Research Methods
Health Services Research spends enormous resources on developing policies and generalizable evidence (guidelines, protocols, scientific facts, etc.). Once these policies and truths in place, this research comes up against the implementation challenge, the policy-practice gap, and the problem of limited up-take of policy and evidence by frontline clinicians.
Alternative research methods need to be deployed to understand and intervene in hospital-clinical communication, patient safety and quality of care, the design of patient care trajectories.
These alternative methods are designed to circumvent the problem of implementation: knowledge is produced from and for where it matters, not at several removes from where it then needs to be made to matter.
Alternative methods for health services research:
1. Discourse research
Discourse research offers means for the reflexive analysis of professional communication. By using transcripts of talk, researchers can reflect with practitioners on the logic and assumptions underpinning their communications and work practices.
Iedema, R. (2007). Essai: On the multimodality, materiality and contingency of organizational discourse. Organization Studies. 28(6): 1-16.
Grant, D. and Iedema, R. (2005) "Discourse Analysis and the Study of Organizations". Text 25(1), 2005, 37-66.
Iedema, R. (2003) The Discourses of Post-Bureaucratic Organization, Amsterdam and Philadelphia: John Benjamins.
Iedema, R. (editor) (2007) Discourses of Hospital Communication: Tracing complexities in contemporary health care organizations. Basingstoke: Palgrave-Macmillan.
2. Video ethnography
Video ethnography extends feedback from the linguistic sphere into the visual sphere. Video as moving footage is crucial to enabling researchers and 'researchees' (practitioners) to revisit facets of their work, and become aware of themselves from unexpected perspectives, leading to unusual insights.
Iedema, R., Long, D., Forsyth, R., & Lee, B. (2006). Visibilizing clinical work: Video ethnography in the contemporary hospital. Health Sociology Review. 15(2): 156-168.
Iedema, R., Forsyth, R., Georgiou, A., Braithwaite, J., and Westbrook, J. (2007) Video research in health: Visibilizing the normative and affective complexities of contemporary care. Qualitative Research Journal. 6(2): pp. 15-30.
Iedema, R. and Rhodes, C. (under review) Beyond The Gaze: An Ethics of Mutual Care In Organizational Surveillance. Human Relations. [submitted 12 February 2006]
Long, D., R. Iedema and B.B. Lee (2007) 'Corridor conversations: Clinical communication in casual spaces'. In Discourses of Hospital Communication: Tracing complexities in contemporary health organizations. R. Iedema (ed.), 182-200. Basingstoke: Palgrave-Macmillan
Iedema, R., Long, D., Carroll, K., Stenglin, M. and Braithwaite, J. (2006) Corridor work: how 'liminal' space can be a focal resource for handling complexities of multi-disciplinary health care. Proceedings of the 11th International Colloquium of the Asia-Pacific Researchers in Organization Studies (APROS), 4-6 December 2005, M. Muetzelfeld (ed), Melbourne, pp 238-247.