Rapid Assessment Process How to
This is an guide to doing a RAP using a hypothetical site visit by Joan Ash and her team studying clinical decision support. Overall arc of visit is subject selection and recruitment for interviews and observation, data collection for 5 days, data analysis, interpretation, and reports to site of study.
Before getting to site (Preparation)
Research team consisting of about 7 members.
Onsite help: Onsite one must find a local investigator and a shepherd. The local principal investigator helps with IRB, site inventory, cultural translation, subject recruitment The shepherd helps with introductions and logistics.
Before getting to your site you should have an:
- experienced ethnographer
- someone with knowledge of the area of study
- identification of all areas contributing to problem
Create a field manual.
- Site inventory profile
- a. Hospital characteristics
- b. Order entry system information
- c. CDS types availabale
- d. CPOE related applications
- e. CDS related governance
- Interview guide (5 areas of question type)
- a. Culture
- b. Control, autonomy, trust
- c. Cognition / emotions
- d. Content
- e. Human computer interface
- Observation guide (Where and What)
- a. Cafeteria
- b. Doctors' lounge
- c. People outside of clinic
- d. 5-10 minute interviews
- Field survey
- a. Jot briefly
- b. Use keywords
- c. Focus on interesting things not everything
- d. Add details throughout the day
- e. As soon as possible (that day or night) expand your notes
Once on site the team does both one on one interviewing and observation and mapping at the same time.
1. One on one interviewing is what it sounds like. It is important to remember that it is not “talking” but asking opened ended questions to get the interviewees opinions and ideas without injecting ones own biases or opinions.
2. Observation and mapping is best described as
Look for assumptions, variables that compose cultures by asking:
1. What do people say/do?
2. What does this say about the assumptions they make about themselves and the world around them?
Onsite Data Collection Methods
- Interviews start board and continually get narrower in scope as the interview progresses. For more interview methods go to Ethnography .
- Interviews need to be transcribed and analyzed.
- Observations can verify interview data.
- Use semi-structured interviews (or field surveys) to find limits of cultural variation
- Conduct structured interviews/assessments so that you can make the explicit comparisons necessary to meet project goals
- Using findings methods must be adapted continually by using debriefs continually during the day.
- Examples: Investigator finds that good gossip happens in the afternoon in the main lobby after lunch. The group decides to send someone to the lobby after lunch tomorrow.
Data analysis (onsite and offsite)
- Interpretation, understanding, making sense of the data
- Organizing to make it manageable
- Code the data 
- Coding data is: Labeling, Linking, Fracturing
- Concurrent with data collection, formulation of research questions
- Continual reflection throughout the entire process
- Asking questions
- Writing memos
- Descriptions not in transcripts
- Emerging themes
- Memos can can become texts for analysis
- Building theory
- Find patterns (example: “Almost all participants reported feeling fear when they rappelled down the cliff”)
- Find themes (example: Fear)
- Iterative process
- Continual team meetings to discuss barriers, themes, and changes that should be made to the field manual are essential to RAP.
Synthesis and Reporting
After analyzing the data and making a summary. Create a report to give to the site. This is a general outline of how to do a RAP.
- - Joan Ash (2015). Rapid Assessment Process: Boot Camp, Portland OR. Held at Portland, OR Northwest Innovations Center at Veterans Hospital.
Submitted by Inho Kim