Choice and judgement in developing models for health technology assessment; a qualitative study

Introduction: The role of models in supporting health policy decisions is reliant on model credibility. Credibility is fundamentally determined by the choices and judgements that people make in the process of developing a model. However, the method of uncovering choices and making judgements in model development is largely unreported and is not addressed by modelling methods guidance. Methods: This qualitative study was part of a project examining errors in health technology assessment models. In-depth interviews with academic and commercial modellers were used to obtain descriptions of the model development process. Data were analysed using framework analysis and interpreted in the context of the methodological literature. Results: The activities involved in developing models were characterised according to the themes; understanding the decision problem, conceptual modelling, model implementation, model checking, and engaging with the decision maker. Finding and using evidence was frequently mentioned across these themes. There was marked variation between practitioners in the extent to which conceptual modelling was recognised as an activity distinct from model implementation. Discussion: Methodological approaches to addressing model credibility described in the wider modelling literature highlight the necessity to disentangle the conceptual modelling and implementation activities. Whilst interviewees talked of judgements and choice making throughout model development, discussion indicated that these were based upon skills and experience with no discussion of formal approaches. Methods are required that provide for a systematic approach to uncovering choices, to generating a shared view of consensus and divergence, and for making judgements and choices in model development

Views on alternatives to imprisonment: a citizens jury approach

Abstract Alarming over-representation of Aboriginal and Torres Strait Islander people in Australian prisons, combined with high recidivism rates and poor health and social outcomes among those released from prison, has led many to claim that incarceration is a social policy failure. An important obstacle to a reform agenda in the criminal justice area is public opinion. The public are often perceived to hold punitive attitudes towards offenders, a situation often exploited by politicians to perpetuate punitive penal policies at the expense of developing decarceration initiatives. However, alternatives to public opinion surveys/polls are needed to assess the public’s views, as survey/poll-based methods typically present shallow, unconsidered public opinion and thwart good policy development and reform. Citizens Juries offer an alternative method to assess the public’s views, views that are critically informed and thus better aid policy development. This project aimed to explore, through Citizens Juries, the views of a critically informed public in three states/territories towards how we, as a community, should address offenders in terms of incarceration and incarceration alternatives. The research focused on a range of incarceration alternatives including Justice Reinvestment. The study also aimed to examine the thoughts of senior policymakers on the outcomes of Citizens Juries. This research provides important information and evidence in the offender health area and contributes to the Justice Reinvestment debate among offender health, criminal justice, political and community stakeholders.&nbsp

Online consultation on experts’ views on digital competence

The objective of this investigation was to provide another perspective on what it means to be digitally competent today, in addition to reviews of literature and current frameworks for the development of digital competence, 5 all of which constitute part of the wider IPTS Digital Competence Project (DIGCOMP). Some common ground exists at a general level in defining digital competence in terms of knowledge, skills, and attitudes, which may be hierarchically organised. However, this does not provide the clarity needed by teachers, employers, citizens – all those who are responsible for digital competence development, be it their own or other people’s ‐ to make informed decisions. Further work is needed to create a common language that helps to enhance understanding across the worlds of research, education, training, and work. This will make it easier for citizens and employers to see what digital competence entails and how it is relevant to their jobs and more generally, their lives

Integrating modes of policy analysis and strategic management practice : requisite elements and dilemmas

There is a need to bring methods to bear on public problems that are inclusive, analytic, and quick. This paper describes the efforts of three pairs of academics working from three different though complementary theoretical foundations and intervention backgrounds (i.e., ways of working) who set out together to meet this challenge. Each of the three pairs had conducted dozens of interventions that had been regarded as successful or very successful by the client groups in dealing with complex policy and strategic problems. One approach focused on leadership issues and stakeholders, another on negotiating competitive strategic intent with attention to stakeholder responses, and the third on analysis of feedback ramifications in developing policies. This paper describes the 10 year longitudinal research project designed to address the above challenge. The important outcomes are reported: the requisite elements of a general integrated approach and the enduring puzzles and tensions that arose from seeking to design a wide-ranging multi-method approach

Knowledge management and communities of practice in the private sector: lessons for modernising the National Health Service in England and Wales

The National Health Service (NHS) in England and Wales has embarked upon a radical and farreaching programme of change and reform. However, to date the results of organizational quality and service improvement initiatives in the public sector have been mixed, if not to say disappointing, with anticipated gains often failing to materialize or to be sustained in the longer term. This paper draws on the authors' recent extensive research into one of the principal methodologies for bringing about the sought after step change in the quality of health care in England and Wales. It explores how private sector knowledge management (KM) concepts and practices might contribute to the further development of public sector quality improvement initiatives in general and to the reform of the NHS in particular. Our analysis suggests there have been a number of problems and challenges in practice, not least a considerable naïvety around the issue of knowledge transfer and 'knowledge into practice' within health care organizations. We suggest four broad areas for possible development which also have important implications for other public sector organizations