Studying health care "quality" qualitatively: the dilemmas and tensions between different forms of evaluation research within the U.K. National Health Service.

The authors tell the story of an attempt to depart from a tradition of evaluation research (ER) and to address the research-practice interface in a different way through a more hands-on, action research (AR) approach, which combines qualitative and quantitative methods. In doing so, they raise issues about the role and nature of evaluation for development and, especially, about the place of qualitative research in such evaluations; the identity of future ER; "paradigm wars" between the positivists and the phenomenologists; and the politics of conducting policy-based evaluations in health care settings and of what happens when qualitative researchers try to help an improvement process.