Evaluate the intervention

Once an intervention is up and running properly, it is important to return to evaluation. As with the pilot evaluation, the full intervention evaluation should consider the three types of evaluation described before: formative, process, and outcome. Much of the same methods from the pilot evaluation may be employed, including questions to check whether previous problems have been successfully overcome. However, the evaluation now has two further goals. First of all, a full evaluation will be able to explore the effects of an intervention in much greater detail. Sometimes intervention evaluations are used as a precursor to research projects. Second, a full evaluation can be used to set benchmarks for future monitoring and audits. Audits in healthcare are intended to be more resource-efficient evaluations once an initial evaluation has taken place and they ascertain whether interventions are continuing in line with the standards they aspire to. Chapter 9 considers the relationship among evaluation, research, and audits in more detail.

Consequently, the evaluation project for the full intervention may repeat methods from the pilot evaluation in greater detail, but crucially it should also draw on the SMART outcomes from the balanced scorecard, using these as a set of measuring standards and ascertaining whether they have been achieved.

If they have, it is a sign that the intervention is running well and a simplified version of the process can be repeated periodically (as an audit) to ensure these standards are maintained. If the standards have not been met, this demonstrates that aspects of the intervention need to be altered, for which the rest of the evaluation (especially the formative and process evaluations) will help to provide more information. For some projects, it may be that the initial targets are simply not met, perhaps because of circumstances beyond the control of those involved. In this instance, it may be that initial ambitions were too high and that they must be readjusted, followed by checking whether all stakeholders and partners are still interested in pursuing the intervention. Or it may be that an intervention has to be withdrawn and rethought before being implemented again. It is possible that interventions that do not meet their targets can still continue. However, it is rare that interventions that are not providing measurable outcomes are able to secure long-term funding, so even if the outcomes have changed, identifying what they are and finding a way of measuring them is important.

Project evaluations are often made public, and this should be encouraged. Positive results may encourage similar projects to be developed elsewhere, while honesty over obstacles and challenges will prevent other teams from repeating the same mistakes. Project evaluations with good results may be further developed into research projects. This will be explored in Chapter 10.

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