Text Size

Tracey Hunter

PhD student: Tracey Hunter


Academic background

BSc Psychology

Postgraduate Diploma in Applied Clinical Applications in Psychology


Title of project

Using Realistic Evaluation to identify factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for the dying patient


Project outline

Main research questions addressed by the research

* What are the underlying mechanisms influencing the implementation of the Liverpool Care Pathway (LCP)?

* What are the key enabling/disabling characteristics of the context for implementation of the LCP?

* How do the mechanisms of implementation and the characteristics of the context combine to support or hinder the implementation of the LCP and achievement of the desired outcomes?


Background evidence to indicate the context and relevance of the research

The LCP is an example of a multi-disciplinary integrated care pathway.  Integrated Care Pathways (ICPs) are plans for patient care “that embed guidelines, protocols and locally agreed, evidence-based, patient-centred, best practice, into everyday use for the individual patient…and uniquely to ICPs, they record deviations from planned care in the form of variances” (NELH, 2005).  ICPs are in use internationally and throughout the UK, in a wide variety of clinical and organizational contexts (Vanhaecht et al, 2005).  Ideally, they are multi-disciplinary, patient focused, and contribute to cost-effective care.  ICPs have been identified as an archetypal service innovation (Greenhalgh et al, 2004), so lessons learned in relation to the factors affecting successful implementation and sustainability of a widely used ICP such as the LCP, will be relevant to service innovators internationally.



Dr Peter O’Hallaran, Prof Sam Porter and Dr Michael Donnelly


Period of studentship

October 2009 – September 2012