VHA Generic Request: Notice Nurse Comment Card; Low Vision Clinic Patient Satisfaction Survey; Vendor Registration; Telephone Transformation Focus Group

Focus Group Discussion Guide
VHA Telephone Transformation Initiative

Objective:
To understand system-level logistics and feasibility, and patients preferences in order to
provide accurate, timely, consistent health care by telephone.
I.

WELCOME and INTRODUCTIONS

Welcome to our focus group today and thank you all for your time. My name is
____________________ and I will be leading the discussion today. [Introduction of
other moderators] By a show of hands, who has participated in a focus group before?
Focus groups are informal group discussions, and they provide a way for us to learn
how a group of people feel about a particular topic or issue. Our main purpose here
today is to learn what you think about your telephone interactions with VA facilities. In
addition, we are interested in your thoughts and preferences about where you place
your call (centrally or locally), with whom you speak, and timeliness of response. We
are going to use the information that you share with us today to develop ways to make
improvements to telephone communication for VA health care.
Before we begin, there are a few “housekeeping” issues we need to address.
• First, we’ll be audio-taping this discussion so that we can focus on what you are saying
and not have to concentrate on taking detailed notes.
• Remember, there are no right or wrong answers. Everyone’s opinion is welcomed,
appreciated, and important.
Please feel free to say anything that you want. Everything that you say will be kept
private. If we use what you have shared with us today, we will not identify you as the
speaker. Please contribute as much as possible, as it is truly your thoughts and ideas
that matter to us. This focus group will take about 60 minutes and your participation is
voluntary. Also, please know that, if at any time, for any reason, you wish to stop your
participation in this focus group discussion; you are free to do so.
Does anyone have any questions about today’s discussion?
Since we will be spending the next hour together, I would like to go around the room
and just ask everyone to introduce himself/herself and tell us a little bit about you. First
names are fine; you can also give us some background including your age, whether you
receive your health care from the VA-only or VA and non-VA, how long you have been
receiving VA health care, and approximately how often you call the VA (within the past 6
months)? (MODERATOR: Provide list of items to participants (attached). For age,
participants are free to answer actual age or ‘under 55 years’ or ‘55 years and over’).

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II.

FOCUS GROUP QUESTIONS (TELEPHONE USE/PREFERENCES)

Topic Area 1 – Preferred Methods of Health Communication/Resolution of health
care concerns via telephone

In general, what is your preferred method of communication with your VA primary
health care provider(s)?
Prompt: Consider communication methods such as in-person visit, by telephone,
by email/electronic internet portal such as MyHealtheVet.
o Please describe the reason(s) for your preference.
Thinking about different reasons you may contact the VA, can you tell me what your
communication preferences are for:
o test results? Prompt: Can you tell me why?
o concerns about an ongoing condition? Prompt: Can you tell me why?
o concerns about a new medical condition or symptom? Prompt: Can you tell
me why?
o treatment instructions? Prompt: Can you tell me why?
o next steps in care? Prompt: Can you tell me why?
o preventive care reminders? Prompt: Can you tell me why?
[MODERATOR: WHERE NEEDED STATE: “CAN YOU TELL ME WHAT YOUR
COMMUNICATION PREFERENCES ARE FOR…”]
Let’s move along now and talk more specifically about contacting the VA by telephone
with regard to your health care.
What would you say are the advantages for using the telephone to communicate
with the VA for your health care?
Prompts, if necessary: Convenience? Transportation limitations? Too far too travel
for visit?
Sometimes people may face challenges in communicating with their health care
providers by telephone. I'm interested in whether or not you agree with that
assessment.
o Please tell me why or why not.
If you were unable to resolve your health care concerns through your telephone
call/attempt, what did you do?
Prompts, if necessary: Did you… call elsewhere? Walk-in to VA clinic/hospital?
Seek urgent/emergency room care? Do nothing?
Was there a time recently (in the past 6 months) that telephone access issues when
calling the VA resulted in a delay in a health care concern being addressed?
o If so, please describe your experience.
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Has using the telephone for your health care concerns helped you with selfmanagement of your health care condition(s), such as helping you manage your
blood pressure, breathing, diabetes, or other concerns)?
o If so, how?
Overall, how would you describe your experience with calling the VA for health care
concerns?
o What do you like about your telephone experiences?
o What would you say are the largest barriers to calling the VA for your health
care concerns?

Topic Area 2 – Importance of timeliness vs. continuity (own provider/provider
team) [tradeoffs]
Now, I’d like to get your opinions about what is most important to you when calling the
VA with questions or concerns related to your medical condition and/or symptoms.
What do you think is an acceptable amount of time before your call into the VA is
answered?
How important is it to you to talk with a health care provider from your own health
care team (who you are familiar with) rather a health care provider from a call center
(who you are not familiar with)?
Which would you prefer when you call your VA for a health care concern?
(a) receiving advice immediately from any qualified health care provider (such as
one from a call center) –or –
(b) receiving a call back from your health care provider by the end of the day?
Prompt: Please describe what factored into your choice.
If your health care provider (or health care team) is not available when you call, how
would you want your concern handled?
What do you think is a reasonable turn-around time for a return call?
Prompt: What specific concerns might require a more rapid return call?
Who would be acceptable staff to respond to that message (assuming that the
primary care physician or provider had given input)?
o Please tell me why.

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Topic Area 3 – Logistics, route of sequence, # to call, local/central

Now, thinking about calls you have placed to the VA over the past 6 months…
When calling the VA for health care concerns, what has your experience been with
being placed on hold?
Prompt: Long/short wait?
What do you hear, if anything, when you are on hold?
o What would you find helpful to hear while on hold?
When calling the VA for health care concerns, what has your experience been with
being transferred?
Prompt: Many/few transfers? Successful transfers?
What has your experience been with menu options upon calling the VA?
o Efficient/confusing?
o Too many options? Too fast/too slow?
Let’s move on and think for a moment about the telephone numbers you call to reach
the VA for your health care needs. [MODERATOR: PLEASE EMPHASIZE THAT
THESE QUESTIONS ARE ABOUT THE ACTUAL TELEPHONE NUMBER AND REDIRECT DISCUSSION IF NECESSARY.]
What are your thoughts about the call-in number or numbers you use to contact the
VA?
o Would you prefer to have one telephone number to call for all concerns (that gets
routed to the appropriate place)? Why or why not?
o Is one number preferred – even if causes potential lengthy hold time?
Prompt: Why or why not?
o Would you prefer having multiple numbers (one for pharmacy, one for primary
care, etc.) that go directly to the service you are trying to reach?
Prompt: Why or why not?
Overall, from your experiences, do you have any suggestions for how the VA
telephone system could be improved?
III.

DISCUSSION WRAP-UP

Thank you very much for the time you spent with us today. Your ideas and responses
will really help us as we continue to develop strategies to improve the quality of
telephone communication to meet your health care needs.
Do you have any questions for us?
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