‘What counts as knowledge and whose knowledge counts?’
Hodgson and Canvin, 2005
What do we mean by effective evidence?
Using evidence to inform practice is at the heart of the performance and improvement framework for social services. A longstanding debate in health and social care revolves around questions of how ‘evidence’ is defined and whose knowledge, or evidence, counts. For the purposes of this Resources Guide, we are using the following definition of effective evidence, which has been developed in discussions with local authority staff in Wales.
Effective evidence: a consensus definition
Effective evidence helps develop an understanding of phenomena and answers questions. It is contextual, relevant and timely, drawing on different sources of knowledge (e.g. research, lived experience, practitioner and organisational knowledge). Effective evidence is accessible, and all relevant individuals can engage with it. It is useful and can lead to improvement, but it is also open (transparent) about its limitations.
Taking a whole system approach
Sandra Nutley and her colleagues at the Research Unit for Research Utilisation, University of St Andrews, a team of well-respected academics who have published widely on ‘what works’ and the use of evidence in practice, suggest this is a complex task. It requires taking a whole system approach to using evidence that gathers and applies evidence across three aspects of any organisation involved:
- Practitioners: having evidence that is engaging and can be applied in practice.
- Embedded systems: research evidence to design organisational systems, processes and environments in ways that allow practitioners to use and apply the evidence they engage with.
- Organisational culture:having good learning environments within organisations that make practitioners feel valued, safe and able to experiment and try things out.
The Developing Evidence Enriched Practice (DEEP) programme, developed in Wales, has a range of tools and approaches to support taking a whole system approach to the generation and use of evidence.
Community of Enquiry Guide. IRISS.
This provides a practical step-by-step guide to using a community of enquiry approach.
Below are case studies of evidence informed performance improvement.
Refreshing Respite - gathering and using diverse types of evidence in a review of respite care.
In early 2019, the West Wales Care Partnership decided to undertake a review of respite care services across the region. Working with the Wales School for Social Care Research, they began by exploring research evidence and organisational evidence about respite from other parts of the UK and then used this as a catalyst to gather local contextual knowledge from carers, practitioners and the people they support. They achieved this through Exploratory Talk discussions in each of the three counties. These discussions were audio-recorded, transcribed and then analysed for key themes. These themes and many of the associated stories and quotes were then shared in a regional event involving a researcher, senior managers, practitioners, carers and the people they support. Participants at this event worked collectively to identify a set of principles and priorities for development, which were then incorporated into the Refreshing Respite report and associated recommendations.
Key themes raised during the day were also woven into a poem that was shared at the end of the event. This poem supported a connection between head and heart in what matters most. Members of the Partnership are currently taking some of these themes forward, including an exploration of how local hospitality services can contribute to providing short breaks for carers. Their dialogic approach to exploring and using diverse types of evidence had the additional benefit of building relationships and trust between carers, practitioners and managers.
North Wales Research, Innovation and Improvement Coordination Hub
The North Wales Research, Innovation and Improvement Coordination Hub is carrying out a review of innovations in health and social care that took place due to the Covid-19 pandemic. The work will use Most Significant Change techniques to capture people’s stories about the changes that took place and to learn from them. The findings of the work will be used to identify which changes we should keep and where we need to improve, particularly around integrated health and social care and the use of digital technologies.