Ethnographic research as an evolving method for supporting healthcare improvement skills: a scoping review

Abstract

Background The relationship between ethnography and healthcare improvement has been the subject of methodological concern. We conducted a scoping review of ethnographic literature on healthcare improvement topics, with two aims: (1) to describe current ethnographic methods and practices in healthcare improvement research and (2) to consider how these may affect habit and skill formation in the service of healthcare improvement. Methods We used a scoping review methodology drawing on Arksey and O’Malley’s methods and more recent guidance. We systematically searched electronic databases including Medline, PsychINFO, EMBASE and CINAHL for papers published between April 2013 – April 2018, with an update in September 2019. Information about study aims, methodology and recommendations for improvement were extracted. We used a theoretical framework outlining the habits and skills required for healthcare improvement to consider how ethnographic research may foster improvement skills. Results We included 283 studies covering a wide range of healthcare topics and methods. Ethnography was commonly used for healthcare improvement research about vulnerable populations, e.g. elderly, psychiatry. Focussed ethnography was a prominent method, using a rapid feedback loop into improvement through focus and insider status. Ethnographic approaches such as the use of theory and focus on every day practices can foster improvement skills and habits such as creativity, learning and systems thinking. Conclusions We have identified that a variety of ethnographic approaches can be relevant to improvement. The skills and habits we identified may help ethnographers reflect on their approaches in planning healthcare improvement studies and guide peer-review in this field. An important area of future research will be to understand how ethnographic findings are received by decision-makers.

The Pervasiveness of Power: Dilemmas for Researchers of Major System Change in Healthcare Comment on "‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration"

“…As noted, Perry et al add an important historical dimension to a burgeoning ethnographic literature. Ethnographic research into healthcare improvement more generally can reveal the influence of power relations and systems, 13 and therefore helps elucidate a political dimension of MSC in healthcare that is not immediately evident otherwise. For example, in their study of the engagement carried out as part of a regional transformation plan in the National Health Service (NHS) in England, Carter and Graham explore the ‘micro-politics’ of patient and public involvement.…”

Correction to: Ethnographic research as an evolving method for supporting healthcare improvement skills: a scoping review

“…Following publication of the original article [ 1 ], the authors noticed that Fig. 1 was incorrect and it needs to be updated.…”