The Stanford Lightning Report Method: A comparison of rapid qualitative synthesis results across four implementation evaluations

Background: Growing demand for medical assistants (MAs) in team-based primary care has led health systems to explore career ladders as one solution to improve MA recruitment and retention. The practical implementation of career ladders remains a challenge for many health systems, and an improved understanding of MA perspectives on career ladders is needed. Methods: Semi-structured focus groups were conducted August to December 2019 in primary care clinics based in three health systems in California and Utah. MA perspectives of existing career ladders, including acceptability, appropriatness and impact on career intentions were discussed, recorded, and qualitatively analyzed.Results: Ten focus groups conducted with 59 participants showed the MA employment decisions were influenced by a number of factors, with opportunities for economic and professional growth predominating. MA career aspirations varied, with “stepping stone” MAs using their role to advance into other health professions and “contented career” MAs hoping to grow within their MA career. Career ladders were acceptable in theory but MAs felt current implementations could benefit from clear and transparent expectations for advancement, consistent recognition of training, experience and work responsibilities, the ability to advance in place, and career counseling. Conclusion: MAs held positive perceptions of career ladders, yet recommended a number of improvements to their practical implementation across three institutions. The emergence of two distinct clusters of MA professional needs and desires suggests an opportunity to further optimize career ladders to provide tailored support to MAs in order to strengthen the healthcare workforce and talent pipeline.

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“…Early ndings were reported back to operational leaders at each institution to inform ongoing improvement. 21…”

Section: Discussionmentioning

confidence: 99%

Tailoring Career Ladders for Medical Assistants in Primary Care: A Qualitative Assessment

Vilendrer

Amano

Brown‐Johnson

et al. 2021

Preprint

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“…Analysis: We used standard qualitative methods, including rapid content analysis 18 19 and member checking. 20 Within the VHA, rapid qualitative approaches have successfully been used to provide real-time insights backed by high-quality research methods.…”

Section: Methodsmentioning

confidence: 99%

“…Per rapid qualitative analysis methods, we created templated case summaries for each interview, which were reviewed by the following team members (CB andKG and discussed during weekly debriefing calls with the research team. 18 Initial themes were derived from these templated case summaries and debriefing calls (conducted with entire coauthor research team).…”

Section: Methodsmentioning

confidence: 99%

“…Step 2: creation and circulation of interim report for feedback (Lightning Report and modified member check). We used a Lightning Report approach—a rapid qualitative actionable product meant for wide distribution 18 —to create a preliminary report based on themes from case summaries and postinterview debriefing calls once we had collected half of the data sample (2 months from first interview: n=10; see online supplemental appendix B for interim report). We circulated this Lightning Report to study advisors, VHA EOH central leadership and participants for feedback, constituting a modified synthesised member check.…”

Section: Methodsmentioning

confidence: 99%

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Protecting the healthcare workforce during COVID-19: a qualitative needs assessment of employee occupational health in the US national Veterans Health Administration

et al. 2021

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ObjectiveEarly in the COVID-19 pandemic, US Veterans Health Administration (VHA) employee occupational health (EOH) providers were tasked with assuming a central role in coordinating employee COVID-19 screening and clearance for duty, representing entirely novel EOH responsibilities. In a rapid qualitative needs assessment, we aimed to identify learnings from the field to support the vastly expanding role of EOH providers in a national healthcare system.MethodsWe employed rapid qualitative analysis of key informant interviews in a maximal variation sample on the parameters of job type, rural versus urban and provider gender. We interviewed 21 VHA EOH providers between July and December 2020. This sample represents 15 facilities from diverse regions of the USA (large, medium and small facilities in the Mid-Atlantic; medium sites in the South; large facilities in the West and Pacific Northwest).ResultsFive interdependent needs included: (1) infrastructure to support employee population management, including tools that facilitate infection control measures such as contact tracing (eg, employee-facing electronic health records and coordinated databases); (2) mechanisms for information sharing across settings (eg, VHA listserv), especially for changing policy and protocols; (3) sufficiently resourced staffing using detailing to align EOH needs with human resource capital; (4) connected and resourced local and national leaders; and (5) strategies to support healthcare worker mental health.Our identified facilitators for EOH assuming new challenging and dynamically changing roles during COVID-19 included: (A) training or access to expertise; (B) existing mechanisms for information sharing; (C) flexible and responsive staffing; and (D) leveraging other institutional expertise not previously affiliated with EOH (eg, chaplains to support bereavement).ConclusionsOur needs assessment highlights local and system level barriers and facilitators of EOH assuming expanded roles during COVID-19. Integrating changes both within and across systems and with alignment of human capital will enable EOH preparedness for future challenges.

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“…Throughout the assessment, early findings were reported back to operational leads to inform ongoing improvement using the Lightning Report Method described in 2019 by Brown-Johnson et al [ 51 ]. This project was reviewed by the Stanford Institutional Review Board and did not qualify as human subjects research (Protocol ID 56126).…”

Section: Methodsmentioning

confidence: 99%

An App-Based Intervention to Support First Responders and Essential Workers During the COVID-19 Pandemic: Needs Assessment and Mixed Methods Implementation Study

Vilendrer¹,

Amano²,

Brown‐Johnson³

et al. 2021

J Med Internet Res

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Background The COVID-19 pandemic has created unprecedented challenges for first responders (eg, police, fire, and emergency medical services) and nonmedical essential workers (eg, workers in food, transportation, and other industries). Health systems may be uniquely suited to support these workers given their medical expertise, and mobile apps can reach local communities despite social distancing requirements. Formal evaluation of real-world mobile app–based interventions is lacking. Objective We aimed to evaluate the adoption, acceptability, and appropriateness of an academic medical center–sponsored app-based intervention (COVID-19 Guide App) designed to support access of first responders and essential workers to COVID-19 information and testing services. We also sought to better understand the COVID-19–related needs of these workers early in the pandemic. Methods To understand overall community adoption, views and download data of the COVID-19 Guide App were described. To understand the adoption, appropriateness, and acceptability of the app and the unmet needs of workers, semistructured qualitative interviews were conducted by telephone, by video, and in person with first responders and essential workers in the San Francisco Bay Area who were recruited through purposive, convenience, and snowball sampling. Interview transcripts and field notes were qualitatively analyzed and presented using an implementation outcomes framework. Results From its launch in April 2020 to September 2020, the app received 8262 views from unique devices and 6640 downloads (80.4% conversion rate, 0.61% adoption rate across the Bay Area). App acceptability was mixed among the 17 first responders interviewed and high among the 10 essential workers interviewed. Select themes included the need for personalized and accurate information, access to testing, and securing personal safety. First responders faced additional challenges related to interprofessional coordination and a “culture of heroism” that could both protect against and exacerbate health vulnerability. Conclusions First responders and essential workers both reported challenges related to obtaining accurate information, testing services, and other resources. A mobile app intervention has the potential to combat these challenges through the provision of disease-specific information and access to testing services but may be most effective if delivered as part of a larger ecosystem of support. Differentiated interventions that acknowledge and address the divergent needs between first responders and non–first responder essential workers may optimize acceptance and adoption.

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The Stanford Lightning Report Method: A comparison of rapid qualitative synthesis results across four implementation evaluations

Cited by 30 publications

References 26 publications

Tailoring Career Ladders for Medical Assistants in Primary Care: A Qualitative Assessment

Tailoring Career Ladders for Medical Assistants in Primary Care: A Qualitative Assessment

Protecting the healthcare workforce during COVID-19: a qualitative needs assessment of employee occupational health in the US national Veterans Health Administration

An App-Based Intervention to Support First Responders and Essential Workers During the COVID-19 Pandemic: Needs Assessment and Mixed Methods Implementation Study

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