The DACHA project has two over-arching elements: understanding, designing, and testing 1) the most effective, feasible, and acceptable content of a minimum data set (MDS) for the UK care home setting; 2) an implementation strategy outlining what needs to be in place within and between system levels and how to achieve it to ensure the MDS is successfully implemented in the UK.
Implementation learning about what will and will not work to implement an MDS in the UK context will be captured across the DACHA work packages (see Figure 1 for DACHA work packages mapped to the overall implementation Double Diamond Approach taken by DACHA). DACHA consultation groups at key time points (Figure 1: PPIE 1-3) will uncover, test and co-develop understanding of knowledge user needs and priorities in relation to the evolving implementation theory.
Figure 1: Double Diamond Approach taken to implementation learning in DACHA with work packages mapped
Theorising implementation helpers and hindrances across the levels of the system begins with opening up (Figure 1: Discover column) and exploring the focus of the theory development and the needs of knowledge users across system levels, and then focusing in through an engaged process of refining and defining the priority areas to theorise (Figure 1 Define column). Once the ‘problem’ (what needs to be in place across system levels for MDS implementation in the UK care home sector) is defined, the DACHA project moves on to collectively designing and testing potential ‘solutions’ to the problem defined (Figure 1: Develop), and narrowing in on a practical working solution and implementing it (Figure 1: Deliver).
DACHA work packages focus on implementation learning at different levels within and between the care home system in the UK (see Figure 2).
Figure 2: Sources of implementation learning in DACHA mapped across levels of the UK care home system
Implementation learning from DACHA work packages 1-4 will be brought together in a conceptual map and associated narrative. These will inform the co-design of the implementation strategy for the RCT in work package 5. The starting point for the conceptual map will be the programme theory diagram developed in the realist review in work package 3. Learning from the systematic review of process evaluations in work package 1 and work package 4 data linkage will be incorporated in to this map as rich theory at the system- to care-home level that complements the focus of the realist review (see Figure 2).
The work package 5 RCT will iteratively test and refine the implementation strategy elements across system levels. Learning from work package 5 will distil implementation learning from DACHA into a final stream-lined conceptual map, narrative, and implementation strategy for National rollout.