Includes bibliographical references and index.

In a context of failing UK health care services, I commenced a professional doctorate in 2010 to explore the use of a new total quality management model that could improve patient care. Although other authors have conceptually developed health-care-specific total quality management models, a dearth of research existed with regard to the implementation and evaluation of such models. My research addressed this paucity by examining the adoption of a new total quality management model I developed using a reflexive action research methodology over an 18-month period in a private health care firm. Fieldwork included gathering qualitative data in three cycles: (a) pre-implementation, (b) implementation, and (c) post-implementation. This case study gives an account of one particular facet of my doctoral research, involving the use of participant observation as a method for gathering data on the everyday experiences, thinking, and actions of participants. The case provides methodological and practical insights into the advantages and limitations of this method and addresses key issues such as bias, reflexivity, and reactivity. Consideration of such issues allows researchers to examine their relationship with the researched, consider alternative ways of interpreting data, and account for participant behaviors when being observed.

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