Fellows further their understanding of their case studies through input from expert faculty
Expert faculty member John Ovretveit gives input to a case study group In the afternoon of Day 2 of the Salzburg Global Seminar program Better Health Care: How do we learn about improvement? Fellows returned to their morning case studies to discuss ways to increase the rigor, attribution, and generalizability of them.
A “Reverse Knowledge Café” was held in which the case study groups from the first half of the day were visited by expert faculty members Don Goldmann, John Ovretveit, Brian Mittman, Gareth Parry, and Abe Wandersman. After expert faculty described their areas of expertise, case study groups took a few minutes to brainstorm questions they wanted to ask them to help them hone in on ways to increase the rigor, attribution, and generalizability of their cases. Each Expert Faculty spent ten minutes with each group and after hearing a summary of their case and a summary of the previous conversations, the groups had time to pose questions and have a discussion with the Expert Faculty. The teams will continue to discuss these conversations tomorrow, but each group shared a few key nuggets that came out of their conversations:
Antenatal care in India case study:
- Big challenge was they wanted to evaluate what the intervention was that actually achieved the results they got (attribution) and find a model that answered how to describe it and how to attribute results to it.
- The group discussed a multiple component model that was multiplicative rather than additive – i.e. if one component was missing there would be much bigger impacts and to develop a logic model to test theories in a prospective manner.
Water quality in Ghana case study:
- The group wanted to use an evaluation design to study the sustainability of the results of the intervention
- The group concluded that they don’t need a control group to do so, pre-post study would suffice
Patient discharge checklist in the UK case study:
- The group debated the difference between improving the design of the intervention itself or the evaluation of the intervention. Ultimately concluded that the point was to find a method that encapsulated the marriage between practice and research.
- The group concluded that they would have had a better sense of the improvement intervention of the evaluation if they followed a more rigorous evaluation model
Pre-eclampsia in Uganda case study:
- The group agreed that a logic model that is adaptive to the changes seen throughout the life of the project is needed
- The key takeaway was to understand who the customer that we are trying to evaluate for is as we take the project from the old to the new
Anaemia in Mali case study:
- A key takeaway was to understand the customer of the evaluation before designing the evaluation model
- Important to understand all barriers (regulatory, process related, structural etc.) and the need to monitor these throughout the process, this calls for flexibility in the evaluation model
