Melbourne Graduate School of Education - Theses

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    Lessons to be learned from an internal evaluation within an acute health care setting: a case study
    ARGIRIDES, ANDREA ( 2001)
    Through a case study in Melbourne, this thesis examined the issues associated with internal evaluations conducted in an acute hospital setting, but specifically for a particular health care project titled, The Hospital and Community Partnerships Project (HCPP). Professional experience as an internal evaluator, combined with primary and secondary data was analysed and compared with the existing body of published literature, in order to investigate issues associated with the process and outcomes of an internal evaluation within a major public teaching hospital. The evaluation design chosen for this study was a single qualitative case study. This approach represented a critical case. The data collection methods selected within this approach entailed document analysis, as well, as semi-structured interviews with six hospital personnel who participated in the HCPP. The critical case dramatises a number of key issues inhibiting a successful internal evaluation process that are consistent with those identified in the literature. These include a lack of resources committed to the project such as funds; time and staff; clarity of purpose of the evaluation; and lack of organisational interest and willingness to participate in and adopt recommendations, regarding a specific innovation such as consumer participation. It is argued that to improve the internal evaluation process, there should be a clear brief as well as increased resources such as specifically trained staff made available during evaluation and subsequent implementation of findings. This would improve the performance of internal evaluations as a valuable means of monitoring progress, and developing policy and programs to facilitate change in response to evolving staff and patient needs. It is also argued there are constraints inherent within the process of internal evaluation relating to organisational politics and culture, professional objectivity and ethics. Furthermore, it is important to understand the purpose for the evaluation. While both the literature and findings of this thesis identify such limitations, in-house evaluations are necessary, valuable and important processes for improving health service delivery. Advantages include the evaluator's intimate knowledge of internal structures and processes. As well as, evaluators possess an awareness and sensitivity regarding the idiosyncrasies that influence the likelihood of successful implementation of recommendations for effective and valuable change. It is believed this is particularly important within an acute hospital environment, where organisational requirements are quite specific and complex. It is recommended that to improve objectivity and consistency in conducting internal evaluations, there should be clearly defined guidelines for health care professionals working in public hospitals. This thesis ends by outlining a number of such guidelines focussing on how to conduct internal evaluations within an acute health care setting, and what critical issues should be considered when embarking on such a task. Finally, through experience of conducting this internal evaluation of an initiative within a Melbourne hospital and the lack of relevant literature for support, it is suggested that there is a need for more health evaluation research of acute health care settings within an Australian context. This is particularly critical due to a shift within the Australian public and private health sectors towards greater accountability in services.