Science provides explanations of some observable phenomena, without resorting to a reliance on supernatural explanations. Kuhn (1996), however, challenged the view that science was a uniquely rational activity. ‘Normal Science’, as described by Kuhn (1996), is research firmly based upon past scientific achievements, which some particular scientific community acknowledges (for a particular time) as supplying the foundation for its further practice.
Scientists commonly recognise that they study their ‘conceptualisation’ of the world and that there is no such objective independent entity as the ‘real world’. For business research studies, Stablein (1996) proposed a definition of data for organisation studies: “data in organisational studies are representations which maintain a two way correspondence between an empirical reality and a symbol system" (p. 514). Science is not an isolated activity and the collection of data, by any researcher, will be based on a frame of reference, from which the researcher has come — and the area of the research, to which he/she is contributing. This is the paradigm of research (Kuhn, 1996).
A continuum of views exists on the nature of science: at one end, a reductionist/ positivist type paradigm of scientific work and at the other end, an irreductionist/
constructivist type paradigm of science. The reductionists aspire to a hierarchy of sciences, where mature sciences, such as physics and chemistry, are at the top. These sciences have significant theory development and a high level of quantitative (‘objective’) measures and predictability. The irreductionists/constructivists accept qualitative research approaches and they view incommensurable and partially incommensurable paradigms and theories, as normal aspects of the ongoing development of scientific knowledge (Kaghan & Phillips, 1998).
Organisations are complex and they can be viewed in a number of different ways, which require different research paradigms. The positivist and constructivist type viewpoints of science make significant assumptions concerning research methodology and the research approaches to be used (Kaghan & Phillips, 1998). The research approaches that need to be considered are: an experimental or non- experimental approach; an inductive or deductive research approach; and a quantitative or qualitative approach. Worthwhile research frequently uses both a quantitative or qualitative approach, in order to obtain a high-quality understanding of the subject of study (Robson, 2002).
KPP was implemented into DHBs without any underpinning theory or previous validation. . The purpose of this research was to both evaluate KPP and explain the findings which in turn contribute to the further development of co–production theory. Ticehurst & Veal (2000) assert that evaluation research arises from the need to make judgements on the success or effectiveness of programs, strategies, policies or practices. Explanatory research seeks to explain the patterns or trends involved, in order to establish causality or the likelihood of causality. Establishing causality requires rigorous data collection, analysis, and interpretation of data within a theoretical framework. A quantitative approach was taken in this research in order to enable causality to be tested. A qualitative approach using observation, informal and in depth interviewing and participant observation would not have enabled me to test for causality. Further, a qualitative approach would have increased the cost of the research and presented significant ethical issues in relation to interviewing long– term clients.
In practice, data is rarely collected without some explanatory model in mind so there is some element of deduction, further it is not possible to develop hypotheses and theories without at least some initial information on the subject in hand, so there is also always an element of induction. This research has both inductive and deductive and retroductive aspects.
KPP was implemented in-situ, thus making true experiments impossible however a quasi–experimental analysis of secondary data was possible.
Management thinking and research has continued to develop in recent times building on the classical (scientific and administrative theories), behavioural, and human relations thinking and research. Modern management thinking and research approaches use both the quantitative approaches and systems theories. Quantitative research is also known as management science or operational research and grew out of statistical approaches first developed during the Second World War. This approach is used to improve the allocation of resources, work scheduling and management decision–making and relies heavily on computer– based applications. Systems theory considers an organisation as a system of interrelated parts. Closed systems are seen to operate independently of their environment and they reflect the frame of reference of the classical management school of thinking and research. Open systems are seen to interact with their external environment (Ticehurst & Veal, 2000). The long–term KPP mental health patients are external to the health organisation, so this research requires an open system theoretical dimension.
Anderson & Lyons (2001) stated that there is only limited evidence to guide the organisation of mental health services. Community mental health service studies have not generally used a standard set of evaluation methods (Dewa, Durbin, Wasylenki, Ochocka. Eastbrook, Boydell & Georing, 2002). Goldman, Thenlander & Westerin, (2000) contend that overall studies of systems typically suffer from a lack of ability to:
• randomly assign clients
• deal with the complexities of longitudinal studies and funding.
Evaluating Managed Mental Health Services: The Fort Bragg Experiment. (Bickman, Gutherie, Foster, Lambert, Summerfelt, Breda & Heflinger, 1995) is considered to be exemplary research in the field, as it won an American Mental Health Research award. The study used program theory, as a basis for the research. Programme theory alerts us to the importance of ensuring clarity of context and rationale for the research, and having a plausible and sensible model of how a program is supposed to work. The possibility of ambiguous temporal precedence is significantly reduced by having clear implementation information that provides baseline data for the evaluation (Shadish, Cook, & Leviton, 1991). The Fort Bragg experiment consisted of two broad phases, the first was to implement a Continuum of Care for Child & Youth at Fort Bragg, and provide evidence that the continuum of care was implemented with sufficient fidelity to allow meaningful examination of the program outcomes. The second phase was to evaluate the outcomes of the program in a quasi-experimental way by comparing a standard of care approach to the continuum of care approach. The types and methods of data collection included: semi structured diagnostic interviews, behavioural checklists, family well-being measures, satisfaction scales, and provider surveys and records review. Data was also collected on acute inpatient care, residential treatment, non- residential activity, crisis calls, and clinical case management, out patient and psychiatric/psychological assessment.
A program theory approach was chosen to evaluate KPP that included an implementation phase and an outcome phase based on open systems theory supported by a quasi–experimental analysis of secondary data to rule out other possible explanations of the outcome findings. Various versions of open system theories were reviewed and their approaches ruled out as not being suitable for this research. For example, Selsky & Barton (2000) undertook a significant study using opens systems theory, based on domains, at New Zealand’s Otago shipping port. The study identified a set of tools for effectively managing ports however; my interest was in identifying a method for evaluating the KPP tool that we had already developed. Further, mental health service delivery relies heavily on the relationships with client, staff, families and other services (Alexander, Bloom,
Zazzali & Jinnett, 1999). Emery’s open systems theory (Emery, 2000) was chosen as a basis for the outcome research, as it is designed to cope with the uniqueness of human nature, and it provides the theoretical basis for the socioecological action research method (Gloster, 2000), which was able to be applied to the KPP process.