Evaluations

Healthcare organisations face the difficult challenge of making evidence-based decisions about the design of policy, provision of health services and implementation of health interventions that meet local needs. Evaluation research is not only about systematically measuring success, but forms an instrumental part of understanding how interventions, programmes and services should be designed and implemented in the most efficient and effective way. Evaluation research can also help organisations learn about how better to achieve service improvements.

There are a range of possible areas for health-related research evaluation and an array of possible methodologies that can be tailored to evaluation challenges. Research tends to fall into three core areas:

• Policy appraisal: Needs and Impact assessment, which is usually undertaken before a policy or intervention starts, and can include a review of the evidence, an analysis of the target audience and intended beneficiaries, an analysis of current service provision, or a needs assessment
• Formative (or Process) Evaluation, which can take place during the life cycle of a policy intervention to provide feedback on its implementation, and address how organisational and other factors can impact on delivery. This can provide policy makers with a valuable understanding of not only whether a policy intervention is working, but also 'how' and 'why' it works. As a formative evaluation can be an iterative process it has the potential to provide managers with the opportunity to put things back on track if anything goes wrong, and make improvements if and when needed
• Summative (or Impact) evaluation, which can involve performance monitoring during a policy intervention and an assessment of whether it has achieved its intended effect at the end of its life cycle, or to provide an evidence base for future policy developments, for example service redesign.