Implementing Effective Care Management in the Patient-Centered Medical Home by Catherine Taliani - Article Example

A Critique of the Literature Name Instructor Date A Critique of the Literature Introduction Research has strengths and weaknesses that can be analyzed to improve treatment and assessment of patients (Taylor, 2010). This paper is a critique of literature on the article ‘implementing effective care management in the patient-centered medical home’ by Catherine Taliani. The critique is important since it helps in evaluation of the research that was carried out while drawing knowledge and skills applied in the research. In analyzing the literature, the quality of the article and the quality of the research that is carried out is reviewed. The critique involves a review on the findings, the quality of methods used, and how appropriate the research is to nursing practice. Further, it looks at the link between the purpose, findings, and the given conclusions. A critique of an article lays a foundation of further research on the same topic since other researchers can use the critique to carry out better research (Taylor, 2010). Title A research title should have clarity so that other may understand the nature of research carried out and ensure that people cannot get distracted (Broomfield, 2008). It should be free from ambiguity to ensure it is very clear in the mind of a reader. The title by Taliani (2013) is clear and does not have any ambiguity thus being directional. In addition, a well-defined title is important to make it easy to understand. The title used by Taliani (2013) is well defined. Taliani has used simple language for the title that makes it easy for everyone to understand and avoid bias. The title of the research is of current importance since there are many people who are searching for the information on effective care management on patients. Abstract The importance of abstracts is to provide a summary of the article. Abstracts are supposed to be concise and easy to read. An abstract should make it easy to find information in the article since it gives a summary of the entire content, the methods used in the research, findings of the research, and the relevance of the study. The abstract is very important to the reader since it will help him or her in judging if the article is worth reading (Houser, 2008). Taliani gives an abstract in the article that is concise and easy to read. The abstract is accurate, brief, and clear in such a way that a reader can easily understand. It is an informative abstract, which gives the purpose of the study, the methodology, the results, and the conclusions drawn from the results. Introduction The article by Taliani (2013) starts by explaining on patient- centered medical home model. The importance of the context is explained and the author explains why it is an area of interest. Further, the specific problem of the study is given and the background of the context given. The general approach that the paper has used is explained and the significance of the results given. The contribution of the article to the context is also explained to catch the reader’s attention. The author also recognizes similar studies that have initially been carried out and are similar to the study. For example, he uses a current review that describes team based care and care management as the most important components in provision of care to patients. The author gives a rationale on why there is need for research and why it was necessary for the research to be carried out. Literature review Literature review is necessary in any research studies. A good literature review should identify a relationship between research that has been carried out previously and the research that is being carried out presently. The review literature gives a summary of the strategy used in research and in identifying trends and literature gaps (Liamputtong, 2010). Taliani does not give a literature review of the studies thus failing to give the reader a chance to review what other authors have done on the same context. It is not possible to tell if the studies are comprehensive and unbiased since the literature, review does not exist. Aims and Hypothesis The article by Taliana (2013) has stated the aim of the research that is carried out but not the hypothesis. The hypothesis is not a necessity in qualitative studies because researchers are open to anything that might come up in the study. However, it is important at some point for a research to have a hypothesis so that the relationship between variables is explained. In the research by Taliani (2013), it is not essential that a hypothesis should exist but it may be provided. Methods The method of study needs to give enough details for the study. Taliani (2013) explains the methods used in carrying out the research. Qualitative data was used in the studies. Sampling The author identified the target population of the study as 136 individuals in 21 out of 25 practices. The sampling process of the study is not explained in the article and it fails to give the reader a technical knowhow of the sampling methods that were used. The 25 practices that were used in the study were ranked according to their improvement in 18 months. A probability sample, for example, would have been used as a population representative. However, it has been noted that in most medical studies samples are not enough to complete the study. The study would have been more direct and less biased if, the sampling process was different and stated in the research. This way the reader could be able to tell if the sampling process is good or not. The author fails to elaborate on the sampling process clearly making the reader not easily identify if there is bias within the study. However, in the results the author gives some details of the sampling process when he describes the practices that were included in the study. How the samples were taken or identified is not explained and the reader is left to imagine on the criteria that was probably used instead of having a clear picture of what actually happened. The author does not recognize if there were any ethical considerations put in place while carrying out the study to ensure consent and privacy on the subjects involved. Design A cross-sectional design was used in study since it involved research conducted on a population at a defined point in time. The author used the 136 individuals to carry out the research during the entire time. In research, it is possible to use a longitudinal study that involves study of one subject at different points of time to identify any possible changes. However, in this study, it would have been time consuming since the sample size is very large; it was not possible to study all the individuals all at different periods of time and finish the research at the same period. Therefore, for the purpose of time the use of cross-sectional design to carry out this research was very appropriate. Threats to internal validity of the research were not overcome in any way since there was no specification on the age of the individuals used for research. The study by Taliani (2013) did not include the eligibility criterion of the study and the exclusion criteria. The exclusion criterion is important to determine if the subjects meet the inclusion criteria. Instruments/measurements The study involved use of qualitative interviews on the 136 individuals who were different in their occupation. The interviews were conducted using interview guides, which are essential when carrying any interviews. Structured interviews are important in ensuring that the information that is collected is uniform across all the individuals involved (Bernard, 2006). Interviews that are structured and semi structured ensure consistency in farming of the interview questions. In the research, only one type of instrument for collecting information was used and thus the survey has nothing to compare with. The researcher would have added at least other instruments of collecting data to ensure that the data collected has its comparison. However, by using the same survey for the study the author avoided threats to the validity of the study. The study does not protect the privacy of the participants neither does it give compensation for the time the subjects used in the interviews. The author does not say if the survey data was secured or restricted. It is an important factor to secure data so that the privacy of the participants is maintained. Data analysis Data was collected using interviews. The author could have used other methods that are more cost effective and time effective like the use of questionnaires. The interviews were 15-20 minutes long and they were recorded and then transcribed. For qualitative analysis, the transcripts were entered into NVivo version 9 software. The individual interviews were analyzed for themes and patterns using grounded-theory methods. Grounded theory methods are easy to use and yet they give information that is relevant and important for the study. The methodology involves iterative development of some theories on what is occurring to the data in the collection process according to QSR International (2010). The method involves developing themes as they emerge from the ground based on open-ended responses during the study. Broad codes had a reflection on responses to the interview questions on PCMH had been created by a team of investigators. The investigators then coded and analyzed the transcripts. Group consensus resolved discrepancies occurring during the coding exercise. Group consensus is the best way of solving discrepancies as they occur in any research. The author gives details on the method of data collection procedures and data analysis. The scientific principles and statements were made within ethical considerations of the research through ensuring that the analysis was thoroughly carried out. However, by failing to indicate if the subjects were subjected to any privacy the author does not consider subjects’ ethical issues. Results The results of the study are concise and are presented in prose form and tables. Evidence shows that the use of graphs to display data is the best method since it is easier to interpret. The results that are of relevance to research questions are included in the results that the author presents. The results are analyzed in categories that make it easy for the reader to follow and understand. The author applies knowledge and skills to analyze the results and be convincing to the reader. There is good flow of information as the author discusses on the results. Results should ensure that there is good flow of information to avoid losing the reader or confusing them. Taliani gives a case study for the results to enhance the understanding of the reader. Use of a case study makes understanding easier and creates a better picture of what is being explained by the author. A cases study acts as a very important tool in explaining and giving details on a particular incidence. The levels of significance were also given which is an important determinant of the significance of the results. A good research is one that can give the significance of the results that are given. Discussion Research papers require discussions that are concise and discuss the significance of findings instead of summarizing findings. The discussion of the research conducted gives details on the results and does not just summarize the findings. Since the study does not have a literature review, the article does not compare the different results from various studies. The author does not show how use of different instruments can affect the results of the studies. Limitations The research paper by Taliani (2013) does not focus on strengths of the study. The author addresses the limitations of the study that should be put into consideration when the conclusion is under scrutiny. The author recognizes that there is need for further research to explore on the effects of clinical care management. The depth of questions about care management that were asked during the interviews has been criticized. The author recognizes that the questions were based on understanding PCMH implementation and not just implementation of care management or the associated tools like the EMR. There is a limitation on the possibility of bias on responses towards questions are perceived as socially desirable. Interviews should have been conducted in settings that gave assurances of confidentiality. Limitations in a research paper are important so that they can be used in considering the validity of the study and in suggesting how to improve the future of the research (Crabtree, 1999). Conclusions The author draws conclusions that are in line with the plan and methodology of the research as well as its findings. Every research requires a conclusion that is in line with the methodology and findings (Bradley, 2009). Conclusions included the approach used by the research to look at the care management in the PCMH, which is a development that has not been explored fully. The author does not point out any areas that need future research. References The reference list by Taliani (2013) is inclusive of all in text citations that are accurate and complete. Summary In summary, the research by Taliani (2013) was carried out thoroughly and it was well researched according to the research guidelines. The information in the article is presented in a logical sequence that is concise and coherent. Further, the methods used, analyses of the data, and the design used was all appropriate. The purpose of the study, its findings, and conclusion are all linked and significant. References Bradley, C (2009). Research in action: using positive deviance to improve quality of health care. Implement Sci; 4:25. Broomfield, R. (2008). A nurses guide to the critical reading of research. Australian Journal of Advanced Nursing , 102-109. QSR International (2010). NVivo Qualitative Data Analysis Software [computer program]. Version 9.0. Burlington, MA: QSR International. Bernard, H. (2006). Research Methods in Anthropology: Qualitative and Quantitative Approaches. 4th ed. Lanham, MD: AltaMira Press. Crabtree, B. (1999) Doing Qualitative Research in Primary Care: Multiple strategies. 2nd ed. Newbury Park, CA: Sage. Denzin, N. (2000). Handbook of Qualitative Research. Thousand Oaks, CA: Sage. Taliani, C. (2013). Implementing Effective Care Management in the Patient-Centered Medical Home. American Journal of Managed Care, 19(12), 957-964. Houser, J. (2008). Nursing Research: reading, using and creating evidence. UK: Bartlett Publishers. Liamputtong, P. (2010). Research methods in health: foundations for evidence based practice. Australia : Oxford University . Taylor, G. (2010). Developing a Framework for critiquing health research: an early evaluation. Nurse Education Today , 1. Read More