The aim of our study is to conduct a theory-based analysis of how the programme partners created an enabling infrastructure to support the implementation of a QI programme across an entire health system. We will examine the technical, social and organisational challenges that programme personnel faced, and elucidate how they overcame these challenges.

In order to do this, we will use a mixed-methods approach to elicit the programme theory (or theories) of the partners involved in the programme in detail, identifying the underpinning assumptions and rationales about mechanisms which link the programme’s processes and inputs to the desired outcomes. The study design will involve (i) conducting semi-structured telephone interviews with the various partners in the programme; and (ii) analysing programme documentation. We will assess the extent to which the various stakeholders share the same views of what is going on with the programme and identify areas of divergence and convergence regarding the most significant aspects of the programme and how it works. We will discuss the results of our evaluation in the wider context of QI implementation and how we can create a culture of learning from such programmes. The outcomes will be a report to the NI Chief Medical Officer and colleagues, suitable for sharing with the UK Department of Health and the Health Foundation, and published as a scientific report and a digest-style output for use by clinicians and improvement practitioners.