Table 1.

Using ethnography to investigate implementation in a healthcare setting

Jansen et al. [58], reporting on an ethnographic process evaluation of a pragmatic trial of multidisciplinary patient care for patients in Rotterdam and The Hague, described ethnographic insights into intervention implementation problems in primary healthcare centres. The process evaluation uncovered barriers such as (1) practice nurses requiring more time to organise the implementation of the intervention and to coordinate with colleagues in the health centre; (2) peer educators, who were delivering health education to some patients, were not allowed to access records in one GP surgery due to a decision by GPs about who could access patient records; (3) GPs were unwilling to change their schedules to accommodate the intervention; and (4) the assistants, whose roles were to support the intervention, were moved to other tasks due to resource constraints. As a result, the researchers produced intervention guidelines to overcome these barriers.