Avoiding evaluation cooptation. Lessons from a renal dialysis evaluation.

An evaluation of the impact of terminating contracts to transport low-income patients for renal dialysis demonstrates how evaluators may become apologists for management and conduct studies too narrow for effective decision making. The evaluation found that patients continued to receive treatment; their death rates had not increased. Changes in their economic and emotional status were not studied; consequently, the evaluators erroneously concluded that the clients had not been seriously harmed. The article reviews the process the evaluation used. The authors conclude that to avoid cooptation, evaluators need independent information available through conducting and analyzing pilot studies and meeting with program constituents. To avoid overly narrow studies, the next level of management should participate in their design. To use the information effectively, evaluators need to see themselves as advisors rather than technicians.