About 60 health system researchers and implementers from around the world gathered in London on April 20th to participate in a workshop on “Evaluation Designs for Quality Improvement Practice and Research”. The meeting was a collaboration between the HSG Thematic Working Group on Quality, the Institute for Healthcare Improvement and Great Ormond Street Hospital.
Following presentations on the evaluation methods and approaches for QI studies by Gareth Parry from IHI and Lisa Hirschhorn from Ariadne Labs, the workshop engaged expert panels and participants in vibrant small group discussions that tackled key questions on evaluation design. A case study on implementing a strategy for integrating HIV-TB care was presented by member of the CAPRISA team from South Africa.
On the topic of the key questions for the evaluation the participants proposed that a well-articulated theory of change would provide the basis for the research questions. The key questions for evaluation are “What happened, and how did it happen?” The exploration of possible evaluation designs to tackle these questions provoked a lively debate on the utility of the proposed cluster randomized design for the study, raising questions on the importance of valid counterfactuals, adaptable designs to account for context as well as ensuring that the study produced knowledge that was scalable.
The participants called out the importance of capturing contextual data as well as the usual linkage of intervention data to process and outcome data. The groups also stressed the importance of having learning systems that can capture and spread the learnings of the project in real time. The case was made for the importance of external evaluation to provide a level of objectivity to the evaluation process. The TWG will continue to promote the discussion on research methods for Improvement and Implementation Science in upcoming virtual events.
Please email Mark Bradshaw if you’d like to join the Quality TWG and receive information about upcoming events. The presentations on evaluation designs for complex interventions are available here and here.