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The two groups of implementation case studies included in our synthesis, although all were conducted in the UK, provide very limited information on how enhanced recovery programmes have actually been implemented in UK NHS settings.
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The first group of implementation problems [20, 21, 22] result from Alexander's singular vision of the one 'right' way of building [3] and allege that his patterns are too controlling and inflexible (Fig. 3).
In order to conduct blinded evaluations, evaluators will not know the participants' assigned groups, status of implementation of the intervention, or information on events obtained by other on-site research staff.
Design of clinical research whose purpose is to answer questions about causality can be classified in relation to four axes: the number of study groups, the implementation of an experimental maneuver, cause-effect directionality and source from which the data are collected.
10 The main topics were expansion of the diagnostic and nonsurgical treatment capacity, as well as establishment of multidisciplinary cancer groups and implementation of clinical databases in order to monitor quality of cancer treatment.
How could the style of decision making (in particular, the degree of participation) and quality of decisions be the same in the two groups, yet the quality of implementation be different?
Based on a PD/SC interface with multiple sub-process connections, this study uses a configuration approach to classify project-level observations into DC groups with similar patterns of implementation.
The difference in overall trajectory of length of stay was not significant between the study groups upon implementation of the initiative (Wald test χ=2.05, P=0.560).
The overall trajectory of length of stay did not differ significantly between the groups upon implementation of the project (Wald test χ=2.05, P=0.560).
The patient groups before implementation of the care bundle were of unequal size and not collected during the same time intervals.
Results The overall trajectory of mortality outcomes differed significantly between the two groups upon implementation of the project (Wald test χ=8.73, P=0.033).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com