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

BMC Medical Research Methodology

Julia E. Friberg¹  Jaime R. Wilson¹  Jane Moeckli¹  Jennifer M. Van Tiem¹  Heather Schacht Reisinger²  Ralph J. Panos³  Lynn Fitzwater³ 

[1] VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, IA, USA;VA Health Services Research & Development Service, Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System (152), 601 Highway 6 West, 52246, Iowa City, IA, USA;VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, IA, USA;VA Health Services Research & Development Service, Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System (152), 601 Highway 6 West, 52246, Iowa City, IA, USA;The Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA;Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA;VISN 10/Cincinnati Tele-CC System, Cincinnati, OH, USA;

关键词: Longitudinal qualitative research;    Science and technology studies;    Implementation;    Telemedicine;    Critical care;    Ethnography;   

DOI  :  10.1186/s12874-021-01215-y

来源: Springer

【 摘 要 】

BackgroundEthnographic 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.MethodsWe 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.ResultsThe 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.ConclusionsSTS 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.

【 授权许可】

CC BY