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Evaluating the Q Lab: embedding reflective practice

At the Q Lab we claim to offer a new approach to making progress on health and care challenges. Our model for change combines approaches from a number of ‘innovation labs’ with tools and techniques from design and quality improvement.

Evaluation is important to the Lab, to help us understand whether our approach is making progress on health and care challenges, and how the approach can be further improved and developed to support change in health and care.

Our learning from the Lab’s pilot project (on peer support) helped identify more clearly the four areas in which we are seeking to achieve impact in order to make progress on a specific health and care challenge. During the Lab’s second project – on how to improve care for people with both mental health problems and persistent back and neck pain (in partnership with Mind – the mental health charity), we want our evaluation to get further under the skin of this.

Q Lab impact model

Good evaluation is rarely easy. A challenge I’ve often experienced in my time working on evaluations within third sector organisations is striking the balance between evaluation to prove that what you are doing results in positive change, and committing time to consider what needs to be done to improve what you are doing, to better achieve that change. In my experience, we often say we want to achieve the latter, but in competitive and uncertain funding environments, we tend to focus more on the former. At the Q Lab we are striving for this balance.

How are we evaluating our work this year?

Our evaluation is a blend of internal and external evaluation. Our external evaluators – the Innovation Unit – bring experience in social innovation and scaling evidence-based solutions to help frame what we are doing within the wider context of social innovation and health improvement.

They are taking an active learning approach through a learning loop methodology – while this isn’t a new idea, I think it’s a really exciting way to structure an evaluation. It puts emphasis on the immediate learning and reflections, which will help us to be more responsive to change.

So far, our evaluation has involved interviews with Lab participants and our partners Mind, participation at workshops and team meetings, and an evidence review to frame our work within the external context.

What are we learning so far?

That through our collaborative research activities, the Lab is well placed to collate and make sense of multiple perspectives on a complex topic, rather than coming up with brand new insights and data. Our UK-wide view allows us to better connect people’s local experiences and practice with the wider, system view of the problem.

“It has helped me to get a broader perspective, to understand that this is a systematic problem, not just a local challenge that we’re experiencing”.

It is an important part of the Lab methodology to spend time understanding the problem, and not to jump straight to solutions (you can read more about why in our essay here). However, shining a light on best practice and solutions that could possibly be scaled is something that the Lab could improve on, to enable others to make more rapid progress in building and testing solutions in practice.

The evaluation has also highlighted the importance Lab participants place on finding out not just about what might work, but how to translate this into their own context. This is something that the team will be particularly mindful of when collecting and sharing learning from the testing phase.

“We often try and impose things that we think work on others but what we write about them is too general – ‘we did this and it works’ –  which doesn’t reflect the context that was required for something to work. So a real understanding of the context is somewhere I would like to get to.”

And finally, we’ve heard that experiential learning remains powerful: while we provide an online space for people interested in the topic to make virtual connections, people value the opportunities the Lab provides to meet in-person, to generate and share ideas in new, creative ways. We place value in recruiting a wide array of people to contribute their expertise to the Lab process and  to drive the work, but we recognise that we need to create meaningful, and accessible, ways for everyone to participate.

Surfacing these challenges and learning has been a useful process to help us to reflect what we can change and improve. The work we’ve started with four organisations to develop and test ideas to improve care for people living with mental health problems and persistent back and neck pain is a new venture for the Lab – and will generate even more learning about how the Q members can encourage sustained change in health and care. We will continue to share this learning with the Q community.

If you’re interested in evaluation, you can join the Q special interest group to connect with others involved in this work within quality improvement.

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