A realist synthesis of multicentre comparative audit implementation: exploring what works and in which healthcare contexts Article Swipe
Sinead McGlacken‐Byrne
,
Nuala Murphy
,
Sarah Barry
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1136/bmjoq-2023-002629
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1136/bmjoq-2023-002629
Background Multicentre comparative clinical audits have the potential to improve patient care, allow benchmarking and inform resource allocation. However, implementing effective and sustainable large-scale audit can be difficult within busy and resource-constrained contemporary healthcare settings. There are little data on what facilitates the successful implementation of multicentre audits. As healthcare environments are complex sociocultural organisational environments, implementing multicentre audits within them is likely to be highly context dependent. Objective We aimed to examine factors that were influential in the implementation process of multicentre comparative audits within healthcare contexts—what worked, why, how and for whom? Methods A realist review was conducted in accordance with the Realist and Meta-narrative Evidence Syntheses: Evolving Standards reporting standards. A preliminary programme theory informed two systematic literature searches of peer-reviewed and grey literature. The main context-mechanism-outcome (CMO) configurations underlying the implementation processes of multicentre audits were identified and formed a final programme theory. Results 69 original articles were included in the realist synthesis. Four discrete CMO configurations were deduced from this synthesis, which together made up the final programme theory. These were: (1) generating trustworthy data; (2) encouraging audit participation; (3) ensuring audit sustainability; and (4) facilitating audit cycle completion. Conclusions This study elucidated contexts, mechanisms and outcomes influential to the implementation processes of multicentre or national comparative audits in healthcare. The relevance of these contextual factors and generative mechanisms were supported by established theories of behaviour and findings from previous empirical research. These findings highlight the importance of balancing reliability with pragmatism within complex adaptive systems, generating and protecting human capital, ensuring fair and credible leadership and prioritising change facilitation.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjoq-2023-002629
- https://bmjopenquality.bmj.com/content/bmjqir/13/1/e002629.full.pdf
- OA Status
- gold
- Cited By
- 1
- References
- 105
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4392514717
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4392514717Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1136/bmjoq-2023-002629Digital Object Identifier
- Title
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A realist synthesis of multicentre comparative audit implementation: exploring what works and in which healthcare contextsWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-03-01Full publication date if available
- Authors
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Sinead McGlacken‐Byrne, Nuala Murphy, Sarah BarryList of authors in order
- Landing page
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https://doi.org/10.1136/bmjoq-2023-002629Publisher landing page
- PDF URL
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https://bmjopenquality.bmj.com/content/bmjqir/13/1/e002629.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://bmjopenquality.bmj.com/content/bmjqir/13/1/e002629.full.pdfDirect OA link when available
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Audit, Context (archaeology), Health care, Benchmarking, Process management, Knowledge management, Business, Psychology, Accounting, Computer science, Political science, Paleontology, Law, Marketing, BiologyTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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