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Table 2 Plausible Hypotheses

From: Application of the critical incident technique in refining a realist initial programme theory

 

Context

Mechanism

Outcome

If there is:

this enacts:

and results in:

PH1

Inter-disciplinary focus and Flattened hierarchy

Understanding of roles & Mutual respect, support and value

Shared decision making and common purpose; self and team efficacy

Increased job satisfaction, higher performance, higher levels of competence, better teamwork and lower feelings of emotional exhaustion.

Breaking down of inter-professional silos; more integrated patient care; connectivity of the team and camaraderie.

PH2

Effective Communication:

Opportunities for communication; Communication \skills;

Communication systems

Shared mental models; Clarity of role; Clarity of purpose

Situational awareness;

More integrated care; Better intervention outcomes;

PH3

Leadership Support & Alignment of team goals with organisational goals

Motivates, empowers and engages staff, creating a sense of team efficacy and a shared sense of responsibility and accountability

Team pride; Camaraderie; Connectedness with broader system; Implementation of Intervention; Sustainability of intervention

PH4

Credibility of intervention provided by experienced trainers who team members can relate to and is perceived to be comprehensive (right amount of core topics) with application to the healthcare context in which the team works,

A sense of confidence and engages and motivates team members with the intervention

High satisfaction; Increased skills, Increased self and team efficacy, Increased role in safety and translation to practice.

PH5

Team composition & Physician involvement- consists of appropriately skilled members including a physician, shares a similar foundational knowledge prior to the intervention and participates in a shared learning experience

Shared understanding of the intervention and feel knowledgeable, competent and confident resulting in

Credibility of the intervention, translation to practice and sustainability.