Evaluation is a key element of NIHR CLAHRC for Northwest London. By ongoing evaluation of the programme we can:
- Know to what extent we have improved care and demonstrate what difference this has made to patients
- Know what facilitates or hinders improvement in different settings and feed this information back regularly to inform the direction of the programme
- Share knowledge effectively between partners and explain to others how improvement can be achieved
- Develop a systematic approach for the rapid adoption of clinically effective interventions.
A broad range of research methods are being applied by our multi-disciplinary teams, looking not just at outcomes, but also the mechanisms used to achieve them and the context in which they are applied.
Evaluation encompasses all aspects of the CLAHRC at a project, theme and programme level. Iterative feedback of results is essential to drive improvement and inform programme development.
Layer 1 - Self Evaluation at Project Level
Regular evaluation at a project level allows projects to reflect on where they are, the progress they have made and identify further work that will drive improvement.
Weekly reporting of a small number of quantitative measures allows project teams to assess how well the project is progressing. Weekly reporting is essential to drive improvement on an accelerated timescale, and allows early identification of system and process factors that may affect the impact of the project.
Regular monitoring of patient experience allows teams to assess how the project affects the patient perspective of care.
Documenting Plan-Do-Study-Act cycles and minutes from team meetings allows qualitative information to be captured regarding the barriers and facilitators to successful projects.
Project teams complete the NHS Institute for Innovation and Improvement Sustainability Model quarterly. The model considers 10 key factors for sustainable improvements including process, organisation and staff.
Layer 2 - Outcome Evaluation
To identify the impact of our work on patients' health and well-being, outcome data will be collected and analysed for all projects. This data can be used to support longitudinal, cohort or population data analysis to understand the impact of the projects at a local and regional level.
Layer 3 - Process and Context Evaluation
In a system as large and complicated as healthcare, successful implementation of new and innovative interventions is highly dependent on context. Numerous factors facilitate or hinder successful and sustainable improvement in quality of care.
Evaluation of the CLAHRC implementation themes and overall CLAHRC model will add to our understanding of how to support and accelerate the delivery of research into everyday practice.
What mechanisms and contexts best support:
- Project delivery
- Building capacity and capability amongst frontline staff
- Knowledge transfer and mobilisation
- Multi-professional and cross-project working
Active involvement of patients in improving care
- Extent, nature and impact of involvement
- Lessons for best practice in different contexts
- Use of the Web Reporting Tool and weekly improvement measures
- Use of healthcare information to drive and inform change
- Evidence based implementation and practice - effects on service delivery
- CLAHRC methodology
- CLAHRC network and partnerships
- CLAHRC infrastructure.
The evaluation theme of CLAHRC is supported by multidisciplinary teams from Imperial College London, London School of Hygiene and Tropical Medicine and NHS organisations across the sector.
The CLAHRC core team coordinates evaluation by a broad range of partners and provides direct support and advice to the project teams on self evaluation and outcome measures.
Imperial College, Department of Primary Care and Social Medicine support interrogation and analysis of data from routinely collected data sets such as Hospital Episode Statistics (HES) and primary care data sets.
Imperial College Business School study the organisational development of CLAHRC and how the CLAHRC model functions to help determine success factors. A health economist supports project evaluation and is studying the cost effectiveness of the PPI theme.
London School of Hygiene and Tropical Medicine are partnering the CLAHRC to perform a qualitative analysis of PPI.