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Grand rounds in methodology: designing for integration in mixed methods research
  1. Timothy C Guetterman1,
  2. Milisa Manojlovich2
  1. 1 University of Michigan, Ann Arbor, Michigan, USA
  2. 2 School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Timothy C Guetterman, University of Michigan, Ann Arbor, Michigan, USA; tguetter{at}


Mixed methods research is a popular approach used to understand persistent and complex problems related to quality and safety, such as reasons why interventions are not implemented as intended or explaining differential outcomes. However, the quality and rigour of mixed methods research proposals and publications often miss opportunities for integration, which is the core of mixed methods. Achieving integration remains challenging, and failing to integrate reduces the benefits of a mixed methods approach. Therefore, the purpose of this article is to guide quality and safety researchers in planning and designing a mixed methods study that facilitates integration. We highlight how meaningful integration in mixed methods research can be achieved by centring integration at the following levels: research question, design, methods, results and reporting and interpretation levels. A holistic view of integration through all these levels will enable researchers to provide better answers to complex problems and thereby contribute to improvement of safety and quality of care.

  • Health services research
  • Qualitative research
  • Implementation science
  • Statistics
  • Evaluation methodology

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  • X @tc_g, @mmanojlo

  • Contributors Both authors conceived this study. TG wrote the first draft and revision and is guarantor. Both authors critically reviewed the manuscript and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer-reviewed.