Using NVivo in Healthcare - Steps for a More Effective Strategy

Editor's Notes

• #2: 1
• #3: From my work using NVivo in the Canadian healthcare system and training others how to use NVivo and hearing about their projects, I have examples of many different ways that NVivo can be used to support and improve analysis of qualitative data. I have often noticed that people assume that NVivo is useful only for research, or for certain kinds of methods, and so on. So – if you are a person who also assumed that NVivo is a tool that’s only useful in qualitative RESEARCH, I am here to expand the horizon. Today I will illustrate many potential uses of NVivo 11 in healthcare settings (beyond academic research), including: policy analysis, literature reviews, environmental scans, survey data, evaluation, quality improvement, report preparation, and engaging stakeholder interest in the data. Let me please note that this presentation is not a training session. I will describe some of the ways I am familiar with NVivo being used, and quickly demonstrate some examples in the software. But I will not be spending time on the details of HOW to do these things in NVivo. The purpose of today’s session is to show you the possibilities. If you are interested in training, I will provide resources for that at the end of the presentation.
• #4: I will alternate between the presentation slides and illustrating examples in NVivo. Once I have NVivo open, I will orient you briefly to the software and some of the key terms we use. Then I will talk about – and show you using NVivo – WHERE NVivo can be used - in a variety of activities that commonly take place in healthcare settings WHEN - at different stages of the work process (e.g., doing your literature review, or reporting) HOW I think the use of NVivo improves qualitative and mixed methods work Finally, we will give you a chance to ask questions, provide you with contact information.
• #5: In a moment we will switch to NVivo so you can see some examples of what it looks like, and how we do some of this work. But, if you were one of the people who thought NVivo was software that was “only for research” I would like to expand that concept. From my own experience, some real life examples of healthcare projects that used NVivo include: environmental scans (in both the literature component and interviews with Subject Matter Experts that were included in the scan) Policy review – to scan dozens of policies to compare definitions of terms across the policy to see how consistent the definitions were (or were not, ) Longitudinal survey data - about patient experience with the healthcare system Evaluation – combining healthcare provider survey and interview data in a large network of various agencies organized around children's’ services Quality improvement – to assess the themes logged in patient concerns calls that could be analyzed over time and geographically by hospital site or unit OR in another example we used NVivo to support collaborative strategic planning of QI work SWITCH TO NVIVO
• #6: Mapping features – to visualize potential approaches to data analysis, to support and capture team discussion of potential topics and themes during early analysis– and turn the ideas in the map into nodes NVivo 11 can be used and adapted to include and compare results over time in longitudinal work (e.g., in patient experience surveys that may be administered on a regular basis (i.e., quarterly or similar) or to analyze themes in patient concerns records over time) and grouped for comparison by institution, program or hospital unit or other unit of analysis tracking methods of analysis and time and other resources spent in project work – to ensure quality and best use of skills and resources And in NVivo 11 Pro – can use it to analyze social networks before and after a QI initiative or program change to see what has changed
• #7: Now let’s talk a little bit about WHEN NVivo can be used. Yes, it is used in data analysis, but I have found NVivo to be helpful when: Scoping, planning projects When at the brainstorming phase of project planning even during grant writing - using NVivo’s project mapping features Managing project documents NVivo can be used to house all of the relevant project documents – the project charter or proposal, various versions of the consent forms and question guides as they change over time, and for tracking and monitoring time and effort spent in the work – e.g., “how many hours does it take to code these interviews?” Information and data collection From your literature to your excel spreadsheet tracking participation and of course all of the qualitative data and information relative to your work Data analysis Synthesis Moving from the analyzed data to themes and a summary of responses to your questions Reporting Making good use of the quotes from your data and NVivo’s visualization features to illustrate your findings and engage the stakeholders in the findings of your work SWITCH TO NVIVO
• #8: So now that you’ve heard and seen more about WHERE and WHEN NVivo can be used, I would like to speak to my experience in HOW NVivo can improve qualitative data work in terms of : important project documents and data are collected, analyzed and summarized within one project (rather than in multiple folders, files and on others’ personal drives) – this can be stored in a location accessible to all team members that require access (e.g., a private group folder on a SharePoint site or shared drive) even password protected if required team members can work on copies of the same project on their own computers (depending on license agreements) then merge the copies back together to compile and compare their work – increasing quality by developing consistent topic definitions and theme content, improving interrater reliability and transparent processes by which the themes were developed project framework (the node structure) can be imported into other NVivo projects to be the foundation of follow up work – or adapted to include and compare results compared over time in longitudinal work – and as themes are developed more fully over time - in NVivo 11 Pro and Plus you increasingly “teach” NVIvo to automate coding within consistent themes (e.g., for use in regularly administered surveys or questionnaires), exporting the list of nodes and their definitions as a code book increases thoroughness with which data and information are reviewed and transparency in how themes were derived, allows others to review and compare work, and can be used in mixed methods work to theme open-ended questions and analysis by demographic variables – or to match interview or focus group data with survey results
• #9: An example with story of how these word clouds engaged stakeholders in the findings of an environmental scan. Large provincial initiative about patient and family centred care Literature review 25+ focus groups with healthcare providers, patients, families, Multiple layers of reporting Up to working group, steering committee And report to each of the participating groups Team of people working together to gather, analyse and report on the data Interim report – word cloud – explanation TIME Patient comment –
• #10: Time was a frequently used word – theme – used in different ways Frequency is not sufficient to Listen – re-ran the queries – and also examined “poor communication”