Health Services Research: the Questions!
Crafting successful health services research questions is deceptively challenging. It is all-too-common for healthcare organizations to gather tons of data and then to wonder, “Now that we have collected all of this data, what should we do with it?” If their surveys, or other data collection instruments, have not been designed correctly they sometimes cannot answer questions they originally planned to, rendering much of the data they collected unusable.
When this happens, a significant waste of time and resources has occurred, as health services research projects are often costly to administer. The most serious errors that healthcare organizations tend to make when deploying surveys, which result in their failure to optimize their use of this health services research method, are addressed in this blog entry: a poor statement of research purpose and weak research questions.
Ideally, all health services data collection should be driven by properly crafted statements of research purpose. These statements should drive the selection of appropriate research methods. Surveys, while a powerful data collection tool for health services research, are not the best method of data collection for all projects.
Sometimes open-ended interviews, focus groups, or observations (all types of qualitative data collection) may be better suited to address the informational needs of a health care organization for a particular research project.
Surveys are best suited for collecting quantitative data (data which can be summarized and expressed numerically) from relatively large groups of people, be they an entire population or a sample. They are often used for research projects where the goal is to measure outcomes, or make inferences from a sample to a population.
Statement of Research Purpose
A statement of purpose that is unclear or improperly specified will potentially negatively impact a survey’s completeness and focus. For example, if a healthcare provider has initiated a healthy diet program and wants to measure the outcomes a statement of research purpose like, “Have members’ eating habits changed?” lacks the appropriate level of specificity.
A statement of research purpose like, “How has the healthy diet program affected members’ knowledge, behavior, and attitudes about eating,” is more complete and focused. By specifying that there are several important components to a healthy diet this statement is more likely to result in a survey that better addresses a variety of issues concerned whereas the less specific statement could lead to survey writers omitting important domains for assessment.
Once a clear statement of research purpose has been elaborated more specific research questions can be crafted. From the statement of research purpose above at least three research questions can be asked. They include: “How much have members learned about the health risks associated with an unhealthy diet?”, “How much have members’ eating habits changed?”, and “How much have members’ values and beliefs about healthy eating changed.”
Specific Measures / Variables
Working from specific research questions survey writers can identify the specific measures (sometimes called variables) that indicate how much change has occurred. Properly defining assessment measures will be the focus of the next component of this series, “Health Services Research: Part 4: Defining Assessment Domains.”
Why It Matters
There can be serious implications for failing to assess outcomes properly. Healthcare organizations often report to the local, state, and federal government or other co-operating agencies and adequately documenting certain outcomes is essential for their continued funding. In addition, when applying for a contract, an organization’s outcome assessment tools are sometimes evaluated for their scope and relevance. Having poor assessment tools can hinder an organization’s ability to secure contracts.
Focusing specifically on developing surveys for HSR studies designed to measure health outcomes, the entries that follow in this series detail more specifically how to create successful surveys:
// Various types of health-related surveys and outcomes that can be measured
// Creating meaningful research questions
// Conceptualizing and operationalizing variables
// Developing sophisticated survey questions
Aday, Lu Ann and Llewellyn J. Cornelius, 2006. “Designing and Conducting Health Surveys: A Comprehensive Guide,” Jossey-Bass: San Francisco, CA.
As an experienced health care professional, Susan (Sue) Dess brings a wide range of experiences to Crestline. Her 15 year administrative and executive management background spans the operations of both managed care and provider organizations.
Additionally, Sue spent 25 years as an Emergency Room and Intensive Care Registered Nurse, further rounding out her ability to understand the “big picture.” Sue is intimately involved with each Crestline project, collaborating closely with consultants and clients.