Challenges, solutions and future directions in the evaluation of service innovations in health care and public health

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Abstract

Evaluating service innovations in health care and public health requires flexibility, collaboration and pragmatism; this collection identifies robust, innovative and mixed methods to inform such evaluations.

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Most cited references 176

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On Organizational Becoming: Rethinking Organizational Change

Robert Chia, Haridimos Tsoukas (2002)

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Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study

Simon Lewin, Claire Glenton, Andrew D Oxman (2009)

Objective To examine the use of qualitative approaches alongside randomised trials of complex healthcare interventions. Design Review of randomised controlled trials of interventions to change professional practice or the organisation of care. Data sources Systematic sample of 100 trials published in English from the register of the Cochrane Effective Practice and Organisation of Care Review Group. Methods Published and unpublished qualitative studies linked to the randomised controlled trials were identified through database searches and contact with authors. Data were extracted from each study by two reviewers using a standard form. We extracted data describing the randomised controlled trials and qualitative studies, the quality of these studies, and how, if at all, the qualitative and quantitative findings were combined. A narrative synthesis of the findings was done. Results 30 of the 100 trials had associated qualitative work and 19 of these were published studies. 14 qualitative studies were done before the trial, nine during the trial, and four after the trial. 13 studies reported an explicit theoretical basis and 11 specified their methodological approach. Approaches to sampling and data analysis were poorly described. For most cases (n=20) we found no indication of integration of qualitative and quantitative findings at the level of either analysis or interpretation. The quality of the qualitative studies was highly variable. Conclusions Qualitative studies alongside randomised controlled trials remain uncommon, even where relatively complex interventions are being evaluated. Most of the qualitative studies were carried out before or during the trials with few studies used to explain trial results. The findings of the qualitative studies seemed to be poorly integrated with those of the trials and often had major methodological shortcomings.

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The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature.

J. M. Valderas, A. Kotzeva, M Espallargues … (2008)

The purpose of this paper is to summarize the best evidence regarding the impact of providing patient-reported outcomes (PRO) information to health care professionals in daily clinical practice. Systematic review of randomized clinical trials (Medline, Cochrane Library; reference lists of previous systematic reviews; and requests to authors and experts in the field). Out of 1,861 identified references published between 1978 and 2007, 34 articles corresponding to 28 original studies proved eligible. Most trials (19) were conducted in primary care settings performed in the USA (21) and assessed adult patients (25). Information provided to professionals included generic health status (10), mental health (14), and other (6). Most studies suffered from methodologic limitations, including analysis that did not correspond with the unit of allocation. In most trials, the impact of PRO was limited. Fifteen of 23 studies (65%) measuring process of care observed at least one significant result favoring the intervention, as did eight of 17 (47%) that measured outcomes of care. Methodological concerns limit the strength of inference regarding the impact of providing PRO information to clinicians. Results suggest great heterogeneity of impact; contexts and interventions that will yield important benefits remain to be clearly defined.

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Author and article information

Journal

Title: Health Services and Delivery Research

Abbreviated Title: Health Serv Deliv Res

Publisher: National Institute for Health Research

ISSN (Print): 2050-4349

ISSN (Electronic): 2050-4357

Publication date Created: May 2016

Publication date (Print): May 2016

Volume: 4

Issue: 16

Pages: 1-136

Article

DOI: 10.3310/hsdr04160

PubMed ID: 27227187

SO-VID: cbc0c23a-643d-4b51-a68a-c31c20bd72bb

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Challenges, solutions and future directions in the evaluation of service innovations in health care and public health

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Most cited references 176

On Organizational Becoming: Rethinking Organizational Change

Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study

The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature.

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