Table 3.

Overview of Research Design^*

Quantitative Phase		Qualitative Phase		Both Quantitative and Qualitative Phase
Phase 1	Quantitative Measures	Phase 2	Qualitative Measures	Phase 3	Qualitative and Quantitative Measures
Develop survey. Administer survey to key infection control and nursing personnel at all Michigan hospitals and a random sample of U.S. hospitals. Analyze survey data.	Infection prevention practice use Urinary tract infection rates Hospital characteristics Infection control program characteristics Environmental context	Select cases for qualitative study based on participation in MHA Keystone HAI, the use of key bladder bundle practices, and maximum variation in other relevant variables. Conduct phone interviews to collect qualitative data from 7 hospitals that have implemented the MHA Keystone HAI bladder bundle and 3 that are planning to implement it. Conduct site visits at 3 hospitals that participated in the phone interviews. Analyze qualitative data using thematic techniques looking within and across cases and begin to develop implementation strategies.	Understand the steps being taken in preparation for implementation. Ascertain barriers to and facilitators of implementing the bladder bundle across a diverse group of hospitals. Understand the processes involved in implementing the bladder bundle. Describe and explain variation in the implementation of the different practices in the bladder bundle among hospitals that have adopted those practices.	Develop and evaluate implementation strategies in collaboration with 3 hospitals that are participating in MHA Keystone HAI and planning to implement the bladder bundle (formative evaluation).	Catheterization rates, catheter discontinuation and re-insertion rates, and catheter-associated urinary tract infection rates Organizational readiness Understand the hospital culture and resources as well as current practices/problems to determine what type of implementation strategies might be most suitable given the context. Practice fidelity.

^*MHA, Michigan Hospital Association; HAI, health care–associated infection.