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Narrative methods in quality improvement research.

T Greenhalgh1, J Russell, D Swinglehurst

  • 1Department of Primary Care and Population Sciences, University College London, London, UK. p.greenhalgh@pcps.ucl.ac.uk

Quality & Safety in Health Care
|December 6, 2005
PubMed
Summary
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This paper distinguishes narrative-based quality improvement research from common quality improvement reports. It reviews four narrative approaches, emphasizing their unique contributions to knowledge generation in healthcare quality improvement.

Area of Science:

  • Healthcare Research
  • Qualitative Research Methods
  • Knowledge Translation

Background:

  • Narrative methods offer unique insights into quality improvement (QI) processes.
  • Distinguishing rigorous narrative research from QI reports is crucial for advancing the field.
  • Current QI literature often lacks systematic narrative inquiry for knowledge generation.

Purpose of the Study:

  • To review and critique diverse approaches to using narrative in quality improvement research.
  • To differentiate narrative-based QI research from standard QI reports.
  • To provide guidance on identifying high-quality narrative research in QI.

Main Methods:

  • Systematic review and critique of narrative approaches in QI literature.
  • Identification and definition of key narrative characteristics (chronology, emplotment, trouble, embeddedness).

Related Experiment Videos

  • Analysis of four distinct narrative methods: narrative interview, naturalistic story gathering, organizational case study, and collective sense-making.

    • Main Results:

    • Four approaches to narrative in QI research are detailed, including their rationale, data collection/analysis, strengths, and limitations.
    • Narrative research in QI presents epistemological challenges regarding 'narrative truth' versus scientific objectivity.
    • Guidance is provided to differentiate robust narrative research from reports, anecdotes, and journalism.

    Conclusions:

    • Narrative methods hold significant potential for generating new knowledge in quality improvement.
    • Establishing clear criteria for rigor is essential for advancing narrative-based quality improvement research.
    • Further development of narrative inquiry is needed to distinguish it from less systematic forms of storytelling in healthcare.