Hidden Dimensions Revealed: Progressive Grounded Theory Study of Quality Care in the Hospital

The delivery of quality care, although acknowledged as being vital to health care systems, is a complex, poorly understood phenomenon. This article describes an attempt to respond to the challenge of studying the meaning of quality nursing care in an acute-care hospital setting. Grounded theory method was used to progressively develop theory incorporating both patients' and nurses' perspectives. Separate studies were undertaken concurrently in the same setting, and the ongoing development of theory is continuing. The patient's perspective is presented as the central focus, with findings and data from the nurse study being used for further comparative analysis. The different levels of analysis and progressive stages of theory development are highlighted.