The Frontline Context of Evidence-Informed Practice: Qualitative Findings from an 11 County Survey

Background & Purpose: Despite the rise in evidence-informed practice (EIP) models in the human services and a descriptive research literature, little is known about how human service workers use evidence to inform their practice and decision-making. Additionally, there has been little attention to the organizational factors promoting EIP (Alexanderson et al., 2009; Julkunen, 2011; Leung, 2009). Drawing from a large survey of public human service staff across 11 counties, this qualitative study aims to increase understanding of how supervisors and managers use evidence to inform their practice and enhance services and agency operations. 

Methods: A survey of senior and mid-level managers, supervisors, and administrative staff in 11 county social service agencies was conducted in June 2013. 497 of 958 agency staff who were invited to participate completed the online survey, corresponding with a response rate of 52%. Survey questions concerned: 1) opportunities for evidence use at work; 2) opportunities for learning and creativity; and 3) supports for EIP-related professional development. The current analysis examined data from open-ended questions related to: ideas for improving client services or agency operations; interest in EIP activities and training; defining and measuring service quality and outcomes. The analysis was carried out in Dedoose (qualitative analytic software) in a phased coding approach involving process, versus, and pattern coding (Saldaña, 2013).

Results: Three major themes emerged related to: 1) benefits of EIP at individual, agency, and client/community levels; 2) EIP processes; and 3) challenges to EIP. Individual benefits of EIP included personal growth, professional development, and improved staff morale. Organizational benefits included efficiency and responsiveness to demographic and practice changes. Client and community benefits included improved outcomes, service quality and engagement. Regarding core EIP processes,, respondents identified learning-oriented (e.g., developing staff), relationship-oriented (e.g., sharing knowledge), and task-oriented (e.g., monitoring using agency data) processes. Finally, challenges associated with EIP concerned: measurement processes; practice dilemmas; stakeholder perspectives; and resource limitations. Key measurement challenges included: defining goals and outcomes; determining models and metrics; and data availability, accessibility and accuracy. Practice dilemmas included the existence of practice silos where EIP was seen as irrelevant, and a disjuncture between service quality and positive outcomes. Perspectives of diverse stakeholders, including clients, community members, and external researchers were viewed as both contributing to and complicating EIP. Finally, while resource limitations were viewed as constraints on EIP, respondents also viewed EIP as promoting organizational efficiency.

Conclusion: Dominant stereotypes concerning EIP in the human services imply that practitioners can be intimidated by and uninterested in EIP. In strong contrast, these findings suggest that practitioners are engaged in multiple EIP processes from which they derive substantial value, and which they suggest provide multiple benefits. Yet findings also suggest that EIP can be complicated by organizational challenges related to measurement processes, practice dilemmas, stakeholder perspectives, and resource limitations. Greater practitioner attention to organizational development processes supporting EIP is thus warranted. Research is also needed to identify promising strategies to expand EIP engagement at all organizational levels.