Form #4 Form #4 Base-line semi-structured interview protocol

A

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

ttachment F. Baseline Semi-structured Interview Protocol

RED Implementation: Interview guide

Hi, my name is _____________ . I’d like to interview you today as part of a project funded by the Agency for Health Care Research and Quality (AHRQ) to improve the discharge process at your hospital. The project is being conducted by Boston University Medical Center. We are grateful that you took time out of your busy schedule to participate in this interview. Your experiences and thoughts are very important and will greatly inform the project. The goal of the interview is to gather your thoughts on the implementation of the Project RED intervention. We will use this information to develop a guide for your hospital and other hospitals to implement Project RED and improve the discharge process. This interview is completely voluntary and confidential. You can refrain from answering any question at any time.

Your hospital is implementing a new process for patient discharges using the procedures and toolkit developed by Boston Medical Center. We would like to talk to you about the anticipated implementation experience including your hospital’s goals, organizational supports needed to ensure that the change is successful, and possible facilitators and barriers to accomplishing project objectives.

1. Impetus: What is your understanding of the reasons for changing the patient discharge process? What are the hospital’s objectives?

   1. How well does the existing discharge process work?

   2. Why do you think redesign is needed?

   3. How receptive are the staff likely to be to changing the process?

2. Fidelity: Based on what you’ve heard during our visit, is your hospital likely to implement all of the procedures recommended in the BMC RED toolkit?

   1. What tools seem most helpful?

   2. What tools seem less helpful?

   3. Are any of the tools or methods already being used here?

   4. Are there areas where your hospital may need to “customize”? Why is that?

3. Implementation Training: Based on what you’ve heard described during this site visit, what are your reactions to:

   1. The way the RED toolkit was introduced

   2. Training provided

   3. Technical assistance available

   4. Other resources available/needed

   5. How could the initial implementation visit be improved?

4. Barriers & Facilitators:

   1. What factors are likely to facilitate the patient discharge redesign process and outcomes? Probes:

• Clinic/practice leadership support for the redesign

• Organizational culture including receptivity to change in affected clinical areas and practices

• Experience with strategies used to successfully introduce new clinical tools and processes

d. And, what barriers will the implementation team likely encounter? Probes:

• Priorities competing for attention

• Role clarity for the areas/disciplines involved in the redesign

• Resources/time

• How does the organization typically address (help resolve) such barriers?

5. Organizational Context:

   1. In your area (and in the larger organization) how do leaders demonstrate their support for major change projects such as this one? Probes:

• Leaders make it clear that the project is a priority

• Leaders communicate their commitment to and support for the project

• The project is adequately resourced

• Leaders provide time and training needed for staff to work on implementation

1. Is project progress is routinely reported to a steering group (or an existing organizational management group) to assure that objectives are being met?

• Do you know where the RED implementation team activities will report?

• What happens if the implementation team is not able to progress as planned?

• How are staff held accountable?

3. How do the organization’s leaders help change teams overcome barriers and challenges they face?

g. What words or phrases would you use to describe your organization’s culture – particularly as it relates to change or improvement processes?

h. Is there anything else that you think will impact the ability of your unit (your organization) to redesign the discharge process by implementing the RED guidelines?

E

Public reporting burden for this collection of information is estimated to average 60 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

nd of interview. Thank participant. Reiterate confidentiality.