The contribution of nursing, midwifery and health visiting to protocol based care and its variants on organisation, patient and staff outcomes, quality and costs of care. Investigators (Study 1) 2004-2007

Investigators: J Rycroft-Malone*, C, Morrell,D, Bick.
Project Funding: NIHR SDO Programme.

Evaluating the nature, impact and nursing contribution to clinical decision-making using protocols (Study 2) 2005-2007

Investigators: J, Rycroft-Malone*, K, Seers, C, Morrell, D, Bick.
Project Funding: NIHR SDO Programme.

The objective of this research was to evaluate the contribution of nursing, midwifery, health visiting to protocol-based care on organisational, patient, staff, and quality of care. An additionally funded project aimed to explore how protocol-based care affects clinical decision-making.

For Study 1, a case study evaluation was undertaken, and for Study 2 a decision-making ethnography. Realistic evaluation was used as the overarching methodological framework for both studies. Seven sites across both studies were purposively sampled and included acute and primary care service provision. A variety of standardised care approaches were studied including pathways, local guidelines, protocols, algorithms, and patient group directives across sites, and sometimes within sites. These covered various patient conditions and types of service delivery.