Interview Guide for Clinician Provider

Attachment C14: Interview Guide, Clinician/Provider

Form Approved

OMB No. 0920-XXXX

Exp. Date __xx/xx/20xx_______

Public reporting burden of this collection of information varies from 30 to 60 minutes with an estimated average of 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX)

A. Introductory Questions

A1. What is your position in this clinic? What are your responsibilities in relation to the spina bifida patients and their families who come to this clinic?

A2. How long have you been involved with this clinic?

A3. Have you received specific training or education with respect to treating patients with spina bifida?

A4. What types of medical assessments are conducted with spina bifida patients in this clinic?

For example:

• ADL

• Assistive technology

• Bladder continence

• Bowel continence

• Developmental screening

• Educational assistance/consultation

• Emotional/behavioral

• Family function

• Fitness

• Gait

• GU function

• Hearing

• Home

• Independence

• Latex

• Manual muscle testing

• Mental health services

• Mobility

• Musculoskeletal

• Neurological

• Neuropsychological testing

• Nutrition

• Orthotics

• Psychoeducational testing

• Pulmonary

• Recreation

• Renal function

• Seating

• Self-assessment

• Sexuality

• Shunt

• Skin

• Spine

• Transportation

• Vision

• Vocational

• Wheelchair

• Women’s health

A5. What types of clinical interventions are delivered to patients in this clinic?

For example:

• Bowel program training

• Decubitus care

• Family counseling

• Follow-up to bowel program training

• Genetic counseling

• Intermittent catheterization training

• Intermittent catheterization training follow-up

• Individual Educational Plans

• Individual counseling

• Mental health services

• Nutrition education

• School system liaison

• Self-care

• Sexuality counseling

B. Care Coordination

We would like to talk about how care is coordinated in this clinic.

B1. How would you describe your interaction/role with care coordination in this clinic?

[Probe: In addition providing direct medical care to spina bifida patients, what is your role in the coordination of care for those patients?]

B2. What do you consider the critical components of care coordination in this clinic? [For example, how is care coordination organized – team or single care coordinator?]

C. Barriers and Facilitators

C1. From your perspective as a health care provider, what would you say are the challenges to providing care coordination in this spina bifida clinic?

Include challenges that have been overcome in offering care coordination and challenges that have not been overcome.

Possible probes:

• Staff training

• Provider attitudes or beliefs regarding value of care coordination

• Reimbursement/cost issues

• Staff time

• Communication between care providers or different care systems

• Organization of systems of care

• Capacity to meet all needs of all patients

• Families’ ability to take advantage of services offered.

• Ability to determine who is eligible for services.

C2. How have the challenges to providing care coordination been overcome in this clinic?

[Probes] For those challenges you say have not been overcome, what is it that keeps the clinic from being able to overcome them? What do you think it would take to be able to overcome those challenges?

C3. Are there benefits that you think have been achieved from care coordination? (How effective has it been in reaching its goals?)

What aspects have worked best?

What aspects have not worked well?

C4. If you were giving advice to a spina bifida clinic that is considering introducing care coordination, what are the most important things they should consider?

C5. What about if a spina bifida clinic already has some level of care coordination, but wants to expand or improve it; what advice would you give them on how best to improve the service they offer?

D. Closing Questions

D1. Do you have any other ideas or recommendations for how best to offer care coordination in spina bifida clinics in general?

D2. Is there anything else you would like to tell us about care coordination services in this clinic (that we may have forgotten to ask)?

D3. Do you have any questions for us before we end the interview?

Thank you very much for taking the time to discuss these issues with us. Your knowledge and perspective is very important to our study. If you have anything else you would like to tell us, or any questions for us, please feel free to contact us.