Role Of Institutional Entrepreneurship In Building Adaptive Capacity In Community-based Healthcare Organisations: Realist Review Protocol
Author: Sweatha Iyengar, Aaron Katz, Jo Durham
Abstract:
Introduction Over the past 3 decades, there has been a substantial shift to the marketisation of government-funded health services. For organisations traditionally buffered from the competitive pressures of for-profit enterprises, such as community-based organisations, this means developing the capacity to adapt to competitive tendering processes, shifting client expectations, and increasing demands for greater accountability. Drawing on ideas of institutional entrepreneurship, we believe that attempts to build adaptive capacity require the transformation of existing institutional arrangements. Key in this may be identifying and fostering institutional entrepreneurs—actors who take the lead in being the impetus for, and giving direction to, structural change. This study focuses on the strategies used by institutional entrepreneurs to build adaptive capacity in the community-based healthcare sector.
Methods and analysis
The research will use an adapted rapid realist review. The review will find underlying theories that explain the circumstances surrounding the implementation of capacity-building strategies that shape organisational response and generate outcomes by activating causal mechanisms. An early scoping of the literature, and consultations with key stakeholders, will be undertaken to identify an initial programme theory. We will search for relevant journal articles and grey literature. Data will be extracted based on contextual factors, mechanisms and outcomes, and their configurations. The analysis will seek patterns and regularities in these configurations and will focus on confirming, refuting or refining our programme theory.
Ethics and dissemination
The study does not involve primary research and, therefore, does not require formal ethical approval. However, ethical standards of utility, usefulness, feasibility, propriety, accuracy and accountability will be followed. The results will be written up according to the Realist and Meta-Review Evidence Synthesis: Evolving Standards guidelines. Once completed, findings will be published in a peer-reviewed journal.
Citation: Sweatha Iyengar, Aaron Katz, Jo Durham Role Of Institutional Entrepreneurship In Building Adaptive Capacity In Community-based Healthcare Organisations: Realist Review Protocol BMJ Open 2016;6:e010915 doi:10.1136/bmjopen-2015-010915
Received: 18 December 2015 Revised: 25 February 2016 Accepted: 29 February 2016 Published: 24 March 2016
Copyright: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Funding
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests
None declared.
Acknowledgments
The authors would like to thank the reviewers for their invaluable comments.
