Table 2 Refined CMOs: facilitating contexts
From: The usage of data in NHS primary care commissioning: a realist evaluation
Category | CMO # | Interviews | Meetings |
|---|---|---|---|
Steps of the commissioning cycle | CMO 24 | If commissioners want to identify commissioning priorities (C) they may consult data as a starting point (O) since they believe they are useful (M) | Silence (CMO not present) |
CMO 25 | If commissioners believe that clinicians or service providers are not aware their performance is below average (C) and they do not want to be perceived as ‘judgemental’ or ‘performance managing’ they may share data with them in the hope of stimulating improvements (O) because of a perception that sharing data can empower clinicians or service providers to come up with solutions (M) | If commissioners believe that clinicians or service providers are not aware their performance is below average (C) they may share data with them in the hope of stimulating improvements (O) based on the assumption sharing this data may trigger discomfort, pressure, and awareness and therefore improvements (M) | |
Characteristics of data | CMO 26 | If commissioners have access to combined datasets (C) they will be more likely to use them (O) because the data are useful (M) and because commissioners can gain a fuller understanding of the patient journey (M) and because the data facilitate integrated commissioning (M) | If commissioners have access to combined datasets (C) they will be more likely to use them (O) because the data are useful (M) and because commissioners can gain a fuller understanding of the patient journey (M) because the data facilitate integrated commissioning (M) and because they have reassurance that the information is comprehensive (M) |
CMO 27 | Presenting key pieces of data in a succinct, visually appealing, and easily digestible manner to commissioners (C) can increase the likelihood the data will be used (O) since this increases their engagement with and understanding of data (M) | Silence (CMO not present) | |
CMO 28 | If commissioners have access to flawed or imperfect data they understand the limitations of (C) and this is the only type of data they have access to (C) they will still try to use the data (O) because they can adapt them in ways that are useful while taking into account the data’s limitations (M) and they believe this is better than using no data at all (M) and the data make decisions more defensible (M) | In a context where commissioners have access to ‘imperfect’ data they understand the limitations of (C) and this is the only type of data they have access to (C) and/or they have a commissioning issue they (urgently) want to address and/or (C) they feel they have an obligation to use the data (C) they will still try to use the data (O) because they can adapt them in ways that are useful while taking into account the data’s limitations (M) and they believe this is better than using no data at all (M) | |
CMO 29 | Having a data champion within the commissioning team support and promote the usage of data in commissioning decisions (C) can increase the usage of data (O) because the data champion can increase engagement and persuade people to use data (M) and because commissioners are more receptive to communication about the importance of data if it comes from a team member (M) | Silence (CMO not present) | |
Commissioners’ capabilities, roles, perceptions, and intentions | CMO 30 | If commissioners want to persuade others about their commissioning proposals (C) they may (selectively) use data to support their proposals (O) due to a perception that they are a form of evidence that are ‘objective’ and can increase the legitimacy of proposals (M) | If commissioners want to persuade or reassure others about their commissioning proposals (C) |
Interpersonal relationships with and perceptions of external providers | CMO 31 | If commissioners perceive external support to be able to provide different or new skills, data, or additional capacity (C) commissioners will be more inclined to use the data and outputs they produce (O) because they are perceived as novel and useful (M) and the commissioners believe this is a worthwhile financial investment (M) | Silence (CMO not present) |