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

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.