Evaluation informed management and clinical governance

High or low quality is as much a result of how care systems are organised as it is a result of individual clinicians’ performance. Failure to introduce new care organisation or quality methods which research shows to be effective is as serious an omission as failing to act on poor clinical performance. Managers make many decisions about policies and organisation which affect the quality of care, but they rarely use evaluation research in making these decisions. Such research is difficult to find, produced using many different types of methods which are difficult for non‐experts to assess, often of poor quality, and difficult to translate to the local setting. However, managers can develop an evaluation informed practice, and make greater use of evaluation research in decisions with high cost or risk implications. The paper explains why the model of evidence‐based medicine is not appropriate, proposes instead a practical four‐step approach, and shows how managers can use evaluation in everyday practice.