Pluralistic evaluation: a situational approach to service evaluation

Background  The increasing emphasis upon fiscal accountability within the British National Health Service has contributed to demand for evaluating the effectiveness of specific interventions and programmes of care. Whilst there is need for proficient measures of effectiveness, the achievement of this ideal is illusive. Issues of perspective, method and the social nature of healthcare contribute to the complexities of evaluation research. Presented with the task of evaluating the effectiveness of health services, academics and healthcare professionals are striving to seek responsive and adaptive methods of measuring success. Aim  This paper critically debates an approach to healthcare evaluation, which claims to respond to the dynamic and thorny issues that arise. Discussion clarifies whether a pluralistic approach to evaluation can measure success upon a criterion which represents the views of key stakeholders. Method  This paper is underpinned by a review of the literature and reflects health, research and management opinions. Literature search methods follow the custom of electronic databases, bulletins boards and the British Library Classification Scheme. Keywords searched are healthcare evaluation, evaluation research, pluralistic evaluation, organizational and policy evaluation. Findings  The integration of policy perspectives and evaluation studies suggests that the pluralistic approach can formulate situational healthcare evaluation. However, there remains a likelihood of marginalizing the viewpoints of particular stakeholder groups. The role of the researcher is to co‐ordinate reliable findings and safeguard against the bias associated with traditional professionally dominated methods of healthcare evaluation. Conclusion  Analysis suggests that pluralistic evaluation has the potential to develop a deep and real illustration of service provision and provide a basis upon which to develop recommendations.