The STS case study: an analysis method for longitudinal qualitative research for implementation science

Abstract

Background Ethnographic approaches offer a method and a way of thinking about implementation. This manuscript applies a specific case study method to describe the impact of the longitudinal interplay between implementation stakeholders. Growing out of science and technology studies (STS) and drawing on the latent archaeological sensibilities implied by ethnographic methods, the STS case-study is a tool for implementors to use when a piece of material culture is an essential component of an innovation. Methods We conducted an ethnographic process evaluation of the clinical implementation of tele-critical care (Tele-CC) services in the Department of Veterans Affairs. We collected fieldnotes and conducted participant observation at virtual and in-person education and planning events (n = 101 h). At Go-Live and 6-months post-implementation, we conducted site visits to the Tele-CC hub and 3 partnered ICUs. We led semi-structured interviews with ICU staff at Go-Live (43 interviews with 65 participants) and with ICU and Tele-CC staff 6-months post-implementation (44 interviews with 67 participants). We used verification strategies, including methodological coherence, appropriate sampling, collecting and analyzing data concurrently, and thinking theoretically, to ensure the reliability and validity of our data collection and analysis process. Results The STS case-study helped us realize that we must think differently about how a Tele-CC clinician could be noticed moving from communal to intimate space. To understand how perceptions of surveillance impacted staff acceptance, we mapped the materials through which surveillance came to matter in the stories staff told about cameras, buttons, chimes, motors, curtains, and doorbells. Conclusions STS case-studies contribute to the literature on longitudinal qualitive research (LQR) in implementation science, including pen portraits and periodic reflections. Anchored by the material, the heterogeneity of an STS case-study generates questions and encourages exploring differences. Begun early enough, the STS case-study method, like periodic reflections, can serve to iteratively inform data collection for researchers and implementors. The next step is to determine systematically how material culture can reveal implementation barriers and direct attention to potential solutions that address tacit, deeply rooted challenges to innovations in practice and technology.

Using multiple qualitative methods to inform intervention development: Improving functional status measurement for older veterans in primary care settings

“…These dual challenges-of implementing routine screening in primary care and developing HIT that enhances rather than detracts from clinician and patient experience-underline the importance of sociotechnical frameworks for informing intervention design. Our study is part of a growing literature employing these concepts to inform intervention development and HIT implementation in healthcare settings [50,51,88,90,91]. This and prior studies show how understanding clinician experience and organizational context provides insight into unintended consequences of HIT implementation, including "alert fatigue," cumbersome tools that exacerbate time limitations, and concerns that documentation does not inform patient care.…”

“…"Sociotechnical" approaches can complement implementation science concepts by increasing our understanding of the dynamic and complex nature of healthcare systems [47][48][49][50][51].…”

Comparison Reviews on E-commerce Research Methods: Suggestions for Post-COVID-19

“…The main advantage of a case study was that researchers might use case studies for mainly unexplored or underexamined topics for which little or scarce empirical evidence existed (Çakar & Aykol, 2021). Another advantage was that researchers and implementors might engage with the complex implementation process and inform data collection by tracking changes over time (Van Tiem et al, 2021).…”

Implementing a tobacco-free workplace program at a substance use treatment center: a case study

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