title: Understanding palliative care on the heart failure care team: an innovative research methodology.
abstract: BACKGROUND
  There is a growing call to integrate palliative care for patients with advanced heart failure (HF). However, the knowledge to inform integration efforts comes largely from interview and survey research with individual patients and providers. This work has been critically important in raising awareness of the need for integration, but it is insufficient to inform solutions that must be enacted not by isolated individuals but by complex care teams. Research methods are urgently required to support systematic exploration of the experiences of patients with HF, family caregivers, and health care providers as they interact as a care team.
  
  
  OBJECTIVE
  To design a research methodology that can support systematic exploration of the experiences of patients with HF, caregivers, and health care providers as they interact as a care team.
  
  
  METHODS
  This article describes in detail a methodology that we have piloted and are currently using in a multisite study of HF care teams.
  
  
  RESULTS
  We describe three aspects of the methodology: the theoretical framework, an innovative sampling strategy, and an iterative system of data collection and analysis that incorporates four data sources and four analytical steps.
  
  
  CONCLUSIONS
  We anticipate that this innovative methodology will support groundbreaking research in both HF care and other team settings in which palliative integration efforts are emerging for patients with advanced nonmalignant disease.
authors.affiliation: Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. Lorelei.Lingard@schulich.uwo.ca
authors.forename: Lorelei A
authors.initials: LA
authors.lastname: Lingard
authors.forename: Allan
authors.initials: A
authors.lastname: McDougall
authors.forename: Valerie
authors.initials: V
authors.lastname: Schulz
authors.forename: Joshua
authors.initials: J
authors.lastname: Shadd
authors.forename: Denise
authors.initials: D
authors.lastname: Marshall
authors.forename: Patricia H
authors.initials: PH
authors.lastname: Strachan
authors.forename: Glendon R
authors.initials: GR
authors.lastname: Tait
authors.forename: J Malcolm
authors.initials: JM
authors.lastname: Arnold
authors.forename: Gil
authors.initials: G
authors.lastname: Kimel
mesh_terms: D002309:Cardiology / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D017146:Models, Organizational; D009864:Ontario; D009937:Organizational Objectives; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D012107:Research Design