Doing a Case Study on Health Care Quality Improvement at a Large Public Teaching Hospital: A Non-Clinician’s Account

This research methods case is based on research undertaken as part of a PhD in Management. The PhD focused on exploring the processes through which patient safety is improved by exploring how a bottom-up falls prevention initiative started and developed in an acute hospital setting. This research contrasted with most of the existing patient safety research at the time, which focused on how top-down patient safety management initiatives could ensure patient safety. Given the exploratory nature of the PhD research, the bulk of this research was based on an empirical case study conducted in an acute teaching hospital in Portugal, which drew on an ethnographic approach. Fieldwork followed a staged-approach. An initial visit to the hospital took place in August 2008 which informed the formal context interviews which were conducted in June 2009. Main data collection took place between December 2009 and February 2010. In total, 46 in-depth interviews were conducted with 49 clinical and non-clinical staff members. The adoption of a staged-approach helped to shape the research according to the context of the hospital and in so doing allowed a more in-depth case study of the hospital.