Complexity embraced: a new perspective on the evaluation of organisational interventions

Organisational interventions are recommended to address the root causes of ill-health in organisations. Yet, the evidence for their effectiveness is inconclusive, likely because such interventions are complex, and their effectiveness depends on how and in which contexts the interventions are implemented. This makes organisational interventions challenging to evaluate. While multiple factors affecting implementation and intervention outcomes have been uncovered, it remains unclear which of them are necessary and which are sufficient to produce desired outcomes. To move forward, we argue that the field would benefit from using a theory of causation that better reflects that factors can combine in various ways, that there may be multiple paths to the same outcome, and that a factor can be necessary for bringing about an outcome and thus always leads to it, or sufficient, implying that multiple factors can independently lead to the same outcome. We believe that the use of evaluation designs that align with this type of causation, such as the configurational comparative methods in general and coincidence analysis in particular, will be a significant turning point for the field. The proposed paradigm will improve the precision of current frameworks and models for the evaluation and implementation of organisational interventions.