The study took place from March to June 2009 using four case
studies each centred on a single hospital’s implementation of
PBB. The cases were considered to be individual experiments,
not a ‘sample’ that is intended to represent the total population
of hospitals in Lesotho. The narrative of each case provides
descriptive information about processes or factors underlying
behaviours and the context of the case study, which is used to
develop hypotheses of how factors affect behaviour, and under
what circumstances these effects are likely to occur (Hartley
1994). If two or more cases support the theory, we can claim
analytic replication and there is an argument for inferences to
be made (Yin 1994). Hospitals were selected to represent
diversity in type, size, geographic location and performance
indicators, such as patient satisfaction and accreditation score