CPPH Lecture: The Art and Science of Non-Evaluation Evaluation by Lorelei Jones and Justin Waring
There is growing recognition of the limitations of realist evaluation, and other theory driven approaches, in research on healthcare policies. These approaches, which seek to surface ‘programme theories’ or construct ‘logic models’ for healthcare policies, are often unable to account for empirical observations of policy implementation in real-world contexts.
In this paper we argue that this failure stems from insufficient theoretical elaboration of the social, cultural, and political dimensions of healthcare policies. Drawing from institutional theory, critical theory and discourse theory, and from organizational ethnography, we set out an alternative approach to research on healthcare reform. We illustrate with examples from our own experience of research on acute care reconfiguration, integrated health and social care and other forms of major system change.