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Introduction to Evaluation Simon Bishop
Why evaluate? Previous evaluations? Theory based evaluation Methods
Why evaluation? 3 good reasons • To evidence progress towards desired outcomes • To provide feedback to guide implementation • To test and develop existing ideas/knowledge/theories (Kubish et al 1998) + Many other ‘less good’ ones!
Torbay Evaluation Kings Fund (2011) Longitudinal action research case study Qualitative and quantitative measures of process and some broad outcomes Overview of long term change Evaluations of Integrated Care Davey et al (2005) Comparative study of co-located and non co-located teams Standardized interviews Identify contextual factors that impact on team development and patient/client outcomes DoH Integrated Care Pilots - Rand / Ernst and Young - (2012) Comparison of 16 diverse care pilots Qualitative (‘living documents’ + Interviews) and quantitative (HES) Process improvements, but changes for patients mixed. Outcomes difficult to unpick Lessons from Sedgefield- Hudson (2002, 2007) Process of front line team integration Mixed qualitative methods Unpicks factors contributing to positive outcome for the teams,
Theory Based Evaluation • Theory on relationship between programme, outputs and outcomes • Different schools • Theory driven evaluation • Theory of change • Realist evaluation • Acknowledges complexity • Take into account context • Making theory explicit improves shared understanding • Improves transferability of findings (as looks at relationship between conditions and outcomes)
‘Assumptions’ and ‘Mechanisms’ Bring to light the underlying assumptions about why it is believed that elements are linked (for example how actions linked to outcomes) Complex initiatives likely to involve a large number of assumptions Unpick intermediate steps in the (assumed/hypothetical) causal chain Impact of context on assumptions needs to be considered Help to identify links between causes and assumed effects
Theories of Change Identifying long-term goals Mapping and connecting outcomes Identifying Assumptions Developing Indicators Identifying Interventions
Why Integrate? What are the underlying assumptions/ mechanisms behind integrated approaches to care? What contextual factors are these assumptions dependent upon?
Methods of Data Collection A combination of different methods usually required to understand the process and outcomes of change …. or no change • Quantitative data Outcome • Hospital Episode Statistics • Health/wellbeing indicators • Surveys Process • Meetings • Teamwork • Qualitative • Staff interviews • Ethnographic methods • Documentary evidence • Reports / structured questions