DATA COLLECTION METHODOLOGY 2
Research Proposal: Data Collection Methodology
The XXXXXX emergency department’s clinical leadership team is concerned with an
increasing number of patients seen in the emergency department as frequent repeat customers.
To combat the problem and increase the efficiency of the emergency department, the Bridge
program was created as a nurse-led, intensive case management program seeking to assist these
high-need patients in obtaining follow-up and ongoing care in an outpatient setting. This
researcher would like to examine the Bridge program’s effects on the number of unreimbursed
Medicare dollars to the emergency department. This paper will describe the study setting,
sampling processes and procedures, and the data collection methodology for this proposed study.
Study Setting
XXXXX is a 504-bed hospital in the greater xxxxx Metropolitan area. The 40-bed
emergency department is a fast-paced environment with a high volume of patients with very
diverse healthcare needs ranging from low to high acuity. The department is staffed by a
multidisciplinary team, including physicians, nurses, care associates, and support team members
who collaborate to provide efficient, high-quality care.
The patient population presenting to the XXXXXXX emergency department is diverse
and includes a wide variety of ethnic and socioeconomic backgrounds and healthcare needs. The
hospital is located in the XXXXX County, Kansas. Urban, suburban, and rural residents have
various healthcare needs, from acute illnesses and injuries to chronic health conditions for which
they seek care. Of concern to this study are those patients with chronic health conditions
presenting for repeated visits, placing a heavy burden on emergency department resources
(Bilazarian et al., 2021). Patients considered to be high-need, high-cost patients are voluntarily
enrolled in the XXXX Bridge program. This nurse-led case management program seeks to
DATA COLLECTION METHODOLOGY 3
determine the underlying cause for repeat emergency department visits and provide resources
and follow-up care to improve the patient’s quality of life and reduce the increased burden
placed on emergency department resources.
Sampling Processes and Procedures
This quantitative, quasi-experimental, retrospective research study will use the
convenience sampling model when enrolling participants. Convenience sampling is a type of
non-probability sampling in which sample bias is a concern (Stratton, 2021). However, since
very little research is available on the effectiveness of similar case management programs on the
outcome of decreased unreimbursed dollars (Bilazarian et al., 2021), this research study will be a
starting point for further research projects regarding the effectiveness of this program.
Participants for this study will be conveniently selected from those XXXX Bridge
program patients meeting the inclusion criteria. A review of the medical records of patients
currently enrolled in the Bridge program at the beginning of the study will be completed. A
power analysis will be conducted to determine whether an adequate sample size was obtained,
but a minimum of 30 participants per independent variable is recommended for a meaningful
study (Gray & Grove, 2020). In the case of this study, there is only one independent variable.
The number of patients currently enrolled in the Bridge program is unknown, but this researcher
estimates it is fewer than 100 patients. This information will be obtained after Institutional
Review Board approval.
Participants included in this study will be those patients aged 40 years or older with a
chronic medical diagnosis, who have had more than 9 visits to the emergency department in the
last 12 months, and who have Medicare as the primary insurance coverage. Aside from those not
meeting the study inclusion criteria, the study will exclude pregnant patients, prisoners, patients
DATA COLLECTION METHODOLOGY 4
with psychiatric diagnoses, and those patients without the cognitive ability to understand or sign
informed consent for their personal healthcare data to be used in a study. Following approval for
this study from the XXXXX Institutional Review Board, data will be collected from internal
reporting sources to give a whole picture of the sample population and size.
Data Collection
Data collection in this quantitative study will be done through direct measurement
because a number can accurately describe the outcome of reimbursed dollars to the organization.
While there is still a probability of error in a study using direct measure methodology, the
incidence is much lower than in other methods (Gray & Grove, 2020). In this study, the Bridge
program is the intervention and, therefore, the independent variable. Data to be collected from
the medical record includes patient age, race, sex, medical diagnoses, primary insurance payor,
date of each emergency department visit, and patient enrollment date into the Bridge program.
This data will be collected from the Health Information Management (HIM) department, not the
researcher, to reduce patient privacy concerns. They will include data from the period of 12
months before the patient’s enrollment in the Bridge program through the 12 months
immediately following enrollment into the program. Should the Institutional Review Board
require consent from patients to enroll in the study, consent will be mailed to the patient’s
address on file. It will include an introductory letter and a self-addressed, stamped envelope for
the return of the signed consent. Patients will be given two months to return the signed consent
for inclusion in the study.
The dependent variable is the effect the intervention has (Gray & Grove, 2020). In this
proposal, the dependent variable to be studied is the number of unreimbursed Medicare dollars.
This measurement will be obtained from the medical record following the billing process. Claim
DATA COLLECTION METHODOLOGY 5
reimbursement amounts will be obtained by the HIM representative gathering data from the
billing office following the final closure of the account. The data to be collected from billing will
include final billing reimbursement from the visits during the 12 months immediately before the
patient is enrolled in the Bridge program and for the 12 months after the patient begins receiving
services from the Bridge program. No measurement tool is necessary because the data collected
related to the outcome are absolute numbers falling under the ratio level of measurement. The
ratio level of measurement is the highest level of measurement and is more effective at
establishing a relationship between the variables (Gray & Grove, 2020).
The researcher understands that errors can occur when transcribing data from the medical
record to the computer document holding study data. The Cronbach alpha coefficient score is the
statistical measure commonly used to test the reliability of ratio-level data. This measurement
can be calculated using a statistical calculator to receive a score from 0 to 1.0. While this risk is
minimal, consideration should be made to reduce these errors. Due to limited resources, every
effort will be made to limit distractions to the researcher during data extraction and will be
double-checked on a different day.
DATA COLLECTION METHODOLOGY 6
References
Bilazarian, A., Hovsepian, V., Kueakomoldej, S., & Poghosyan, L. (2021). A systematic review
of primary care and payment models on emergency department use in patients classified
as high need, high cost. Journal of Emergency Nursing, 47(5), 761–777.e3.
https://doi.org/10.1016/j.jen.2021.01.012
Gray, J. R., & Grove, S. K. (2020). Burns and Grove's the practice of nursing research:
Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.
Stratton, S. J. (2021). Population research: Convenience sampling strategies. Prehospital and
Disaster Medicine, 36(4), 373–374. https://doi.org/10.1017/s1049023x21000649
Powered by TCPDF (www.tcpdf.org)
