Exploring Policy Response and Quality of Care from Lessons Learned during COVID-19 in Moderate Testing, High-Complexity Laboratories in the Department of Defense
College of Health Sciences and Public Policy, Walden University
How they used Delve
A doctoral candidate at Walden University used Delve to line-by-line code interviews with seven Department of Defense laboratory professionals, relying on it for secure transcript storage, coding, analytic memoing and iterative theme development in a reflexive thematic analysis organised by the Donabedian model.
“The Delve Qualitative Analysis tool was used to support data organization, secure storage of transcripts, systematic coding, analytic memoing, and iterative theme development. Delve is a secure, web-based qualitative analysis platform designed to facilitate rigorous, transparent analytical processes (Paulus, 2023). [...] Compared to manual coding methods using word processing or spreadsheet software, Delve enabled more systematic management of large qualitative datasets, reduced the risk of overlooking meaningful data segments, and supported [analytic rigor].”
- Field
- Health policy and clinical laboratory medicine; what Department of Defense moderate- and high-complexity laboratories learned during COVID-19 and whether those lessons reached policy and quality improvement
- Data
- Semistructured interviews with seven laboratory professionals working in moderate- and high-complexity Department of Defense laboratories through COVID-19 operations, conducted over Teams and reviewed by participants for accuracy
- Approach
- Phenomenological study of lived experience, analysed with an inductive reflexive thematic analysis through Braun and Clarke's six phases. Transcripts were verified with participants, then coded line by line in Delve to generate initial codes grounded in participants' responses, with codes applied systematically to meaningful units of text. Manual coding was run alongside the software as a deliberate dual method. Twenty themes were organised against the Donabedian model of Structure, Process and Outcome. Trustworthiness rested on peer debriefing with colleagues expert in qualitative research and laboratory practice, member checking, methodological triangulation, reflexive practice and a full audit trail.
- Data types
- Interviews
Abstract
Historically, pandemics have exposed critical gaps in health system preparedness, underscoring the need for resilient infrastructures.Despite extensive research on COVID-19, limited attention has been given to the role of government healthcare facility laboratories-particularly within the Department of Defense (DoD)-in informing policy responses and sustaining quality of care.The purpose of this study was to explore laboratory lessons learned during the pandemic, examine efforts to translate those lessons into policy and quality improvement processes, and assess perceptions of their impact on policy and quality outcomes.Guided by the Donabedian Model, this qualitative study explored the lived experiences of laboratory professionals working in moderate-and high-complexity DoD laboratories during COVID-19 operations.Data were collected through semistructured interviews with seven laboratory professionals and analyzed using phenomenological methods.Twenty themes were identified and organized using the Donabedian model: Structure, Process, and Outcome, including seven structural, eight process, and five outcome themes addressing the research question.Findings indicated that leadership, standardized processes, workforce adaptability, and information systems were critical to laboratory performance.Results highlight the importance of integrating operational lessons into policy and preparedness frameworks.Implications for positive social change include enhanced laboratory readiness, improved policy-informed decision making, and strengthened quality of care during future public health emergencies.
Citation
Carmen Alesia Bell (2026). Exploring Policy Response and Quality of Care from Lessons Learned during COVID-19 in Moderate Testing, High-Complexity Laboratories in the Department of Defense. ScholarWorks (Walden University).