Explanatory case study design: application in paediatric burns health services research

Background: Explanatory case study design offers a way to address complex research issues; however its application in health arenas has been limited. Contents: This article describes the application of explanatory case study design when investigating complex, multifactorial phenomena in a clinical setting. To provide an example, this article shows a case where it was applied to the investigation of functional outcome following burn injury in children, within the real-life contexts of hospital, home, and school. Conclusions: Strategies implemented to maintain quality and rigour of the research design, whilst responding to the inherent difficulties of working in a clinical setting, are outlined. A summary model of the implementation of explanatory case design is presented to provide a benchmark against which this methodology, as applied in health research, can be appraised.