What's its purpose in systems grantmaking?
To identify which interventions are most likely to influence the system in a specific context, what mechanisms need to be put in place first, and a few simple rules to guide systems change.
What is it?
A narrative reporting resource used in 10 rapid steps to quickly understand what interventions are likely to change a system, under what circumstances, through which mechanisms (i.e., structures, processes, activities) and with whom. The 10 steps, of which steps three through seven are iterative, include the following:
- Recruit reference and expert panels and develop the project scope.
- Develop the specific research questions.
- Identify how the findings and recommendations will be used.
- Develop search terms.
- Identify articles and documents for inclusion in the review.
- Conduct quality scoping literature review.
- Extract data from the literature and appraise and synthesize the evidence.
- Validate findings with content experts.
- Synthesize the findings into a final report.
- Disseminate the results.
When is it useful?
- When there is a specific systems intervention or question.
- In rapidly changing, emergent environments where a large amount of information needs to be processed and decisions made quickly.
- It has been used most in health care and for policymaking but could be applied to other issues.
What are tips and cautions for systems grantmakers and the social sector?
- This is an alternative to traditional policy research and analysis or landscape scans. It explores what works for whom under what circumstances.
- Since the information gathered is historical and current, newly emerging and untested future ideas are not captured. Thus, RRR recommendations may need to be complemented with other methods to generate innovations.
- Some fields may not contain enough published or grey literature to adequately draw conclusions about relationships among context, mechanisms and outcomes.
- While not participatory, RRR incorporates contributions from content experts and knowledge users. Those contributions are key to ensuring that RRR captures emerging ideas not yet in the literature, and validates the findings. If it isn’t possible for grantmakers to survey these individuals, the data may be limited and biased.
A Time-Responsive Tool for Informing Policy Making: Rapid Realist Review
By Jessie E. Saul, Cameron D. Willis, Jennifer Bitz and Allan Best
Implementation Science, 2013
Knowledge and Action for System Transformation (KAST): A Systematic Realist Review and Evidence Synthesis of the Role of Government Policy in Coordinating Large System Transformation
By Allan Best et al.
Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 2010
Large-System Transformation in Health Care: A Realist Review
By Allan Best, Trisha Greenhalgh, Steven Lewis, Jessie E. Saul, Simon Carroll and Jennifer Bitz
The Milbank Quarterly, 2012
Allan Best, Ph.D.
Managing Director, InSource