Our Vision - Evaluation for QI

This section provides core principles for collaboration for NHS employers and educators who are undertaking evaluations of health interventions that involve patient supported quality improvement.

Meaningful evaluation has an essential role in the work of improving healthcare and in enabling learning to be shared (Dixon-Woods et al 2011).  Evaluation that is done ineffectively can impede the potential for quality improvement. In the absence of evaluation (effective evaluation) health interventions may be perceived as a waste of effort, with improvements only realised locally and the potential for the wider spread of innovation lost.

Our vision for evaluation is underpinned on the principle of ‘co-production’, which is increasingly being applied to the delivery of health and social services in the UK; there is no single definition. Working together in this way for the evaluation of health and social care interventions, is built on the principle that clinical, academic and lived experience are valued in equal measure. Therefore co-production is a way of working and thinking about evaluation for quality improvement.

'Quality improvement is everyone’s business – we all have a role to play' - ENQuIRE Working Group – a shared perspective

What is Evaluation?

Evaluation tells us whether a quality improvement initiative, project or programme worked (Health Foundation 2015) as an ‘intervention’). There are many definitions of evaluation including for example:

  • ‘The process of determining the merit, worth or value of something’ (Scriven, 1991)
  • Using systematic, data-base inquiries about whatever is being evaluated (American Evaluation Association (www.eval.org, 2004)
  • A process undertaken for purposes of improvement, decision-making, enlightenment, persuasion (Hadish et al 1990)

Done well evaluation facilitates learning to help the wider spread of successful interventions and the development of new.

What is IMPACT in evaluation?

The term impact is used to show demonstrable change in a range of contexts such as academic, health and social care, service improvement or policy development (East Midlands Academic Health Science Network). It is an effect on, or changes to, the activity, (attitude, awareness, behaviour, capacity, opportunity, performance, policy, practice, process) or understanding of a beneficiary / audience at a range of levels (community, organisational or individual). Impacts must be distinct and make a material contribution. Evaluations may show change(s) that may not have occurred without the contribution of the intervention, for example the HEI Challenge project.

Examples impact dimensions, as defined by East Midlands Academic Health Science Network (EMAHSN) include:

  • Benefitted patient experience or outcome
  • Led to documented changes in organisational / management practice or service delivery structures
  • Influenced or changed commissioning
  • Led to a reduction in harm, risk, or other negative effect
  • Led to impacts on public or other audience awareness, attitudes, understanding or behaviour
  • Reduced costs and/or improved efficiency of providing a service or intervention
  • Change that has benefited the economy, society, culture, public policy or service, health, the environment or quality of life
  • Assisted the adoption and spread of innovation or research translation into practice
  • Increased the turnover, profitability or employment of a UK based commercial company or UK subsidiary of an international company