Qualitative approaches can provide a solid basis for introductory explorations of a defined need, performance gap, or issue, add description, explanation, and or validation to raw data, and offer insights for empirical generalizations derived from quantitative approaches.
We have worked with various physician and patient groups to develop and categorize perspectives, identify issues and barriers, and develop the basis for larger quantitative surveys around information gaps and needs. Here are some examples:
Project Title: Optimizing Comorbid COPD and Cardiovascular Disease Management Among Socially Disadvantaged Patients: Clinician Perspective
Project Aim: Identify and prioritize clinician level barriers to the integrated ambulatory management of comorbid COPD and CVD in patients with social disadvantage.
Outcomes: High-ranking barriers identified in the integrated management of COPD and CVD include both disease specific challenges and system challenges that adversely impact multimorbidity for future
multi-level interventions to improve the integrated management of comorbid COPD and CVD in patients experiencing multiple
social determinants of health
Project Title: Evaluating the consistency with guideline recommendations for diagnosis and management of idiopathic pulmonary fibrosis in non-academic settings
Project Aim: Ascertain the level of consistency with the 2011 IPF guidelines among community physicians and chaacterize evidence used to support diagnosis of IPF.
Outcomes: Identification of policies to ensure provider roles are clearly identified, and explicit need for patient education materials to improve self-management.
Project Title: Defining the denominator for measuring quality of end-of-life care in children with cancer: Results of a modified Delphi process
Project Aim: Identify provider perspectives on barriers to providing diabetes care for women with Breast cancer and prioritize possible intervention strategies. Discussion groups conducted with primary care providers and breast oncologistsacross the USA.
Outcomes: Low level of consistency in applying IPF guidelines among pumonologists in non-academic settings that can be enhanced through education.
Project Title: Optimizing the Delivery of diabetes Management During Breast Cancer Care: Provider Perspectives
Project Aim: Identify provider perspectives on barriers to providing diabetes care for women with Breast cancer and prioritize possible intervention strategies. Discussion groups conducted with primary care providers and breast oncologistsacross the USA.
Outcomes: Identification of policies to ensure provider roles are clearly identified, and explicit need for patient education materials to improve self-management.
Project Title: Optimization of Hyperlipidemia Management among Patients with Rheumatoid Arthritis: Physician Nominal Groups
Project Aim: ldentify and prioritize barriers to screening and treatment for hyperlipidemia among patietns with rheumatoid arthritis. Discussion groups conducted with primary care providers and rheumatologists.
Outcomes: Identification of differences between rheumatologists and primary care providers in key care barriers.
Project Title: Identifying Barriers to Antigen Detection and Avoidance for Patients with Chronic hypersensitvity Pneumonitis
Project Aim: Improve care of patients with CHP by identifying common barriers to atigen detection and determining diagnostic criteria. Discussion groups conducted with pulmonologists at academic medical centers with five years of experience treating patients with ILD.
Outcomes: Improved strategies for recommending adetection and voidance techniques based on understanding patient-level factors.
Project Title: Improving Care for Acute Ischemic Stroke: Focus on Timely Assessment and Thrombolytic Treatment
Project Aim: Identify (from each audience’s perspective), what makes it difficult to administer tissue plasminogen activator (tPA) to acute ischemic stroke patients. Discussion groups were conducted with four audiences; ED Nurses, ED Physicians, Neuroradiologists, and Neurologists.
Outcomes: Ideas and next steps to assist in addressing the barriers associated with door to needle times. Ideas generated included procedural improvements as well as educational interventions for each audience based on needs uncovered during nominal groups.
Project Title: Patient-Centered Initiative in RA: The Role of Registries and Patient-Reported Outcomes
Project Aim: Develop and test an intervention that supports effective dialogue and aligns the different perspectives, understanding, and knowledge of clinicians and patients to focus on their common goal. A prioritized list of questions was developed that patient participants consider most important to them in understanding their disease, its consequences, and its impact on their day-to-day quality of life.
Outcomes: Information learned in the nominal groups was be used to create education that will optimize communication between physicians and patients about RA-related topics and further develop patient education content delivered in a patient centered manner.
Project Title: Improving Engagement and Compliance through Physician-Patient Communication: A Demonstration Research Project
Project Aim: Collect and categorize information aimed at improving surgeon-patient communication in the perioperative environment, patient engagement and compliance, and family and patient satisfaction.
Outcomes: Results informed the development of a conceptual framework guiding the design of an intervention intended to improve physician and patient/caregiver communication across all settings. The findings will and can be applied across all areas of medicine where important and often technical information needs to be effectively communicated to multiple stakeholders.
Project Title: Cardiovascular Disease, Prevention, Treatment, and Outcomes
Project Aim: Identify primary care physician attitudes on common statin side effects, reasons for statin discontinuation, and barriers to re-initiating statins among patients who discontinue treatment.
Outcomes: Intended to complement information on patient attitudes being evaluated in a separate project, data gathered from these groups aided in the development of effective strategies to increase the appropriate use of statin therapy to reduce cardiovascular disease risk
Project Title: Primary care physicians’ perspectives on barriers to beta-blocker use and up-titration in patients with heart failure
Project Aim: Elicit opinions from primary care physicians’ on perceived barriers to beta-blocker use and up-titration in heart failure patients.
Outcomes: Primary care physicians identified specific barriers to use of beta-blockers in patients with Heart Failure and reduced Ejection Fraction. Physician-identified barriers to up-titration of beta-blockers in patients with Heart Failure were also examined.
Project Title: Improving care for people with IPF: A collaborative approach
Project Aim: Identify and mitigate barriers to providing evidence-based care to patients with ideopathic pulmonary fibrosis
Outcomes: Education developed based on physician-identified barriers correlatedwith an increase in percentage of eligible patients getting treatment, an increase in routine patient visits, and increased percentage of patients monitored for exercise-induced hypoxemia.