Using qualitative mixed methods to study small health care organizations while maximising trustworthiness and authenticity

Abstract

BackgroundThe primary health care sector delivers the majority of health care in western countries through small, community-based organizations. However, research into these healthcare organizations is limited by the time constraints and pressure facing them, and the concern by staff that research is peripheral to their work. We developed Q-RARA—Qualitative Rapid Appraisal, Rigorous Analysis—to study small, primary health care organizations in a way that is efficient, acceptable to participants and methodologically rigorous.MethodsQ-RARA comprises a site visit, semi-structured interviews, structured and unstructured observations, photographs, floor plans, and social scanning data. Data were collected over the course of one day per site and the qualitative analysis was integrated and iterative.ResultsWe found Q-RARA to be acceptable to participants and effective in collecting data on organizational function in multiple sites without disrupting the practice, while maintaining a balance between speed and trustworthiness.ConclusionsThe Q-RARA approach is capable of providing a richly textured, rigorous understanding of the processes of the primary care practice while also allowing researchers to develop an organizational perspective. For these reasons the approach is recommended for use in small-scale organizations both within and outside the primary health care sector.

Referring to multimodal rehabilitation for patients with musculoskeletal disorders – a register study in primary health care

“…The final regression analyse showed the complexity between factors impact on referral to MMR, such as socioeconomic status, PHCC location/ community size, and whether or not the PHCC provided their own MMR. The importance of organisational factors is confirmed in several recent studies [18, 47, 49]. …”

“…Accounting for quality in healthcare can be problematic and can result in counterproductive effects when it is not fully understood [48]. Phillips et al [49] describes another measurement for health care organisations including interviews and observations to assess the quality in health care. Changes in the methods used and how work is organised in health care could lead to a better use of different competencies.…”

Optimising a complex stroke caregiver support programme in practice: a participatory action research study

“…Using more than one method helped us to take advantage of the strengths of both, as reported by Creswell (2009). Moreover, it augmented the trustworthiness of this study (Phillips et al 2014). By first analysing each dataset separately, and then integrating the findings in the CBBs, we achieved data convergence and complementarity (Greene, Caracelli, and Graham 1989).…”

How Do We Work as Researchers in the Real World? Mapping the Trajectory of Methodological Decision Making in Health Services Research

“…The "qualitative rapid appraisal, rigorous analysis" approach, specifically developed for multisite analysis, is one of the few available frameworks (Phillips et al, 2014). We selected this approach due to its track record with similar methods as well as coherence with our previously described methodological position concerning the retention of site specificity (Phillips et al, 2014).…”