Table 4 Methods for collecting and analyzing data that help to plan, implement, and evaluate the impact of improvement interventions (adapted from references [31, 42, 47, 48])

Directly observing professional practices during work activities

Interviewing (in depth) patients and families, physicians, and other key staff

Obtaining surveys of staff, structured checklists of practice environments, and medical chart reviews

Systematically identifying and validating case narratives of connections between professional process elements or solutions

Creating process-oriented narratives and maps that go beyond technical aspects of interventions to represent properties of the professional communities into which interventions are introduced; keeping records of the dynamic cultural and political changes (including both events and structures) that appear to underlie observed changes in clinical processes and outcomes

Collecting information from staff-generated journals and field notes that record the practice characteristics, events, and situations seen as affecting the observed range of success in practice improvements

Using complex adaptive systems theory in data analysis

Recording examples of emergent properties, self-organization, and co-evolution within the organizational environment