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transcribed verbatim to contribute towards reduction of observer bias (Voss, 2009).
The interview texts were sent back to the interviewees after transcription to check the
interview contents. Verification of interviews is useful in identifying and clarifying
misunderstandings and obtaining a higher degree of validity (Johnston et al., 1999).
4.5.2 Document research
The interviews were complemented by examination of relevant documentation.
Document research is a good way to acquire objective information since it is obtained
without the interference of an interviewee. At the same time, the researcher has to keep
in mind that documentation often has been written down within a certain context and
with a certain goal in mind.
At the outset of each case, we studied documents and information sources (annual
reports, websites) that would give insight into the characteristics of each case: its working
environment, strategy and plans for the future. For each case we studied the process
descriptions set up by the case organizations, which described the formal way of working
in the total care process. In addition, we studied product books that described the total
range of supply of each case organization as well as the setup and arrangement of this
supply. Moreover, we studied policy documents and other documentation such as project
plans and quality manuals that would give additional insights in the organization of
processes and product supply.
4.5.3 Direct observation
Each case involved three one-day field visits to observe and experience the working
processes. In this way we obtained a frame of reference of the context in which this
research took place. It allowed the researcher to learn the ‘language’ of the long-term
care field, which might enable the sharpening of the questions asked during the
interviews and making data collection more specific. Furthermore, an accurate and
well-informed feel for the particularities and characteristics of the field of long-term
care for the elderly might aid in the correct interpretation of data collected.
Practices observed covered the total care process. We were present during needs
assessment and the subsequent translation of needs into appropriate care and service
parts, during the execution of care and service parts at the homes of the clients, and
during evaluation interviews with clients, as well as during client meetings. We followed
interactions between clients and professionals, and between professionals. This gave the
richest picture possible of the processes and practices used by the case organizations. We
took notes during each observation visit and worked out these notes shortly after the
visit to ensure we were able to capture most of the things that had been observed.
Modular
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To summarize, the case study protocol that we have described in this section contained
a topic list as well as the indicative questions. Sources of information were identified as
well as the procedures for data collection. The protocol ensured consistency over the
cases and maximized the potential for comparisons. It thereby enhanced the reliability
and validity of the case research data. Table 4.3 summarizes and links the different
issues covered by our data collection protocol.
4.6 Data analysis
According to Miles and Huberman (1994) qualitative data analysis consists of three
concurrent activities: data reduction, data display, and conclusion drawing. We describe
each of these activities for our research below. First, however, we will present two
practices that we used throughout the data analysis stage of this research and that helped
us to develop the rich and comprehensive data collected in this study into meaningful
results and insights. These two practices are expert meetings and memo-ing.
4.6.1 Expert meetings
Conducting empirical research requires extensive and thorough thinking about
and discussion of interpretation of collected data, which might naturally lead to
the collection of new data and testing of alternative interpretations. In our research
we chose to involve practice in this process of reflexivity, and not go through it in a
scientific setting alone. To this end, we set up so-called expert meetings in which each
case organization was represented.
The overall goal of the meetings was to continuously discuss, test, and develop the
interpretation and findings of our data analysis. In addition, the expert meetings were
used to focus the ongoing research on the most relevant and / or interesting issues.
Finally, we used the expert meetings to continuously transfer and translate modularity
and long-term care concepts and practices, as such, relating our insights gained into
elderly care practice. This was considered important since terms and concepts used
in this research mainly stem from the field of operations management in general and
modularity in particular, and are usually not used in the day-to-day operations of care
organizations for the elderly.
The expert meetings started in the summer of 2007 and were held every six week until
the end of the research in March 2010. In this way, the expert meetings took place over
the course of the data collection, data analysis, and write up stages of this research.
The core participants in the expert meetings were the main researcher of this project
and experts from each case organization. These experts were the same persons as the
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