‘How did it come to this?’ Causal network analysis in practice and service development

Practice development has been widely used to support change in healthcare for more than 20 years (McCormack et al., 2006), a result there is a growing body of knowledge which, describes the process and context together with the factors that influence the outcomes of such developments. Learning from failure in practice and service development is fundamental if we are to identify and understand what factors can influence success. Too often the analysis of failure has been subjective and has relied upon anecdotal accounts. This article explains the use of the methodology developed by Miles and Huberman (1994) to inductively map how variables and factors interact to produce a particular outcome. Causal Network Analysis (CNA) is useful in exploring the factors, which can influence developments, as well as exploring what triggered the success or failure of a particular development.