Using normalisation process theory to evaluate the implementation of a comprehensive template to support personalised care for people with multiple long-term conditions

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

3B.6

Presenter:

Andrew Turner

Twitter:

@ATurner0

Co-authors:

Andrew Turner1, Rachel Johnson1, Clare Jinks2, Mari Carmen Portillo3, Caroline Coope1, Alice Moult2, Kate Lippiett3, Dereth Baker2, Cindy Mann1, Krysia Dziedzic2, Zoe Paskins2, Simon Chilcott1, Grace Scrimgeour1, Chris Salisbury1

Author institutions:

1. Centre for Academic Primary Care University of Bristol, 2.School of Medicine Keele University, 3. Health Sciences University of Southampton

Problem

Increasing numbers of people live with multiple long-term conditions (MLTC). People living with MLTC report that their care is poorly co-ordinated and not sufficiently focused on what matters to them. Healthcare services are currently often organised around single conditions and are grappling with the challenge of configuring services to meet the needs of people with MLTCs.

Approach

The PP4M study evaluated the implementation of a comprehensive annual review template to promote personalised care for people with MLTC in UK primary care. The template was available to participating practices, along with implementation support that included resources explaining the intervention purpose and requirement of practices, researcher supported process mapping, IT support, training, and ongoing support for implementation processes.Normalisation Process Theory (NPT) is a framework to understand how innovations are implemented in healthcare settings. NPT was used to inform both the development of the implementation strategy and the qualitative evaluation of the implementation of the template.

Findings

We will present methodological findings from using the relatively recently published ‘normalisation process theory coding manual for qualitative research’. The coding manual was designed to facilitate and streamline analyses guided by NPT, as well as link NPT concepts to realist evaluation methods. We describe, practically, how the coding manual was operationalised and how the analysis was conducted collaboratively within a multi-site team.

Consequences

Critical reflection on how an NPT coding manual was used to analyse qualitative data about the implementation of an improved MLTC review template will be useful to other researchers conducting implementation studies, using NPT, and, or performing qualitative analysis collaboratively in multi-site teams.

Submitted by:

Andrew Turner

Funding acknowledgement:

This research is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Multiple Long-Term Conditions Implementation Programme. This research was supported by NIHR ARC West, NIHR ARC Wessex, NIHR ARC West Midlands, NIHR ARC South West Peninsula. CJ and KD are part-funded by NIHR ARC West Midlands. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.