Evaluating health system change--using focus groups and a developing discussion paper to compile the "voices from the field".

The authors describe the contribution of a series of focus groups and a progressively revised discussion paper to the evaluation of health care reform in South Australia. The focus groups informed the evaluation about participants' experiences of the impact of reform on their agencies while enabling increased understanding about change in the health system. A discussion paper describing global health service trends and emerging findings from our evaluation was prepared prior to the first focus group and subsequently revised to incorporate participants' comments before being sent to the next group. The results was a paper that enhanced participants' discussion, and reflected their views. As an action research-based method, this iterative process was valuable for participants and the evaluation, and supported organizational learning.