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2015 HSR&D/QUERI National Conference Abstract

2009 — Direct Observation Methods for Health Services and Implementation Research

McCullough MB, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, MA; Kim B, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford/Boston MA; Wang S, Mental Illness Research, Education and Clinical Center (MIRECC) and CHOIR Bedford; Fix GM, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, MA; Boston University School of Public Health;

Workshop Objectives:
Direct observation is both a qualitative and quantitative observation method used to study processes, procedures, activities or people acting in specific roles. Individuals are often unaware of their behaviors, thereby making them difficult to capture via other methods. Direct observation is increasingly useful in VA Health Services Research (HSR) and Implementation Science (IS), because data from direct observation adds new contextual dimensions to traditional methods such as database analyses, surveys and interviews. Disciplines, such as anthropology, psychology and systems engineering, use direct observation as an essential research methodology to understand human behavior in context. The objective of this workshop is to introduce direct observation fundamentals from these disciplines, with a particular focus on the exigencies of implementation research in healthcare contexts.

This workshop will equip participants with the tools to conduct direct observation as part of HSR and IS studies. Presenters will offer a brief overview of observational techniques from anthropology, psychology, and systems engineering. Didactic components will include 1) Learning when to include direct observation as part of a project. 2) How to select an appropriate activity (e.g. prescribing, shared-decision making), a process (e.g. implementation of a clinical reminder, a process of care) or people (e.g. doctor, patient) to observe, including practical examples from actual research studies. 3) Techniques for collecting and analyzing observational data. This will focus on using an example project and having participants try different observational techniques. Participants will be provided a resource toolkit that includes templates and checklists for collecting direct observational data. 4) How to address challenges such as possible behavior change as a result of being observed (the Hawthorne Effect), as well as the logistical and practical issues of setting up team-based observations, gaining access, and obtaining necessary permissions. Participants will leave with the ability to determine when to include direct observation in a project, familiarity with several common observational methods, and a resource toolkit with references, templates and checklists as well as data analysis techniques.

Target Audience:
Investigators and methodologists interested in using direct observation in HSR and IS studies.

Assumed Audience Familiarity with Topic:
Introductory to mid-level familiarity with IS and/or observation.