Analys av Region Östergötlands utvärderingar inom det kris och katastrofmedicinska området avseende genomförande, resultat och effekt
2023
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Background:
Within Region Östergötland, evaluations of crisis and disaster medical preparedness are routinely conducted following real incidents and crisis management exercises. Despite their prevalence, uncertainty has existed regarding how these evaluations are performed, what types of findings and action proposals they generate, and to what extent these proposals result in concrete organizational change.
Within Region Östergötland, evaluations of crisis and disaster medical preparedness are routinely conducted following real incidents and crisis management exercises. Despite their prevalence, uncertainty has existed regarding how these evaluations are performed, what types of findings and action proposals they generate, and to what extent these proposals result in concrete organizational change.
Objective:
The aim of this study was to systematically analyze evaluations conducted within the crisis and disaster medical domain in Region Östergötland between 2012 and 2022, with a focus on evaluation design, methodological approaches, generated action proposals, and the degree to which these proposals were implemented.
The aim of this study was to systematically analyze evaluations conducted within the crisis and disaster medical domain in Region Östergötland between 2012 and 2022, with a focus on evaluation design, methodological approaches, generated action proposals, and the degree to which these proposals were implemented.
Results:
A document analysis of 24 evaluation reports identified 202 action proposals. Most evaluations relied on qualitative data, primarily observations, indicators, and document analysis, and were predominantly conducted by internal evaluators. Methodological justification and references to evaluation theory were rare, and user or stakeholder involvement was limited. Action proposals most frequently targeted competence development, working methods, and routines, and were distributed across micro-, meso-, and macro-level implementation. A focus group interview revealed that 28% of action proposals were implemented directly as a result of the evaluations, while 45% were implemented but could not be directly attributed to a specific evaluation. Only 12% were not implemented. Evaluations of real incidents, those using interviews, workshops, or surveys, and those that provided arguments or guidance for implementation were more likely to result in directly attributable implemented actions. Thematic analysis indicated that many proposals reiterated previously identified issues or ongoing work and were often vaguely formulated.
A document analysis of 24 evaluation reports identified 202 action proposals. Most evaluations relied on qualitative data, primarily observations, indicators, and document analysis, and were predominantly conducted by internal evaluators. Methodological justification and references to evaluation theory were rare, and user or stakeholder involvement was limited. Action proposals most frequently targeted competence development, working methods, and routines, and were distributed across micro-, meso-, and macro-level implementation. A focus group interview revealed that 28% of action proposals were implemented directly as a result of the evaluations, while 45% were implemented but could not be directly attributed to a specific evaluation. Only 12% were not implemented. Evaluations of real incidents, those using interviews, workshops, or surveys, and those that provided arguments or guidance for implementation were more likely to result in directly attributable implemented actions. Thematic analysis indicated that many proposals reiterated previously identified issues or ongoing work and were often vaguely formulated.
Conclusions:
The findings suggest that evaluations within Region Östergötland are not without effect, as a majority of action proposals are implemented in some form. However, evaluations often confirm already known deficiencies rather than generating novel insights. To increase their impact, future evaluations should employ diversified data collection methods, clearly define their purpose, involve users and stakeholders, reference and justify methodological choices, and present concrete, well-argued, and implementable action proposals.
The findings suggest that evaluations within Region Östergötland are not without effect, as a majority of action proposals are implemented in some form. However, evaluations often confirm already known deficiencies rather than generating novel insights. To increase their impact, future evaluations should employ diversified data collection methods, clearly define their purpose, involve users and stakeholders, reference and justify methodological choices, and present concrete, well-argued, and implementable action proposals.
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