title: Using qualitative mixed methods to study small health care organizations while maximising trustworthiness and authenticity.
abstract: BACKGROUND
  The primary health care sector delivers the majority of health care in western countries through small, community-based organizations. However, research into these healthcare organizations is limited by the time constraints and pressure facing them, and the concern by staff that research is peripheral to their work. We developed Q-RARA-Qualitative Rapid Appraisal, Rigorous Analysis-to study small, primary health care organizations in a way that is efficient, acceptable to participants and methodologically rigorous.
  
  
  METHODS
  Q-RARA comprises a site visit, semi-structured interviews, structured and unstructured observations, photographs, floor plans, and social scanning data. Data were collected over the course of one day per site and the qualitative analysis was integrated and iterative.
  
  
  RESULTS
  We found Q-RARA to be acceptable to participants and effective in collecting data on organizational function in multiple sites without disrupting the practice, while maintaining a balance between speed and trustworthiness.
  
  
  CONCLUSIONS
  The Q-RARA approach is capable of providing a richly textured, rigorous understanding of the processes of the primary care practice while also allowing researchers to develop an organizational perspective. For these reasons the approach is recommended for use in small-scale organizations both within and outside the primary health care sector.
authors.affiliation: Medical School, Peter Baume Building 42A, Australian National University, Canberra, ACT, 2601, Australia. Christine.phillips@anu.edu.au.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Phillips
authors.affiliation: Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia. kathryn.dwan@anu.edu.au.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dwan
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia. julie.hepworth@qut.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Hepworth
authors.affiliation: Inner East Medicare Local, Burwood, Victoria, Australia. chris_pearce@mac.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Pearce
authors.affiliation: Medical School, Australian National University, Canberra, Australia. sally.hall@anu.edu.au.
authors.forename: Sally
authors.initials: S
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002648:Child; D002675:Child, Preschool; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D013222:State Medicine / Q000458:organization & administration*; D055815:Young Adult