The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia.
The School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
Health Res Policy Syst. 2020 May 12;18(1):45. doi: 10.1186/s12961-020-00562-4.
Effective efforts to strengthen health systems need diverse, multi-stakeholder networks working together on complex or 'wicked' problems such as prevention and control of chronic diseases, solutions to which go beyond the role and capability of one organisation. The contextual complexities inherent in 'wicked' problems mean that solutions warrant a systems approach that encompasses innovation and new ways of thinking about, facilitating and implementing collective decision-making processes and change practices.Innovation platforms are a mechanism for facilitating communication and collaboration among diverse stakeholders, promoting joint action and stimulating innovation. Developmental evaluation is an approach that is increasingly being used to evaluate innovative and emergent programmes and projects, as it enables evaluators to provide real-time feedback so that evaluation findings can be used to guide development and adaptations. Developmental evaluation emphasises learning and adaptation, and aligns well with the implementation of innovation platforms that have continuous reflection, learning and adaptation as a specific design principle.Here, we outline our rationale for applying a developmental evaluation to enhance the formation, functioning and outcomes of an innovation platform aimed at accelerating and strengthening large-scale quality improvement efforts in Australian Aboriginal and Torres Strait Islander primary healthcare. We provide examples to explain how the developmental evaluation findings were used for adaptation of the innovation platform and assess to what extent our application of developmental evaluation was consistent with, and reflective of, its essential principles.Our evaluation aligned strongly with the principles of developmental evaluation, and the approach we took was well suited to situations with a developmental purpose, innovation niche and complexity such as innovation platforms. As a result, along with the increasing interest in multi-stakeholder platforms (e.g. innovation platforms) and the inherent challenges with evaluating these complex networks, we anticipate our use of this approach being of interest globally.
为了加强卫生系统，需要各种利益攸关方网络共同努力，解决诸如预防和控制慢性病等复杂或“棘手”问题，而这些问题的解决方案超出了一个组织的作用和能力。“棘手”问题固有的背景复杂性意味着解决方案需要系统的方法，包括创新和新的思维方式，以促进和实施集体决策过程和变革实践。创新平台是促进不同利益攸关方之间沟通和协作的机制，促进联合行动和激发创新。发展性评价是一种越来越多地用于评估创新和新兴计划和项目的方法，因为它使评价者能够提供实时反馈，以便将评价结果用于指导发展和调整。发展性评价强调学习和适应，与具有持续反思、学习和适应作为特定设计原则的创新平台的实施非常吻合。在这里，我们概述了将发展性评价应用于增强创新平台的形成、运作和结果的基本原理，该平台旨在加速和加强澳大利亚原住民和托雷斯海峡岛民初级保健中的大规模质量改进工作。我们提供了一些示例，解释了如何利用发展性评价的结果来调整创新平台，并评估我们对发展性评价的应用在多大程度上符合并反映了其基本原则。我们的评价与发展性评价的原则密切一致，我们采取的方法非常适合具有发展目的、创新利基和复杂性的情况，如创新平台。因此，随着对多利益攸关方平台（如创新平台）的日益关注，以及评估这些复杂网络所固有的挑战，我们预计我们对这种方法的应用将在全球范围内引起关注。
