https://doi.org/10.4081/qrmh.2021.9821
Using observation to better understand the healthcare context
Submitted: 20 April 2021
Accepted: 11 January 2022
Published: 31 January 2022
Accepted: 11 January 2022
Abstract Views: 4414
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Despite potential to capture rich contextual information, observation remains an underutilized data collection method. This paper provides a practical guide for using observation to understand complex issues in healthcare settings. Observation is a qualitative data collection method comprised of viewing and documenting phenomena in the usual environment. Drawing on our recent work using observation to better understand personal protective equipment use among healthcare personnel, we describe when to consider collecting data via observation, how to prepare and perform observation, and how to analyze resulting data. Observation data are documented in field notes that contain detailed information about setting, participants, and activity associated with the topic of interest. Field notes can be analyzed alone or triangulated with other types of data using theoretical or conceptual frameworks or by identifying themes. Observation is a valuable data collection method for health services researchers to identify key components involved in a topic of interest, a vital step in forming relevant questions, measuring appropriate variables, and designing effective interventions. Used with other methods or alone, observation yields the detailed data needed to address context-specific factors across a wide range of healthcare research topics and settings.
Keller J, Wolfensberger A, Clack L, et al. Do wearable alcohol-based handrub dispensers increase hand hygiene compliance?-a mixed-methods study. Antimicrob Resist Infect Control
;7:143.
Kea B, Alligood T, Robinson C, et al. Stroke prophylaxis for atrial fibrillation? To prescribe or not to prescribe—A Qualitative study on the decisionmaking process of emergency department providers. Ann Emerg Med 2019;74:759-71.
DOI: https://doi.org/10.1016/j.annemergmed.2019.03.026
Daliri S, Bekker CL, Buurman BM, et al. Barriers and facilitators with medication use during the transition from hospital to home: a qualitative study among patients. BMC Health Serv Res 2019;19:204.
DOI: https://doi.org/10.1186/s12913-019-4028-y
Pettit KE, Rattray NA, Wang H, et al. Coming in warm: Qualitative Study and concept map to cultivate patient‐centered empathy in emergency care. AEM Educ Train 2019;3:136-44.
DOI: https://doi.org/10.1002/aet2.10328
Emmerson RM, Fretz RI, Shaw LL. Writing ethnographic fieldnotes. Chicago, IL: University of Chicago. 1995.
DOI: https://doi.org/10.7208/chicago/9780226206851.001.0001
Adler PA, Adler P. Observation techniques. In: Denzin NK, Lincoln YS, eds. Collecting and interpreting qualitative materials. Thousand Oaks, CA: Sage; 1998. p. 79-109.
Bernard HR. Research methods in anthropology: Qualitative and quantitative approaches: Rowman & Littlefield; 2017.
Atkinson P, Hammersley M. Ethnography and participant observation. Strategies of Qualitative Inquiry Thousand Oaks: Sage. 1998:248-61.
Brinkmann S, Jacobsen MH, Kristiansen S. Historical overview of qualitative research in the social sciences. The Oxford handbook of qualitative research. 2014:17-42.
DOI: https://doi.org/10.1093/oxfordhb/9780199811755.013.017
Horwitz LI. The importance of user-centered design and evaluation: Systems-level solutions to sharp-end problems. JAMA Internal Med 2018;178:1023-4.
DOI: https://doi.org/10.1001/jamainternmed.2018.1902
Pope C, Van Royen P, Baker R. Qualitative methods in research on healthcare quality. BMJ Quality & Safety 2002;11:148-52.
DOI: https://doi.org/10.1136/qhc.11.2.148
Krein SL, Mayer J, Harrod M, et al. Identification and characterization of failures in infectious agent transmission precaution practices in hospitals: a qualitative study. JAMA Internal Med 2018;178:1051-7.
DOI: https://doi.org/10.1001/jamainternmed.2018.1898
Gold R. Roles in sociological field observation. Social Forces 1958;36:217-23.
DOI: https://doi.org/10.2307/2573808
Higginbottom G, Pillay JJ, Boadu NY. Guidance on performing focused ethnographies with an emphasis on healthcare research. Qualitative Rep 2013;18:1-6.
Punch KF. Qualitative research design & collecting qualitative data. Introduction to social research: Quantitative and qualitative approaches. Sage; 2013. p. 113-66.
Taylor SJ, Bogdan R, DeVault M. Participant observation: In the field. Introduction to qualitative research methods: A guidebook and resource: John Wiley & Sons; 2015. p. 55-95.
Green J, Thorogood N. Observational methods. Qualitative methods for health research. Thousand Oaks, CA: Sage; 2018. p. 151-78.
Yin RK. Doing Fieldwork. Qualitative research from start to finish: Guilford Publications; 2015. p. 116-62.
Jorgensen DL. The methodology of participant observation. Participant observation. Thousand Oaks, CA: SAGE Publications, Inc.; 1989. p. 12-26.
DOI: https://doi.org/10.4135/9781412985376
Pearsall M. Participant observation as role and method in behavioral research. Nursing Res 1965;14:37-41.
DOI: https://doi.org/10.1097/00006199-196501410-00011
Baker L. Observation: A complex research method. Library Trends 2006;55:171-89.
DOI: https://doi.org/10.1353/lib.2006.0045
Creswell JW, Poth CN. Qualitative inquiry and research design: Choosing among five approaches: Sage publications; 2017.
Mulhall A. In the field: notes on observation in qualitative research. J Adv Nurs 2003;41:306-13.
DOI: https://doi.org/10.1046/j.1365-2648.2003.02514.x
Guest G, Namey EE, Mitchell ML. Participant observation. Collecting qualitative data: A field manual for applied research. Thousand Oaks, CA: Sage; 2013. p. 73-112.
DOI: https://doi.org/10.4135/9781506374680
Harrod M, Montoya A, Mody L, et al. Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities. J Am Geriatrics Soc 2016;64:2059-64.
DOI: https://doi.org/10.1111/jgs.14341
Huberman AM, Miles MB. Data management and analysis methods. In: Denzin NK, Lincoln YS, editors. Collecting and interpreting qualitative materials. Thousand Oaks, CA: Sage; 1998. p. 179-210.
Dixon-Woods M, Agarwal S, Jones D, et al. Synthesising qualitative and quantitative evidence: a review of possible methods. J Health Serv Res Policy 2005;10:45-53.
DOI: https://doi.org/10.1177/135581960501000110
Dixon-Woods M, Bosk C. Learning through observation: the role of ethnography in improving critical care. Current Opinion Critical Care 2010;16:639-42.
DOI: https://doi.org/10.1097/MCC.0b013e32833ef5ef
Glaser BG, Strauss AL. Discovery of grounded theory: Strategies for qualitative research: Routledge; 2017.
DOI: https://doi.org/10.4324/9780203793206
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008;62:107-15.
DOI: https://doi.org/10.1111/j.1365-2648.2007.04569.x
Carayon P, Schoofs Hundt A, Karsh BT, et al. Work system design for patient safety: the SEIPS model. Qual Saf Health Care 2006;15:i50-8.
DOI: https://doi.org/10.1136/qshc.2005.015842
Reason J. Understanding adverse events: human factors. BMJ Quality Safety 1995;4:80-9.
DOI: https://doi.org/10.1136/qshc.4.2.80
Reason J. Human error: models and management. BMJ 2000;320:768-70.
DOI: https://doi.org/10.1136/bmj.320.7237.768
Harrod M, Weston LE, Gregory L, et al. A qualitative study of factors affecting personal protective equipment use among health care personnel. Am J Infect Control 2020;48:410-5.
DOI: https://doi.org/10.1016/j.ajic.2019.08.031
Harrod M, Petersen L, Weston LE, et al. Understanding workflow and personal protective equipment challenges across different healthcare personnel roles. Clinical Infect Dis 2019;69:S185-S91.
DOI: https://doi.org/10.1093/cid/ciz527
Gregory L, Weston LE, Harrod M, et al. Understanding nurses’ workflow: Batching care and potential opportunities for transmission of infectious organisms, a pilot study. Am J Infect Control 2019;47:1213-8.
DOI: https://doi.org/10.1016/j.ajic.2019.03.034
Krein SL, Kronick SL, Chopra V, et al. Comparing inpatient versus emergency department clinician perceptions of personal protective equipment for different isolation precautions. Am J Infect Control 2020;48:224-6.
DOI: https://doi.org/10.1016/j.ajic.2019.08.029
Payne G, Payne J. Key concepts in social research. Sage; 2004.
DOI: https://doi.org/10.4135/9781849209397
How to Cite
Weston, Lauren E., Sarah Krein, and Molly Harrod. 2022. “Using Observation to Better Understand the Healthcare Context”. Qualitative Research in Medicine and Healthcare 5 (3). https://doi.org/10.4081/qrmh.2021.9821.
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