Janet Harris posted:
> ... audit can be part of a service or programme evaluation. Evaluation is
> a form of research. After doing evaluations in North America for many
> years, it was confusing for me to experience the National Health Service
> definition of audit as 'not research'.
Whether called audit, formative (or summative) evaluation, or survey,
perhaps a key distinction emerging in this thread is one of funding and
management responsibilities vs. a conceptual framework for
strength-of-evidence?
Kev and Badri posted pertinent examples, and I offered Last's definition of
research involving "generalizable knowledge." Under that definition, I'd
vote with Badri to consider the Tropman et al. study applied health service
research. I might even vote to fund such studies from public sources since
they provide generalizable knowledge about the evaluation and provision of
health services when they address unknown ground. On a population-health
level, it might even be worth funding a series of regional or national
research studies to see how well programs are addressing community health
needs over time. On the other hand, once a standard of care is defined and
criteria for its evaluation set within a specific health service
organization, then one responsibility of sound organizational management is
on-going evaluation (which could still be considered applied research of
interest to fewer stakeholders but essential to inform quality improvement
decisions) that should be supported by that organization's operational
budget rather than from external research funding competitions. Audit as a
simple case-series or survey type research design provides an approach to
gathering evidence that is relatively easy but susceptible to bias. I agree
with Karen and Badri that its purpose defines whether a given audit project
should be funded as research or as a normal management responsibility.
David Birnbaum, PhD, MPH
Adjunct Professor
Dept. of Health Care & Epidemiology
University of British Columbia, Canada
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