Basic concepts in mental health evaluation: integrating program evaluation and medical audit.
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Evaluation Studies as Topic↗
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Program evaluation for accreditation.
Program evaluation in preparation for accreditation provides opportunities for the identification of program strengths, weaknesses, and improvement potential. In the present study, naturalistic inquiry, an evaluation methodology responsive to the concerns of persons with a stake in the program, was successfully used in preparation for the accreditation of an occupational therapy program. The experiences of undergraduate students who implemented the program evaluation as part of an honors elective course describe the process, outcomes, benefits, and problems associated with the use of naturalistic inquiry as a responsive program evaluation.
Accreditation↗
Moving child abuse and neglect prevention programs forward: improving program evaluations.
This paper focuses on evaluations of programs to prevent child abuse and neglect. It discusses the quality of the evaluations and offers suggestions for improvement to evaluators, program planners, and funders. Thirteen evaluations recommended by experts and published from 1978 through 1988 were reviewed. Using the true experiment as the standard of quality, we found evaluations frequently characterized by careful attention to methodologic detail. Evaluators describe eligibility criteria; half of the studies had control groups or followed progress. However, to learn more about prevention of abuse and neglect the caliber of evaluation research must improve. Evaluators do not define abuse or neglect; they accept reports of abuse. This has the effect of shifting the responsibility to others whose concerns and reporting standards differ. Lack of definition is reflected in a paucity of valid measurements; we could not assess the characteristics of families who benefit most from programs. Evaluators also omit important topics. Although seven evaluations studied health-related variables, no comprehensive analysis of the consequences and costs of medical neglect could be found; very little information on costs and benefits of any kind was available.
Child↗
What is evaluation: nurse decision-makers' perceptions of program evaluation.
This study investigates alternate reasons for conducting program evaluation in community health care settings and their relationship with information needs. One hundred and thirty-six community health nurses representing New York state associations were the decision makers used in the survey. Results indicated that the most frequent reasons cited for conducting program evaluation were accreditation and standard control. These were followed by need for information for formative program changes and aiding decision makers. Participatory and scientific evaluation purposes were rated last. When examining information sources, respondents were unable to differentiate needs on an independent item-by-item basis; all items were considered important. When asked, however, to select the most critical items of these sources, a pattern of needs was established. Decision makers felt that program goals, identification of staff concerns, and presentations of client opinions were the most crucial types of information.
Community Health Nursing↗
Outcomes assessment and program evaluation: partners in intervention planning for the educational environment.
Accountability of educational institutions is a current trend in academia. Outcomes assessment provides a method of evaluating educational programs to ensure they are meeting their objectives. This paper presents an overview of outcomes assessment and describes its relationship to and integration with program evaluation. It also describes the implementation of an outcomes assessment program at Kean College of New Jersey, Union, New Jersey. A model for assessment within occupational therapy programs, which parallels a model for intervention planning, is introduced and discussed.
Curriculum↗
Can program evaluation be saved from its enthusiasts?
Program evaluation--the use of scientific techniques to measure the value of an agency's work--has become the focus of major attention and enthusiasm in mental health service planning and administration. However, the author points out that completed program evaluation studies are few in number and provide no evidence of great impact on the operation of programs or agencies and that unrealistic enthusiasm for program evaluation can lead to unrealistic rejection when performance fails to reach promise. He concludes that program evaluation should be applied only when it can have an impact, i.e., in a limited number of carefully selected cases.
Community Mental Health Services↗
Program evaluation. Part 2: A responsive model proposal.
While program evaluation is necessary for understanding and improving educational programs in nursing, it is frequently surrounded by a climate of unease and perplexity. The first article (September/October 1990) in this two-part series reviewed models of program evaluation. This second article examines the state-of-the-art of program evaluation in nursing education and proposes implementation of a responsive model of evaluation in schools of nursing. The series aims to foster more dynamic, efficient program analysis, thereby enhancing the effectiveness of nursing education programs.
Education, Nursing↗
Program evaluation. Part 1: Four generations of theory.
Program evaluation is necessary for understanding and improving educational programs in nursing, but it is frequently surrounded by a climate of unease and perplexity. This first article in a two-part series reviews and evaluates extant models of program evaluation using Guba and Lincoln's four generations of evaluation as a theoretical framework. The second article (November/December 1990) examines the state-of-the-art of program evaluation in nursing education and proposes implementation of a responsive model of program evaluation in schools of nursing. The series aims to foster more dynamic, efficient program analysis, thereby enhancing the effectiveness of nursing's educational programs.
Humans↗
A program evaluation instrument.
The evaluation of education programs provides valuable information for the program coordinator or instructor. The Program Evaluation Instrument (PEI) was developed with the use of various educational settings and subjects. The PEI provides a valid, reliable instrument that is generalizable to a variety of programs.
Attitude of Health Personnel↗
Program evaluation within a health promotion framework.
Program evaluation can assist in assessing the conceptualization, design, implementation and utility of health promotion action. Evaluation of health promotion, with multiple strategies combining individual, social and policy action, lends itself to an evaluation-as-politics paradigm. Consideration of the interests of all major stakeholders, use of a series of related studies, and a commitment to multiple methods and multiple perspectives characterize this paradigm. Simple, practical research that is adequate for answering relevant questions is required. The program evaluator is not a neutral, scientific observer--he/she is a participant in the political arena along with other stakeholder groups. A model of the areas of interest in evaluation of health promotion, some potential evaluation questions, and a health promotion impact evaluation model are presented to emphasize unique aspects involved in evaluation of health promotion action. The evaluator can take a proactive role and challenge problems in conception and implementation of health promotion action. He/she can advocate for health promotion.
Health Policy↗
A model for program evaluation in a unitized setting.
The unitized psychiatric hospital poses unique problems for the design of successful program evaluation systems. Using the model of program evaluation in operation at the Harlem Valley Psychiatric Center in New York, the authors describe what they have found to be essential components of a successful evaluation system, including methods of data input, processing, and feedback. Also discussed are the roles of key personnel and the utilization of data by clinical and administrative staff. The reasons for success of the system are discussed, as well as the potential role of program evaluation in integrating services, training, and administration of the facility.
Aftercare↗
A reinforcement exchange analysis of the power aspects of program evaluation.
Power, examined within a reinforcement exchange model, is proposed as an essential dynamism through which program evaluation is mounted, executed, and utilized. The ability of the program evaluator to influence or control the policies or operations of the evaluatee depends chiefly on an exchange of behaviors which nets all participants of the evaluation interaction a fair and sufficient "payoff" in terms of contingent reinforcements. Other contextual features of program evaluation, particularly those that constrain on utilization of the recommendations, are briefly discussed.
Attitude of Health Personnel↗
Community influences on mental health program evaluation.
Research in community psychology has demonstrated that community environments can play a key role in defining the operations of human service institutions. This study questioned whether significant community groups might indirectly influence the program evaluation record-keeping of mental health outpatient programs to reflect contact with problem areas considered important by those groups. An inventory of program evaluation materials was conducted in three types of mental health programs. The ranked frequencies of record completion for 10 designated problem areas were correlated with staff rankings of importance for agency work with problems identified by key community groups. Results indicate that the more important the community demand is to the staff, the more systematically complete will be data sources which document agency performance for that demand. Given the general lack of comprehensive development of program evaluation in many mental health programs, the results suggest that community interest groups may play a major role in determining what types of information on mental health problems are made available to the public. The resultant lack of balance and scope in these data inevitably limit the range of community responses for program improvement.
Community Mental Health Services↗
Program evaluation--a systematic means of program improvement.
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Education, Nursing↗
Do we really want a program evaluation strategy based solely on individualized goals? A critique of goal attainment scaling.
Goal attainment scaling is a program evaluation technique that measures program success using individualized client goals rather than the same measuring instrument for all clients. Although the reliability of the goal attainment scales is generally acceptable, such scales have not exhibited satisfactory validity. Also when clients have not been assigned to programs randomly, evaluations comparing two or more programs using goal attainment scales are potentially more biased than evaluations that use the same outcome measure for all clients. Thus since goal attainment scaling does have therapeutic value, program evaluators should adopt a multivariate assessment strategy combining goal attainment scaling with uniform measuring instruments.
Community Mental Health Services↗
Program evaluation of a physical medicine and rehabilitation unit: a new approach.
Rehabilitation units must meet the increasing demand for empirical documentation of the quality of care patients receive. Hospitals wanting to do program evaluations will find few published materials providing norms by which to judge the adequacy of the functional outcomes achieved by their rehabilitation patients. The purpose of this research was to develop an approach to program evaluation that would serve the accreditation needs and would be relatively inexpensive to implement. Sixty-nine consecutive admissions for cerebral vascular accidents (CVA) were assessed on activities of daily living (ADL) and cognition using a behaviorally defined procedure called the "Level of Rehabilitation Scale" that was developed for program evaluation purposes. Nurses and spouses of patients were interviewed to obtain the observations that were rated. Further ratings on ADL and cognition were made at discharge. Those at home 6 weeks and 4 1/2 months after discharge were assessed on the same scales and on home-relevant activities. Experience with the instrument showed that ratings of function can be made in a reliable and valid fashion. The research provides the beginning of the accumulation of improvement norms for CVA inpatients and documents maintenance of improvement 4 1/2 months after discharge. Hospitals and rehabilitation units can utilize these norms and this method of program evaluation economically using nonclinically trained staff.
Activities of Daily Living↗
Let's quit stalling and do program evaluation.
Five issues have been identified as major impediments to program evaluation. Examination of these issues shows many of them to be resolved in the process of conducting evaluations. It is asserted that only by implementing evaluations will the field move foreward. At the present time much energy is wasted discussing or arguing the five issues and the ideal approach to making program evaluations. Examples are provided from ongoing evaluations that show how the issues are resolved.
Community Mental Health Services↗
Essential features of a faculty evaluation program.
A faculty evaluation system should be developed by cooperation between evaluation specialists and dental faculty. The system should depend on a broad spectrum of data collected from a variety of sources in order to reduce personal bias and subjective judgments concerning the performance of all faculty members. Its primary purpose should be to help faculty improve and to this end should be linked to both a faculty development program and a reward system. The criteria for each faculty member's evaluation should be clearly specified in advance and be directly linked to his duties. Department and college goals must be considered as well as the individual faculty member's own interests. Standards or criteria for both rewards and sanctions should be clearly defined, and guidelines for the operation of the system should be given to each participant. The system itself should not cost more than the benefits derived from it justify, and adequate resources should be allocated to make the system effective.
Costs and Cost Analysis↗