce ‘valid evidence’ but the validity itself needs to be assessed against each specific research method and purpose. Existing appraisal tools for qualitative research (JBI, CASP, ETQS) are shown to have limited relevance for the appraisal of systematic case studies through a comparative tool assessment. Third, the paper develops purpose-oriented evaluation criteria for systematic case studies through CaSE Checklist for Essential Components in Systematic Case Studies and CaSE Purpose-based Evaluative Framework for Systematic Case Studies. The checklist approach aids reviewers in assessing the presence or absence of essential case study components (internal validity). The framework approach aims to assess the effectiveness of each case against its set out research objectives and aims (external validity), based on different systematic case study purposes in psychotherapy. Finally, the paper demonstrates the application of the tool with a case example and notes further research trajectories for the development of CaSE tool.

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A Capabilities-Led Approach to Assessing Technological Solutions for a Rural Community

Energies ◽

10.3390/en14051398 ◽

2021 ◽

Vol 14 (5) ◽

pp. 1398

Author(s):

Xinfang Wang ◽

Rosie Day ◽

Dan Murrant ◽

Antonio Diego Marín ◽

David Castrejón Botello ◽

...

Keyword(s):

Rural Community ◽

Rural Areas ◽

Assessment Method ◽

Unintended Consequences ◽

Energy Services ◽

Grid Systems ◽

Technological Interventions ◽

Solution Design ◽

Improve Access

To improve access to affordable, reliable and sustainable energy in rural areas of the global south, off-grid systems using renewable generation and energy storage are often proposed. However, solution design is often technology-driven, with insufficient consideration of social and cultural contexts. This leads to a risk of unintended consequences and inappropriate systems that do not meet local needs. To address this problem, this paper describes the application of a capabilities-led approach to understanding a community’s multi-dimensional energy poverty and assessing their needs as they see them, in order to better design suitable technological interventions. Data were collected in Tlamacazapa, Mexico, through site visits and focus groups with men and women. These revealed the ways in which constrained energy services undermined essential capabilities, including relating to health, safety, relationships and earning a living, and highlighted the specific ways in which improved energy services, such as lighting, cooking and mechanical power could improve capabilities in the specific context of Tlamacazapa. Based on these findings, we propose some potential technological interventions to address these needs. The case study offers an illustration of an assessment method that could be deployed in a variety of contexts to inform the design of appropriate technological interventions.

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How Barunga Aboriginal Community Implemented and Sustained an Anaemia Program‐ A Case Study Evaluation

Health Promotion Journal of Australia ◽

10.1002/hpja.457 ◽

2021 ◽

Author(s):

Jodi Phillips ◽

Raelene Brunette ◽

Marita Hefler ◽

Julie Brimblecombe ◽

Therese Kearns

Keyword(s):

Aboriginal Community ◽

Study Evaluation

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A mixed methods multiple case study to evaluate the implementation of a care pathway for colorectal cancer surgery using extended normalization process theory

BMC Health Services Research ◽

10.1186/s12913-020-06011-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

R. van Zelm ◽

E. Coeckelberghs ◽

W. Sermeus ◽

A. Wolthuis ◽

L. Bruyneel ◽

...

Keyword(s):

Colorectal Cancer ◽

Healthcare Professionals ◽

Care Pathway ◽

Implementation Process ◽

Colorectal Cancer Surgery ◽

Protocol Adherence ◽

Multiple Case ◽

Specific Factors ◽

Normalization Process

Abstract Background Specific factors that facilitate or prevent the implementation of enhanced recovery protocols for colorectal cancer surgery have been described in previous qualitative studies. This study aims to perform a concurrent qualitative and quantitative evaluation of factors associated with successful implementation of a care pathway (CP) for patients undergoing surgery for colorectal cancer. Methods This comparative mixed methods multiple case study was based on a sample of 10 hospitals in 4 European countries that implemented a specific CP and performed pre- and post-implementation measurements. In-depth post-implementation interviews were conducted with healthcare professionals who were directly involved. Primary outcomes included protocol adherence and improvement rate. Secondary outcomes included length of stay (LOS) and self-rated protocol adherence. The hospitals were ranked based on these quantitative findings, and those with the highest and lowest scores were included in this study. Qualitative data were summarized on a per-case basis using extended Normalization Process Theory (eNPT) as theoretical framework. The data were then combined and analyzed using joint display methodology. Results Data from 381 patients and 30 healthcare professionals were included. Mean protocol adherence rate increased from 56 to 62% and mean LOS decreased by 2.1 days. Both measures varied greatly between hospitals. The two highest-ranking hospitals and the three lowest-ranking hospitals were included as cases. Factors which could explain the differences in pre- and post-implementation performance included the degree to which the CP was integrated into daily practice, the level of experience and support for CP methodology provided to the improvement team, the intrinsic motivation of the team, shared goals and the degree of management support, alignment of CP development and hospital strategy, and participation of relevant disciplines, most notably, physicians. Conclusions Overall improvement was achieved but was highly variable among the 5 hospitals evaluated. Specific factors involved in the implementation process that may be contributing to these differences were conceptualized using eNPT. Multidisciplinary teams intending to implement a CP should invest in shared goals and teamwork and focus on integration of the CP into daily processes. Support from hospital management directed specifically at quality improvement including audit may likewise facilitate the implementation process. Trial registration NCT02965794. US National Library of Medicine, ClinicalTrials.gov. Registered 4 August 2014.

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Building Bayesian networks for legal evidence with narratives: a case study evaluation

Artificial Intelligence and Law ◽

10.1007/s10506-014-9161-7 ◽

2014 ◽

Vol 22 (4) ◽

pp. 375-421 ◽

Cited By ~ 24

Author(s):

Charlotte S. Vlek ◽

Henry Prakken ◽

Silja Renooij ◽

Bart Verheij

Keyword(s):

Bayesian Networks ◽

Legal Evidence ◽

Study Evaluation

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Industrial case study: Evaluation of a mixed-mode resin for selective capture of a human growth factor recombinantly expressed in E. coli

Journal of Chromatography A ◽

10.1016/j.chroma.2009.07.023 ◽

2010 ◽

Vol 1217 (2) ◽

pp. 235-242 ◽

Cited By ~ 51

Author(s):

Kimberly A. Kaleas ◽

Charles H. Schmelzer ◽

Shelly A. Pizarro

Keyword(s):

Growth Factor ◽

Mixed Mode ◽

Human Growth ◽

Industrial Case Study ◽

E Coli ◽

Study Evaluation

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Reducing bias in risk indices for COVID-19

Geospatial health ◽

10.4081/gh.2022.1013 ◽

2022 ◽

Vol 17 (s1) ◽

Author(s):

Michał Paweł Michalak ◽

Jack Cordes ◽

Agnieszka Kulawik ◽

Sławomir Sitek ◽

Sławomir Pytel ◽

...

Keyword(s):

Infectious Diseases ◽

Spatial Heterogeneity ◽

Disease Burden ◽

Risk Indices ◽

Study Evaluation ◽

Dynamical Properties ◽

Time Periods ◽

Regional Disease ◽

Over Time

Spatiotemporal modelling of infectious diseases such as coronavirus disease 2019 (COVID-19) involves using a variety of epidemiological metrics such as regional proportion of cases and/or regional positivity rates. Although observing changes of these indices over time is critical to estimate the regional disease burden, the dynamical properties of these measures, as well as crossrelationships, are usually not systematically given or explained. Here we provide a spatiotemporal framework composed of six commonly used and newly constructed epidemiological metrics and conduct a case study evaluation. We introduce a refined risk estimate that is biased neither by variation in population size nor by the spatial heterogeneity of testing. In particular, the proposed methodology would be useful for unbiased identification of time periods with elevated COVID-19 risk without sensitivity to spatial heterogeneity of neither population nor testing coverage.We offer a case study in Poland that shows improvement over the bias of currently used methods. Our results also provide insights regarding regional prioritisation of testing and the consequences of potential synchronisation of epidemics between regions. The approach should apply to other infectious diseases and other geographical areas.

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