Out-of-Hospital Cardiac Arrest (OHCA) strategy: case study

Annex A: Full methodology

1. Design

This project will use a semi-structured interview design with partner organisations involved in the design and delivery of the OHCA Strategy. The draft interview schedule is provided in Annex B.

1.2 Rationale for design

Qualitative research, fundamentally, “seeks to discover and to describe narratively” (Erickson 2017, p 36). In aiming to assess whether the OHCA Strategy represents the Scottish Approach in practice, using a quantitative ‘how many’ approach would not capture the opinions and experiences of design and delivery. A semi-structured interview format was adopted as this allows for core predetermined questions to be asked, as well as giving freedom for “other questions emerging from the dialogue between interviewer and interviewee/s” (DiCicco-Bloom and Crabtree 2006, p 315).

2. Partner organisations

As highlighted in Section 2.4 above, there are over 15 organisations involved in the immediate design and delivery of the OHCA Strategy. We aimed to ensure that all sectors – government, emergency services, third sector and academic partners – were represented. Given the timescale of this research project we had to limit the number of partner organisations invited to interview to ensure that the project was achievable.

We contacted staff from the Scottish Government, Scottish Ambulance Service, Police Scotland, Scottish Fire and Rescue Service, British Heart Foundation, British Red Cross, St Andrew’s First Aid, Chest Heart & Stroke Scotland, Resuscitation Research Group and Save A Life for Scotland. Using a standardised introductory letter ( Annex B), we sought permission to audio record interviews which were deleted after completion of the interview process.

A list of the organisations contacted is given in Annex C.

3. Analysis

Central to the challenge of qualitative research is the need to produce valid – and to a certain degree reliable – results (Paley and Lilford 2011). Interviews present the researcher with an inordinate number of ways of communicating the processes of their study. For example, should the researcher identify categories, codes, labels, expressions, incidents, themes, units, chunks or concepts? And should these be induced from the data in a grounded theory style, or deduced from a priori theories?

Whilst I acknowledge these issues, I want to avoid this project being hindered by the chronic disputes associated with qualitative research (Denzin and Lincoln 2017). Instead, I adopt a pragmatic view which focusses on producing relevant, credible and useable findings. Owing to this, the influential paper by Ryan and Bernard (2003) is used to guide the analysis. Here, techniques such as identifying repetitions, transitions, metaphors and analogies, and linguistic connectors will be used. This will then be put through a “cutting and sorting” process technique. Although there is variation in how this can be done, this broadly involves segmenting sections of text into related sub-themes. Important for this study is the recognition that specific quotes or phrases need to be placed within the context in which they were spoken as interviews are not being transcribed verbatim (see Section 2.5 below). From here, these sub-themes will then be ordered into their higher order themes in line with the aims and objectives of the research internship.

4. Rigour

I have used Clausen’s (2012) worked example of a technique known as The Individually Focussed Interview ( TIFI) which is based on Kvale’s (1997) gold standard traditional thematic analysis of interviews. The main challenge that this project has had to contend with in terms of rigour is that, due to the timescale, the audio recordings have not been transcribed verbatim. Clausen suggests that TIFI offers “methodological quality without transcription of audio recordings” (p 1) if a standardised verification process is followed. This is a 6 stage process: (1) thematisation (2) thorough introduction to the interview method (3) the interview and co-produced statements (4) writing the draft and further joint production (5) analysis (6) results.

Analysis of verbatim interview transcripts normally occurs independently of the interviewee where the researcher sifts through speech line-by-line and identifies codes within the text (Saldana 2015). However, TIFI posits that the interviewer and interviewee verify findings together (Stage 3 and 4). For this project, hand-written notes were taken during the interview and permission was sought from all participants to audio record the interview for ‘light touch’ note taking after the interview. The written notes were combined with these summary notes taken from review of the audio recordings and an initial report was sent to the participant. The interviewee was invited to amend any statements or suggest additional themes which then formed the final anonymised report.