Pragmatic Healthcare Ethnography: Methods to Study and Improve Healthcare

This practical and accessible textbook provides an overview of the key principles for conducting ethnography in healthcare settings. Shedding new light on healthcare delivery and experiences, ethnographic research methods provide a useful set of tools for observing how people act in the world and help us understand why people act as they do. Increasingly recognized for their explanatory power, especially around behavior and social context, ethnographic methods are an invaluable approach for understanding challenges and processes in healthcare services and delivery.

This guide takes the reader step-by-step through the research process, from grant writing and study design to data collection and analysis. Each chapter, illustrated by a range of examples, introduces ethnographic concepts and techniques, considers how to apply them in pragmatic research, and includes suggestions for tips and tricks. An in-depth case study describing real-world ethnographic research in a healthcare setting follows each chapter to demonstrate both the “how to” and the value of ethnographic approaches. The case studies discuss why the researcher used ethnography, the specific approach taken, the setting for the work, and key lessons that demonstrate ethnographic principles covered in the related chapter.

This is an essential text for researchers from a range of health-related backgrounds new to ethnographic methods, including students taking courses on qualitative research methods in health, implementation science, and applied anthropology.

Alison B. Hamilton is a VA Research Career Scientist and Implementation Research Director with the Center for the Study of Healthcare Innovation, Implementation, and Policy at the VA Greater Los Angeles Healthcare System, a Professor-in-Residence in the University of California Los Angeles (UCLA) Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine, and an Honorary Professor in the Department of Psychiatry and Mental Health, University of Cape Town, South Africa. Her research interests include gender and health, mental health, implementation science, and research methods.

Gemmae M. Fix is an Associate Professor at Boston University Chobanian & Avedisian School of Medicine and a Research Health Scientist with the Center for Healthcare Organization and Implementation Research co-located at the VA Bedford/VA Boston Healthcare Systems. As an applied medical anthropologist, she has almost two decades of experience conducting federally funded ethnographic research in healthcare settings. Her research focuses on the delivery of patient-centered care, particularly for people living with HIV. She is a fellow of the Society for Applied Anthropology.

Erin P. Finley is a Professor with the Departments of Medicine and Psychiatry and Behavioral Sciences at the Long School of Medicine, University of Texas (UT) Health San Antonio, and Core Investigator and Qualitative Methods Core Lead with the Center for the Study of Healthcare Innovation, Implementation, and Policy at the VA Greater Los Angeles Healthcare System. Her research interests include veterans’ health, mental health, and diverse methods in implementation planning and evaluation.