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Evaluating impact of clinical guidelines using a realist evaluation framework

Reddy, Sandeep, Wakerman, John, Westhorp, Gillian and Herring, Sally (2015). Evaluating impact of clinical guidelines using a realist evaluation framework. Journal of Evaluation in Clinical Practice (Online),21(6):1114-1120.

Document type: Journal Article
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IRMA ID 84278914xPUB72
Title Evaluating impact of clinical guidelines using a realist evaluation framework
Author Reddy, Sandeep
Wakerman, John
Westhorp, Gillian
Herring, Sally
Journal Name Journal of Evaluation in Clinical Practice (Online)
Publication Date 2015
Volume Number 21
Issue Number 6
ISSN 1365-2753   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84959372430
Start Page 1114
End Page 1120
Total Pages 7
Place of Publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Rationale, aims and objectives
The Remote Primary Health Care Manuals (RPHCM) project team manages the development and publication of clinical protocols and procedures for primary care clinicians practicing in remote Australia. The Central Australian Rural Practitioners Association Standard Treatment Manual, the flagship manual of the RPHCM suite, has been evaluated for accessibility and acceptability in remote clinics three times in its 20-year history. These evaluations did not consider a theory-based framework or a programme theory, resulting in some limitations with the evaluation findings. With the RPHCM having an aim of enabling evidence-based practice in remote clinics and anecdotally reported to do so, testing this empirically for the full suite is vital for both stakeholders and future editions of the RPHCM.


The project team utilized a realist evaluation framework to assess how, why and for what the RPHCM were being used by remote practitioners. A theory regarding the circumstances in which the manuals have and have not enabled evidence-based practice in the remote clinical context was tested. The project assessed this theory for all the manuals in the RPHCM suite, across government and aboriginal community-controlled clinics, in three regions of Australia.


Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation.
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Created: Tue, 26 Jul 2016, 12:55:34 CST