Change and transformation: the impact of an action‐research evaluation on the development of a new service

Abstract

Evaluation is an essential part of service development and quality management and this is especially pertinent when introducing new initiatives. In 2001 a new countywide assessment and rehabilitation Intermediate Care service, consisting of three care management Rehabilitation Link Teams (RLT), was implemented for older people. To monitor the implementation and impact of the service an evaluation study was conducted. The study centred on evaluating team development, interagency working, outcomes from multiple perspectives (client, carer, clinical and service) and the cost effectiveness of the service. Of particular importance to the study, however, was the action‐research approach that provided the underpinning philosophy to the study. This paper provides insight into the ways that the action‐research approach was used to facilitate learning and change within the organization. To enable this to happen, it was important for the health and social care staff to understand that the researchers’ role was not to judge their role proficiency, but to gather information to facilitate learning and understanding within the organization. It was also vital that the teams being evaluated were provided with regular insight into the emerging study findings and opportunity to address these. Three examples are provided to illustrate how regular information feedback sessions influenced the implementation of the service. Insight is also provided into the participant's views of being evaluated. Although at times, the RLT members found the evaluation burdensome, almost all stated that the action‐research approach allowed opportunity for reflection, catharsis and personal action planning. Overall, the action‐research approach to evaluation fitted well with the organization's need to learn and change simultaneously, allowing emergent data collection to inform decision making and service and team development.

The research/practice nexus: underlying assumptions about the nature of research uptake into practice in literature pertaining to care of the older person

“…Hockley and Froggatt (2006) used action research to generate knowledge and bring about change in practice to palliative care for older people in care homes. Reid et al. (2007) used action research for the development of a new service for older people.…”

“…Hockley and Froggatt (2006) used action research to generate knowledge and bring about change in practice to palliative care for older people in care homes. Reid et al (2007) used action research for the development of a new service for older people. In terms of writing about the research/practice nexus, Nay (2003)argues that evidence based practice has a lot to offer gerontic nursing and care of older people if a wider definition of evidence is used and promotes action research as a strategy for implementing research and improving practice.…”

Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: a realist synthesis

“…Leaders were seen to set the ''tone'' of the team, influence its direction and objectives, facilitate the process of reflection, and provide the vision and practical resources required for implementing innovative ideas (Kirchner et al, 2004;McCallin & Bamford, 2007;Proctor-Childs et al, 1998;Reid et al, 2007). Critical reflection and innovation were mentioned less often than leadership despite evidence that they may be the factors that best predict team effectiveness (West, 2004).…”

“…This included, for example, setting the ''tone'' (i.e. the climate, culture, values and philosophy) of the team, influencing the team's vision, direction and objectives, coordinating the team, facilitating reflection (though this was rarely addressed empirically) and supporting team members (Cole & Crichton, 2006;Kirchner et al, 2004;McCallin & Bamford, 2007;Pryor, 2008;Reid, Kneafsey, Long, Hulme, & Wright, 2007;Solheim, McElmurry, & Kim, 2007). The areas in which team leaders were noted to be lacking were chairmanship or facilitation skills, communication and listening, and coaching ability (Cole & Crichton, 2006;Hall, Weaver, Handfield-Jones, & Bouvette, 2008;Whale, 1993).…”

Participatory action research into implementing open access in musculoskeletal X-ray: Management and staff perspectives

“…PAR is grounded on the best available conceptual evidence. This study therefore assumed a mixed-methods approach using semi-structured interviews and focus groups to ensure the maximum validity and trustworthiness of findings 13,16,17 .…”