Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/32029
Title: What to expect when you're evaluating healthcare improvement: a concordat approach to managing collaboration and uncomfortable realities.
Authors: Brewster, Liz
Aveling, Emma-Louise
Martin, Graham
Tarrant, Carolyn
Dixon-Woods, Mary
Safer Clinical Systems Phase 2 Core Group Collaboration & Writing Committee
First Published: 2-Apr-2015
Publisher: BMJ Publishing Group
Citation: BMJ Quality & Safety, 2015, 24:318-324
Abstract: Evaluation of improvement initiatives in healthcare is essential to establishing whether interventions are effective and to understanding how and why they work in order to enable replication. Although valuable, evaluation is often complicated by tensions and friction between evaluators, implementers and other stakeholders. Drawing on the literature, we suggest that these tensions can arise from a lack of shared understanding of the goals of the evaluation; confusion about roles, relationships and responsibilities; data burdens; issues of data flows and confidentiality; the discomforts of being studied and the impact of disappointing or otherwise unwelcome results. We present a possible approach to managing these tensions involving the co-production and use of a concordat. We describe how we developed a concordat in the context of an evaluation of a complex patient safety improvement programme known as Safer Clinical Systems Phase 2. The concordat development process involved partners (evaluators, designers, funders and others) working together at the outset of the project to agree a set of principles to guide the conduct of the evaluation. We suggest that while the concordat is a useful resource for resolving conflicts that arise during evaluation, the process of producing it is perhaps even more important, helping to make explicit unspoken assumptions, clarify roles and responsibilities, build trust and establish open dialogue and shared understanding. The concordat we developed established some core principles that may be of value for others involved in evaluation to consider. But rather than seeing our document as a ready-made solution, there is a need for recognition of the value of the process of co-producing a locally agreed concordat in enabling partners in the evaluation to work together effectively.
DOI Link: 10.1136/bmjqs-2014-003732
eISSN: 2044-5423
Links: http://qualitysafety.bmj.com/content/24/5/318
http://hdl.handle.net/2381/32029
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2015. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Appears in Collections:Published Articles, Dept. of Health Sciences

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