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Poster Numbers 77 to 94 – Planning care: Poster No: 89
Advancing mixed-methods research: using timelines to depict patient journeys
  1. Natalie Momen1,
  2. Marilyn Kendall2,
  3. Stephen Barclay3 and
  4. Scott Murray2
  1. 1CLAHRC End of Life Care, Institute of Public Health, University of Cambridge, UK
  2. 2Centre for Population Health Sciences, University of Edinburgh, UK
  3. 3Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK

Abstract

Background There is great interest to explore best models of collaborative cancer care, with specialists and Primary Care work together. In a study evaluating an electronic cancer ongoing record in primary care, the research team needed to display and overview a large amount of diverse data from clinical records, hospital letters and study interviews. Innovative techniques were required to understand the complexities of patient experiences involved.

Aims To investigate the use of timelines to help display, overview and analyse a complex dataset in order to examine patients' experiences and the relationships between primary and secondary care.

Methods General Practice case note reviews were carried out for 106 patients who had received a new diagnosis of cancer in the previous 12 months. Data concerning each patient was extracted into a form designed for the study. Timelines were created in Microsoft Visio, displaying cancer related consultations with clinicians in primary care (home visits, surgery consultations and phone calls) and secondary care (outpatient clinics, inpatient admissions, outpatient treatments).

Results In addition to cancer related primary care appointments, all postdiagnosis primary care consultations were depicted, with additional annotations if co-morbidities were the main reason for consultation, to provide context. Relevant prediagnosis appointments, from initial presentation with symptoms, were included. The timelines were used to aid discussion in meetings of the project team and advisory group and in presentations of the study findings.

Discussion The timelines provide a visualisation of patients' journeys that incorporated a diverse dataset from a range of sources, including case reviews and interview data. In some cases they highlighted the ways in which patients may recall consultations differently from health professionals' clinical records. Patient timelines are a useful technique to add to the health services research toolbox.

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