Exploration of Patient Ethics and Communication Excellence (PEACE) Rounds

Qualitative data about participants' experiences throughout the PEACE Rounds will be collected using semi-structured interviews and participant observation. This data will be analyzed to describe and explain the perceptions that emerge from participant experience.

Qualitative Sampling Purposive samples are identified to initiate data collection and analysis, and then are used to select participants who are likely to clarify, verify, or contradict data as it is collected. Sampling concludes when the data are "saturated," which means the coded categories are well-defined and no new significant insights are emerging from additional interviews.

Semi-structured Interviews

The study team will conduct semi-structured interviews, which will be recorded and transcribed, following a consented subject's participation in at least one PEACE round. Open-ended questions, intended to elicit participants' perspectives on their experience of PEACE Rounds, will frame the interview. These are:

"What/who do you remember most vividly?" "What was most meaningful to you? "What would you change about the experience, if you could? " "Would you do it again? Why or why not?" "What, if anything, changed after PEACE rounds?"

Observation PEACE Rounds will be observed by the PI to collect data that will provide further insight to participants' experiences. Observations of interactions and reactions in real time will be documented and the data will be coded and analyzed using thematic analysis methods. Observational data will not be integrated into interview data but will be used to confirm or contrast reported data.

Qualitative Data Analysis Qualitative methodology does not seek to verify hypotheses based on logical assumptions, as quantitative measures do, instead it is used to derive salient constructs directly from the data. This methodology allows inductive understanding of participants' perceptions of their participation in PEACE Rounds.

The qualitative data will be analyzed according to the thematic analysis method based on that of Braun and Clarke . the researcher has become familiar with the data and generated an initial list of ideas that are relevant to the research objective, codes will be generated. The codes will reflect a specific feature of the data that further explicates it. After the data has been coded, the researcher will look for how different codes can be combined to create overarching themes. When there is essentially no new information coming from the codes, the data is considered saturated and no new themes are created. At this point, the researcher will review the themes and refine them, so they can be expressed in a data map expressing how they fit together to tell the story of the data.

Inclusion criteria

• An employee of AdventHealth (AH), or a physician with privileges there, who has participated in PEACE Rounds at AdventHealth.
• Over the age of 18
• Able to provide informed consent
• Must speak and understand English

Exclusion criteria

• Discernable cognitive impairment