Research, Audit and Evaluation

A variety of approaches may be used to review a service. These can be grouped into three broad categories as described below:

• Research
  'Research can be defined as the attempt to derive generalisable new knowledge by addressing clearly defined questions with systematic and rigorous methods.'⁽¹⁾ 

• Audit
  'Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria.' ⁽²⁾ 

• Evaluation
  '...the rigorous and systematic collection of research data to assess the effectiveness of organisations, services and programmes in achieving predefined objectives.' ⁽³⁾

In practice, there may be overlap between the above approaches. Furthermore, they are not mutually exclusive - service reviews may contain elements of each of these approaches.

A research approach would generally be adopted if there was uncertainty as to the best way to deliver a service, and would aim to produce knowledge that would be relevant to settings outwith that in which it was conducted. Research should be undertaken in accordance with research governance guidance, and should be discussed with the NHS Grampian Research & Development Team - see www.nhsgrampian.org/randd for further details.

An evaluative approach would typically be used to collect information to assess if a service was achieving its pre-defined objectives. In contrast to research, the primary focus of an evaluation is to produce information of relevance in the local context. However, it is recognised that the distinction between research and evaluation is not always clear. ⁽⁴⁾

For some services, research evidence will exist which supports the effectiveness of the service. Based on this, standards may have been developed against which services can be assessed or audited (e.g. Standards developed by NHS Quality Improvement Scotland).  

For more information on research, audit and evaluation, please see the leaflet 'Defining Research' produced by the National Research Ethics Service, available via the link below. 
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(1): Research Governance Framework for Health and Social Care. Department of Health, 2005.
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(2): Principles for best Practice in Clinical Audit. © 2002 National Institute for Clinical Excellence.
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(3): Bowling A. Research methods in health. Investigating health and health services. Second edition. Open University Press, 1997.

(4): Notes on developing procedures within NHS organisations for appropriate authorisation and management of research and related projects. NHS Research & Development Forum, 2006.
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