Thought Pieces

Thematic Review

Thematic Review

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Niche have considerable experience in carrying out thematic reviews. Such reviews typically form part either of evaluation, or of patient safety / investigation work.

Within evaluations, thematic review is used to draw out the “stories” from the range of qualitative data available to us. This can include: notes of our own interviews and focus groups; service descriptions; implementation plans; progress reports; and feedback material gathered from service users, families, and staff.

Within patient safety / investigation work thematic review can support the development of a safety improvement plan. We will consider the findings from multiple incident responses to identify: related contributory factors; common or linked recommendations and action plans. We will also consider and work to identify how connections should be made along a patient pathway – for example where a safety problem early in treatment is commonly associated with other problems later in the pathway.

Thematic analysis of clinical notes can also enable a detailed understanding of the extent to which practice has adopted agreed changes in policy – and answer questions as to whether current patients risk the same safety problems, or can be seen to be benefiting from the implementation of new services.

Whenever we carry out thematic review, we:

  • Make sure we have access to as full and balanced a range of data as possible. Interviews should reach a good range of informants; documents should cover all topics of concern. We stay alert to what we don’t know, as well as what we do.
  • Apply a balance of deductive and inductive approaches. Deductively, we will start with a set of questions or lines of enquiry, to ensure that our analysis has a structure and focus which are consistent with already-identified concerns. But inductively, we will not be constrained by these frameworks – we are always willing to follow the data, and to identify and develop themes which are unexpected. This can include themes which challenge original structures of thinking.
  • Triangulate our qualitative and quantitative findings. Do the numerical metrics tell the same story as we are hearing from interviewees? If not, why not? We will work to go beyond what each source of data says, to uncover what it really means.
  • Make use of a range of supportive tools and techniques. This will often include use of NVivo to enable thematic mapping – showing how themes inter-relate, and where they seem to co-occur most frequently. Data visualisations such as word maps and theme trees can often be helpful.
  • Report our findings with a strong use of direct quotations, anonymised case studies, and tangible examples. This material really brings more theoretical analysis to life, and enables a clear understanding of the nature and impact of an identified theme.
  • Thematic review works best if we stay both curious and open-minded. We always aim to be both!

    Niche is a national leader in the design and delivery of thematic reviews having developed methodologies whilst undertaking some of the largest evaluations in the NHS . There are increasing calls for the NHS to use more thematic review analytical approaches in understanding issues such as patient safety, clinical outcomes and patient feedback. Read more about this by clicking download below.


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