Secondary analysis of qualitative video health experience interviews to inform policy and practice - what matters most to users about quality of care?

对定性视频健康体验访谈进行二次分析，为政策和实践提供信息 - 对于用户而言，关于护理质量最重要的是什么？

• 批准号: ES/L01338X/1
• 负责人: Louise Locock
• 金额: $ 21.06万
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2014
• 资助国家: 英国
• 起止时间: 2014 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FL01338X%2F1
• 关键词: Secondary; analysis; qualitative; video; health

Our proposal aims to use secondary analysis to provide evidence for user-centred quality improvement in health and social care. It builds on two existing initiatives:1. An archive of 3000 qualitative video and audio interviews on over 80 topics with users about their health and illness experiences held by the Health Experiences Research Group (HERG), University of Oxford (and disseminated publicly on www.healthtalkonline.org run by the DIPEx Charity)2. Experience-Based Co-Design (EBCD), a participatory action research approach which actively involves service users in service design and has been implemented in over 60 care services in six different countries since being piloted in 2006. Past evaluations have shown it to be effective in achieving quality improvement and cultural change.Both initiatives include video-recorded in-depth interviews with people talking about their experiences. HERG interviews are nationally collected and wide-ranging, whereas EBCD interviews are collected locally with a more specific focus on 'touchpoints' - key interactions between users and services where quality improvements can be made - in each care setting. In EBCD analysis of these touchpoints is used to create a 'trigger' film which staff and users watch together to start a discussion about improving care locally, before setting up co-design working groups to plan and implement changes together.These two initiatives have already collaborated on a recent study for the National Institute for Health Research (NIHR) which demonstrated EBCD in two care pathways based on secondary analysis of HERG interviews rather than new local interviews worked just as well, saving time and cost.This provides a strong evidence base to propose further secondary analysis to support care organisations seeking to apply experience-based quality improvement in an affordable and timely way across more conditions. We will reanalyse ten of our existing interview collections. In each case the primary research question for the secondary analysis will be: What touchpoints do users identify in their experiences of care where quality could be improved?The HERG collections are generally focused around a particular condition or health topic. However, there is much material in the collections that could inform service settings and integration of care across sectors. Alongside the analysis for touchpoints in each condition, we will also ask: What are the touchpoints for a) outpatient care and b) interactions between health and social care across a range of different conditions which could be used to redesign services? The secondary analyses will involve a researcher going back to the full transcript collection to identify touchpoints. On healthtalkonline, we also have a set of lay summaries identifying key topics of importance to interview participants in each condition (though not specifically analysed for touchpoints). A key further empirical question to ask is therefore: What touchpoints would emerge from a re-analysis of the website summaries, compared to re-analysis of the full transcripts? Can further time savings be made in identifying touchpoints by this method or is too much lost in the process?We will also involve service users in the secondary analysis process, supporting them in analysing both selected transcripts and selected website summaries, and discussing with them similarities and differences in the touchpoints they identify compared to the social science researcher.We will disseminate findings from the secondary analysis in the form of a series of trigger films made in collaboration with the DIPEx Charity, using our existing video recordings to illistrate the touchpoints we identify, and make these available through both www.healthtalkonline.org and the Point of Care Foundation online EBCD toolkit. With the close and active support of NHS England our findings will have a clear route to impact on policy and practice

我们的建议旨在利用二次分析为以用户为中心的卫生和社会保健质量改进提供证据。它建立在两个现有的倡议：1。由牛津大学健康体验研究小组（HERG）举办的关于用户健康和疾病经历的80多个主题的3000个定性视频和音频访谈档案（并在DIPEX慈善机构运营的www.healthtalkonline.org上公开传播）2。基于经验的共同设计（EBCD）是一种参与式行动研究方法，积极让服务用户参与服务设计，自2006年试行以来，已在六个不同国家的60多个护理服务机构实施。过去的评价表明，这一举措在实现质量改进和文化变革方面是有效的，这两项举措都包括对人们谈论其经历的深入访谈进行录像。HERG访谈是在全国范围内收集的，范围广泛，而EBCD访谈是在当地收集的，更具体地侧重于“接触点”-用户和服务之间的关键互动，可以提高质量-在每个护理环境中。在EBCD中，这些接触点的分析被用来创建一个“触发”电影，工作人员和用户一起观看，开始讨论如何改善当地的护理，这两个倡议已经在最近为国家健康研究所（NIHR）进行的一项研究中进行了合作这表明EBCD在两个护理途径的基础上，二次分析的HERG访谈，而不是新的本地访谈工作一样好，节省时间和成本。这为提出进一步的二次分析提供了强有力的证据基础，以支持寻求应用经验的护理组织-在更多的条件下，以负担得起的和及时的方式进行质量改进。我们将重新分析我们现有的10个采访集。在每种情况下，次要分析的主要研究问题将是：用户在其护理体验中识别出哪些接触点可以提高质量？HERG系列通常集中在特定的条件或健康主题。然而，收集的材料中有许多可以为服务环境和跨部门护理一体化提供信息。除了分析每种情况下的接触点，我们还将问：a）门诊护理和B）健康和社会护理之间在一系列不同条件下的相互作用的接触点是什么，可以用来重新设计服务？二次分析将涉及一名研究人员返回到完整的成绩单收集，以确定接触点。在healthtalkonline上，我们也有一套简单的总结，确定了每种情况下采访参与者的重要主题（尽管没有专门分析接触点）。因此，需要进一步提出的一个关键的实证问题是：与重新分析完整的记录相比，重新分析网站摘要会出现什么样的接触点？通过这种方法确定接触点是否可以进一步节省时间，或者在这一过程中损失太多？我们还将让服务用户参与二次分析过程，支持他们分析选定的成绩单和选定的网站摘要，并与他们讨论他们识别的接触点与社会科学研究人员相比的异同。我们将与DIPEX慈善机构合作，以一系列触发电影的形式传播二次分析的结果，使用我们现有的视频记录来说明我们识别的接触点，并通过www.healthtalkonline.org和Point of Care Foundation在线EBCD工具包提供这些信息。在NHS英格兰的密切和积极支持下，我们的研究结果将对政策和实践产生明确的影响

项目成果

Involving service users in the qualitative analysis of patient narratives to support healthcare quality improvement.

• DOI: 10.1186/s40900-018-0133-z
• 发表时间: 2019-01-01
• 期刊: Research involvement and engagement
• 作者: Locock, Louise;Kirkpatrick, Susan;Robert, Glenn
• 通讯作者: Robert, Glenn

Response to "comments on: involving service users in the qualitative analysis of patient narratives to support healthcare quality improvement.

回应“评论：让服务使用者参与患者叙述的定性分析，以支持医疗保健质量的改进。

• DOI: 10.1186/s40900-019-0158-y
• 发表时间: 2019
• 期刊: Research involvement and engagement
• 作者: Locock L