Suchergebnisse

Plagued by doubt and methodological unease, two researchers from a large Australian study resolve their quandary by revisiting methodological literature related to narrative inquiry, visual approaches and contemporary interviewing to find that the application of poststructuralist theory to methodology provides a useful way of addressing their concerns. Before embarking on extensive writing about the project, they trouble issues of data authenticity, analytic integrity and the problem of voice. The main value of this deliberation is its applicability to the wider discourse about contemporary qualitative inquiry that other researchers facing analytical dilemmas may also find helpful.

In this paper we narrate a story of working on a large project funded by an Australian Research Council Linkage grant the 'Keeping Connected: Young People, Identity and Schooling' project. The purpose of the study is to consider the social connection and schooling of young people who have experienced long‐term chronic illness. While the research involves both quantitative and qualitative elements, the qualitative component is the largest and involves the most researcher time and diversity. At an early stage of the project, three of the researchers working on the qualitative team consider why the study was framed as a series of case studies rather than as ethnography. The second issue considered in this paper is the different approaches to data collection, data analysis and truth claims we might take.

Abstract Background To develop services, healthcare professionals must make business cases to managerial bodies within Hospital Trusts and if approved, to commissioning bodies. Patients with hip fracture are at high risk of subsequent fracture. To prevent this, guidance recommends structuring fracture prevention services around coordinator based models. These are known as Fracture Liaison Services (FLS). Methods 33 semi-structured qualitative interviews were conducted with healthcare professionals with experience of making business cases for FLS. Data was analysed thematically. Results Challenges in the development of business cases included collecting all the relevant data and negotiating compartmentalised budgets that impeded service development. Participants described communication and cooperation between providers and commissioners as variable. They felt financial considerations were the most important factor in funding decisions, while improved quality of care was less influential. Other factors included national guidelines and political priorities. The personalities of clinicians championing services, and the clinical interests of commissioners were seen to influence the decision-making process, suggesting that participants felt that decisions were not always made on the basis of evidence-based care. Effective strategies included ways of providing support, demonstrating potential cost effectiveness and improved quality of care. Using a range of sources including audit data collected on the successful Glasgow FLS, and improving cooperation between stakeholders was advocated. Participants felt that the work of commissioners and providers should be better integrated and suggested strategies for doing this. Conclusions This study provides information to healthcare professionals about how best to develop business cases for FLS. We conclude with recommendations on how to develop effective cases. These include using guidance such as toolkits, aligning the aims of FLS with national priorities and benchmarking services against comparators. Introducing a 'Local Champion' to work alongside the service manager and establishing a multi-disciplinary working team would facilitate communication between stakeholders. Involving commissioners in service design would help integrate the roles of purchasers and providers.