title: Development of a qualitative exploratory case study research method to explore sustained delivery of cognitive services.
abstract: OBJECTIVE
  To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case.
  
  
  METHODS
  The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark.
  
  
  METHODS
  A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods.
  
  
  RESULTS
  The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data.
  
  
  CONCLUSIONS
  The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the sustainability of cognitive services.
authors.affiliation: Institute of Pharmacology and Pharmacotherapy, Section for Social Pharmacy, Faculty of Pharmaceutical Sciences, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen, Denmark. ska@farma.ku.dk
authors.forename: Susanne
authors.initials: S
authors.lastname: Kaae
authors.forename: Birthe
authors.initials: B
authors.lastname: Søndergaard
authors.forename: Lotte Stig
authors.initials: LS
authors.lastname: Haugbølle
authors.forename: Janine Morgall
authors.initials: JM
authors.lastname: Traulsen
mesh_terms: D003695:Delivery of Health Care / Q000379:methods*; D003718:Denmark; D004994:Ethics, Pharmacy; D006284:Health Plan Implementation; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007857:Leadership; D009313:National Health Programs; D019982:Organizational Case Studies; D010353:Patient Education as Topic / Q000941:ethics / Q000379:methods / Q000458:organization & administration; D010593:Pharmaceutical Services / Q000458:organization & administration* / Q000592:standards; D010594:Pharmacies / Q000458:organization & administration*; D010865:Pilot Projects; D011361:Professional Competence; D011786:Quality Control; D019984:Quality Indicators, Health Care; D012107:Research Design