Service evaluation, audit and research: what is the difference? Alison Twycross, 1 Allison Shorten 2 Knowing the difference between health service evalu- ation, audit and research can be tricky especially for the novice researcher. Put simply, nursing research involves finding the answers to questions about “what nurses should do to help patients,” audit examines “whether nurses are doing this, and if not, why not,” 1 and service evaluation asks about “the effect of nursing care on patient experiences and outcomes.” In this paper, we aim to provide some tips to help guide you through the decision-making process as you begin to plan your evaluation, audit or research project. As a starting point box 1 provides key definitions for each type of project. How do I decide whether my project is service evaluation, audit or research? Despite their differences there are clear similarities between service evaluation, audit and research. All start with important questions, require data to answer the questions, and each needs a systematic approach and sound design. 1 Research methodologies are often used to evaluate practice or measure outcomes, so this can be confusing. The key differences in approach relates mostly to project scope and intent. Table 1 outlines key criteria to help guide your decision-making about what might be the right approach for different types of clin- ical projects. So if, for example, we were to explore management of children’s postoperative pain we could: 1 Undertake a service evaluation and ask parents and children to complete a questionnaire about how well they think postoperative pain was managed for them during their experience on the paediatric unit. 2 Complete an audit by comparing postoperative pain management practices in the paediatric unit to current best practice guidelines using a standardised data collection tool. 3 Undertake a research project to identify the most effective postoperative pain management practices for children. Online resource The Health Research Authority in the UK has a useful online decision-making tool—see: http://www.hra.nhs.uk/research-community/before-you- apply/determine-whether-your-study-is-research/ Box 1 Definitions of service evaluation, audit and research ▸ What is service evaluation? Service evaluation seeks to assess how well a service is achieving its intended aims. It is undertaken to benefit the people using a particular healthcare service and is designed and conducted with the sole purpose of defining or judging the current service. 2 The results of service evaluations are mostly used to generate information that can be used to inform local decision-making. ▸ What is (clinical) audit? The English Department of Health 3 states that: Clinical audit involves systematically looking at the procedures used for diagnosis, care and treatment, examining how associated resources are used and investigating the effect care has on the outcome and quality of life for the patient. Audit usually involves a quality improvement cycle that measures care against predetermined standards (benchmarking), takes specific actions to improve care and monitors ongoing sustained improvements to quality against agreed standards or benchmarks. 45 ▸ What is research? Research involves the attempt to extend the available knowledge by means of a systematically defensible process of enquiry. 6 Table 1 Key criteria to consider when deciding whether your project is service evaluation, audit or research 27 Service evaluation Audit Research Overall aim (intent) To judge the quality of the current service To measure clinical practice against a standard To generate new knowledge/ add to the body of knowledge Initiated by Service providers Service providers Researchers Involves a new treatment No No Sometimes Randomisation No No Sometimes Allocates patients to treatment groups No No Sometimes Editor’s choice Scan to access more free content 10.1136/eb-2014-101871 1 Faculty of Health and Social Care, London South Bank University, London, UK 2 Yale University School of Nursing, New Haven, Connecticut, USA Correspondence to: Dr Alison Twycross Faculty of Health and Social Care, London South Bank University, London SE1 0AA, UK; alisontwycross@hotmail.com Evid Based Nurs July 2014 | volume 17 | number 3 | 65 Research made simple group.bmj.com on April 19, 2017 - Published by http://ebn.bmj.com/ Downloaded from