Steps to Quality Improvement > Evaluation

After assessing the organization, identifying its needs and planning and implementing a program to improve care for diverse populations, some organizations may assume the program works as intended and is producing the desired results. Evaluation is sometimes an afterthought, particularly if the need for the intervention was obvious and success was a foregone conclusion. Investing in an evaluation can be difficult if the resources might otherwise be used to sustain the existing program.

Despite this, evaluating programs that reduce racial and ethnic disparities in health care is critical to understanding the extent of their success. QI Teams regularly make decisions about a program, even if the default decision is to continue existing efforts without significant change. Decisions are strongest when informed by accurate information about a program, how it is running and its success to date.

Make the Evaluation Useful

A practical approach that uses readily available data and simple analytic techniques may yield highly useful information, and in many cases, may be relatively inexpensive and fast. The goal of a practical evaluation is to answer these questions.

• How well is the program running?
• Is it successful?
• What factors contribute to its success?
• Should the program be continued or changed?
• Is the quality of care for minority patients improving?
• Are disparities decreasing?

These questions do not require advanced statistical techniques or complex study designs to develop useful, actionable information that staff and leadership can use when making decisions about the program.

It is important to understand what evaluation questions the available data will answer. The best evaluation design cannot compensate for a lack of data. The most practical evaluation will result from maximizing the use of available data and supplementing that information with additional data collection where needed.

Finally, it is important to use the evaluation. Sharing results with the QI team, sponsors, individuals and coalitions that support (or object to) the program can help advance dialogue and decision making about the program and similar, future efforts. Sharing results can give more detailed feedback and perspective about why results look the way they do and engage leadership and staff in making necessary improvements.

Evaluation conducted after implementing the entire initiative is different from smaller evaluations performed throughout planning and implementing each small test of change. The QI team can use these analyses to modify and mitigate risk, and learn about changes that should be made before moving forward. The final program evaluation lets the QI team measure the success of the program as a whole and determine whether it is accomplishing the goals set at the beginning of the initiative.