Background: Literature on multi-disciplinary healthcare team interventions to improve quality and safety of care in acute hospital contexts tends to focus on evaluating the success of the intervention by assessing patient outcomes. In contrast, there is little focus on the team who delivered the intervention, how the team worked to deliver the intervention or the context in which it was delivered. In practice, there is a poor understanding of why some interventions work and are sustained and why others fail.

This research seeks to deepen understanding of enablers and barriers for effective team interventions. Using two case studies, we will evaluate our initial programme theories to understand, what worked for whom, in what conditions, why, to what extent and how?

Methods: A realist evaluation approach will be employed to test a previously formed set of initial programme theories. Two multi-disciplinary acute hospital team interventions in two different geographical and organisational contexts will be identified. In case study 1, a theory based approach to interviewing will be used and in case  study 2, interview transcripts obtained using a semi- structured approach for primary research purposes will undergo secondary analysis.

Researchers will iteratively interrogate both data sets to identify the characteristics or resources present in each context that influenced how the team intervention worked to produce particular outcomes. Data will then be synthesised across contexts in order to reach a middle range theory and produce more generalisable insights.

Ethics and Dissemination: Favourable ethical opinion has been received from University College Dublin Ethics Committee (HREC-LS-16-116397) for this research without requirement for further ethical review (LS-E-19-109) for testing in healthcare organisational contexts. Written permissions have been secured from both organisations involved in the case studies. Results will be disseminated via peer-review journals, national and international conferences and presentations to relevant stakeholder groups.      

Data was collected via one to one interviews using these interview formats.

These are interviews only.