Rapid Assessment Process How to

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This is an guide to doing a RAP using a hypothetical site visit by Joan Ash and her team studying clinical decision support.

Before getting to site (Preparation)

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
  • Field survey

Onsite (Investigation)

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

  • Gossip
  • 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