Form #1 Form #1 Cognitive Interview Guide for Hospital VE Survey

Attachment A – Cognitive Interview Guide for Hospital VE Survey

Interview Guide for Draft Hospital

Value and Efficiency Survey

File Contents:

1. Introduction for telephone cognitive interviews (with oral consent recorded)

2. Draft survey questions by potential dimensions and scripted interview probes

1-4-13

H

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

ospital Value and Efficiency Survey

Round 1 Telephone Cognitive Interviews: Introduction and Oral Consent

Respondent ID#: ___________________________

Respondent Job Title: __________________________

Date of Interview: _________________________

Time of Interview: _________________________

Interviewer: __________________________

Tape Recorded? _________________________

Introduction and Consent

Hello, my name is _____________________________. I have [a/two] colleague(s) with me here – [NAME(S)]. We work for Westat, a private research company in Rockville, Maryland. Thank you for taking the time to complete and talk about the draft survey on value and efficiency in hospitals.

Westat is working with the Health Research and Educational Trust (affiliated with the American Hospital Association) on this project, which is funded by the Agency for Healthcare Research and Quality, Department of Health and Human Services. One purpose of the project is to develop a survey about improving efficiency in the delivery of quality care that can be administered to everyone working in the hospital. You recently completed a set of these draft survey items.

I am talking with you today to find out how the survey items worked for you – for example, were the questions easy to understand and answer? I am interested in what you think about the questions, and I will be asking you what the questions mean to you. There are no right or wrong comments. Please speak up freely and tell me what you think.

This is a research project and your participation is voluntary. You may skip any question you do not want to answer and you may stop the interview at any point. I expect the interview to take about 1¼ hours. We take many steps to keep your comments and survey responses private. I will discuss your responses only with other project team members. We will not include your name or your hospital’s name in any written findings reports.

I

Public reporting burden for this collection of information is estimated to average 1 ½ hours per response, the estimated time required to complete the interview. 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.

will be happy to answer any questions you may have about this task. If you have any questions about your rights as a research participant, you may contact Westat’s IRB administrator, Sharon Zack. Would you like her phone number? (IF YES: Please call her toll-free at 1-800-937-8281 and ask for Sharon Zack).

Because I want to pay close attention to what you say, I would like to tape record our interview so that I can listen to it later to see if I missed anything. Is that okay?

TURN ON THE RECORDER: I need to ask your permission again so that it is recorded: Today is mo/day/year at [time]. Do you agree to participate in this interview and to have it audio recorded?]

I will review the definitions on the first page, then ask a few general questions about the survey items, and then address specific survey items. Your comments will help in identifying possible problems. Please share your thoughts and don’t hesitate to bring up problems, suggest changes, or say which items you prefer – the whole purpose of this pretest is to improve the items and use the best ones in the survey.

Do you have a copy of your survey with you? Good. Before we start, do you have any questions? Okay, let’s begin.

Hospital Value and Efficiency Survey
Instructions

Think about the way things are done in your hospital and provide your opinions on the efficiency with which care is delivered.

If a question does not apply to you or your hospital unit or you don’t know the answer, please check “Does Not Apply or Don’t Know.”

For the purposes of this survey, the following definitions apply to several items in this survey:

• Wastesuch as wasted time, wasted materials, extra steps in a process, repeating work, etc.is anything that does not add value for patients or staff.

• Efficiency in health care means removing waste from the system and establishing care and business processes that are as streamlined and simplified as possible.

• Value includes quality, cost, and outcomes and is ideally driven by patient preferences of care.

Definitions Probes

Did you notice and read the definitions on the first page?

(IF DID NOT READ: Can you say more about that?)

IF YES: How easy or difficult were they to understand? (Why?)

(Would you change the definitions in any way?) (How?)

How helpful were the definitions in answering the questions?

How often do you hear the terms waste, efficiency, and value in your hospital?

SECTION A: Your Work Area/Unit

In this survey, think of your “unit” as the work area, department, or clinical area of the hospital where you spend most of your work time or provide most of your clinical services.

What is your primary work area or unit in this hospital? Select ONE answer.

a. Many different hospital units/No specific unit

b. Medical/surgical unit

c. Operating room

d. Obstetrics

e. Pediatrics

f. Emergency department

g. Intensive care unit (any type)

h. Psychiatry/mental health

i. Rehabilitation

j. Pharmacy

k. Laboratory

l. Radiology

m. Anesthesiology



n. Other, please specify:

How difficult was it for you to select your primary work area/unit? (IF DIFFICULT: Why?)

Now, let’s move on to the survey items.

Interview Guide: Draft Items by Dimension and Probes

1. Manager support for value/efficiency/waste reduction

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Managers expect staff to identify ways to simplify work processes	1	2	3	4	5	9
Managers encourage staff to come up with more efficient ways of doing things	1	2	3	4	5	9
Managers follow up with staff about their suggestions to improve work processes	1	2	3	4	5	9

Before we start reviewing each question in Item set 1, do you have any general comments to make about the survey items overall or specifically?

Probes:

Q1. In question 1, whom were you thinking about when you read the word “Managers”?

What does “simplify work processes” mean to you? (Can you give me some examples?)

IF POSITIVE ANSWER: How do staff learn that this is an expectation?

Q2. How did you arrive at your answer to question 2?

(How do managers encourage staff?)

What staff were you thinking about?

Q3. Tell me more about your answer to question 3.

Is there a formal or informal process for making suggestions? (Please describe the process.)

(IFA?SA: How do managers follow up? Any examples?)

1. Manager support for value/efficiency/waste reduction (continued)

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Managers discuss workflow problems with staff but don’t follow through with solutions	1	2	3	4	5	9
Managers recognize staff for their ideas to improve efficiency	1	2	3	4	5	9
Managers recognize staff for implementing an improvement effort	1	2	3	4	5	9

Probes:

Q4. Please tell me more about your answer to question 4.

(You said ____. What are some examples?)

Q5. What do you think question 5 is saying?

Were you thinking about both successful and unsuccessful implementation efforts?

IF POSITIVE ANSWER: What managers do this?

IF POSITIVE ANSWER: How do they recognize staff?

IF NONPOSITIVE ANSWER: What does recognize staff mean to you?

Q6. Please tell me more about your answer to question 6.

(Are staff recognized if an improvement effort is not successful?)

Wrap up: If questions 1 through 6 had asked about Senior leaders in your hospital instead of Managers in your hospital unit, would you have answered any of the items differently? IF YES: Which ones and why? IF NO: Why not?

2. Staff engagement & empowerment

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Staff are asked for their opinions when changes to their work processes are proposed	1	2	3	4	5	9
Decisions about work processes are made with little involvement from those doing the work	1	2	3	4	5	9
Staff are encouraged to come up with more efficient ways of doing things	1	2	3	4	5	9

Probes:

Let’s look at Item set 2.

Q1: IF POSITIVE RESPONSE: You said ____ for item 1; can you tell me more about your answer?

(How are staff asked?)

(Who asks for staff opinions?)

(When are they asked?)

IF NONPOSITIVE RESPONSE: You said _____ for item 1. What do you think this question is asking?

Have there been any changes to your work processes?

Q2: In item 2, whom were you thinking about?

NOTE IF R ANSWERED Q1+Q2 CONSISTENTLY (SIMILAR ITEM BUT ONE IS NEGATIVELY WORDED)

IF RESPONSE IS INCONSISTENT: Tell me about why you answered ______________.

Q3. IF SA/A, I noticed you answered ____ for item 3. Can you tell me more about your answer – how are they encouraged?

IF SD/D, I noticed you answered _____ for item 3. What does it mean to you to be “encouraged to come up with more efficient ways of doing things”? Who might encourage you?

IF NA/DKA, I noticed you answered _____ for item 3. Can you tell me more about your response?

2. Staff engagement & empowerment (continued)

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Staff feel empowered to try solutions for their own workflow problems	1	2	3	4	5	9
Staff in this hospital take responsibility for improving work processes	1	2	3	4	5	9
Staff are treated as experts on how to improve their work processes	1	2	3	4	5	9

Probes:

Q4: In your own words, what is item 4 saying? (look for understanding of terms “empowered,” “solutions,” “workflow problems”)

Q5: Whom were you thinking of when you read item 5?

How did you arrive at your answer?

(IF SA/A: In what ways do they take responsibility?)

Q6. For question 6, you answered ____________. Can you tell me more about your answer?

(IF A/SA: What are some examples?)

2. Staff engagement & empowerment (continued)

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Staff prefer to just do what they are told rather than try to improve things	1	2	3	4	5	9
Staff are comfortable making suggestions to managers/senior leaders about ways to make their jobs more efficient	1	2	3	4	5	9

Probes:

Q7: When you read question 7, what staff were you thinking about?

Tell me more about your answer to Q7.

Q8: For question 8, you answered ____________. Can you tell me more about your answer?

What managers were you thinking about?

What senior leaders?

Do you think staff are equally comfortable making suggestions to managers and senior leaders? (Why is that do you think?)

3. Waste reduction

How often do the following statements apply to your WORK AREA/UNIT?	Never 	Rarely 	Sometimes 	Most of the time 	Always 	Does Not Apply or Don’t Know 
We examine our work processes to get rid of unnecessary steps	1	2	3	4	5	9
We waste time looking for needed supplies or equipment	1	2	3	4	5	9
We waste time trying to get necessary information from physicians or staff	1	2	3	4	5	9

[BE SURE TO PROBE ON NEUTRAL OR DK/DNA ANSWERS FOR ALL ITEMS]

Probes:

Now let’s look at the third set of items.

Q1. In your own words, what is item 1 saying?

(What does work processes mean to you?)

(Whom were you answering about – how did you interpret we?)

You answered ______________for question 1. Can you tell me more about that?

(IF Always/Most of the time: How did staff in your unit examine their work processes?)

(What are examples of unnecessary steps?)

Why do staff do this?

IF NOT POSITIVE ANSWER: If you were told to do this, what would you think about doing?

Q2. Tell me how you arrived at your answer of __ for question 2.

(What does time is wasted mean to you?)

[Ask for examples if none given.]

(Whom were you answering about – how did you interpret we?)

Q3. In your own words, what is question 3 saying?

(What would be some examples of this?)

How did you arrive at your answer?

(Whom were you answering about – how did you interpret we?)

2. Waste reduction (continued)

How often do the following statements apply to your WORK AREA/UNIT?	Never 	Rarely 	Sometimes 	Most of the time 	Always 	Does Not Apply or Don’t Know 
We keep supplies where they are commonly used at the point of care	1	2	3	4	5	9
Physicians spend too much time on tasks that others could do	1	2	3	4	5	9
Staff spend too much time on tasks that others should be doing	1	2	3	4	5	9

Probes:

Q4. In your own words, what is question 4 saying?

(What does the phrase point of care mean to you?) Why would supplies be kept at the point of care?

IF POSITIVE ANSWER: What are some examples of supplies that are kept at the point of care?

IF NONPOSITIVE ANSWER: How good an idea do you think it is to keep supplies at the point of care? (Why?)

Q5. Tell me more about your answer to question 5.

(IF NOT NEVER: Ask for examples)

Q6. Again, please tell me how you arrived at your answer?

(IF NOT NEVER: Ask for examples)

2. Waste reduction (continued)

How often do the following statements apply to your WORK AREA/UNIT?	Never 	Rarely 	Sometimes 	Most of the time 	Always 	Does Not Apply or Don’t Know 
Different physicians expect staff to follow different processes to do the same things	1	2	3	4	5	9
Physicians in this hospital tend to resist efforts that promote standard ways for them to do things	1	2	3	4	5	9
Staff have to duplicate work that has already been done	1	2	3	4	5	9

Probes:

Q7. In your own words, what is question 7 saying?

(What are some examples of this?)

Tell me more about your answer.

Q8. You answered ___ for question 8. How did you arrive at that answer?

[Ask for examples if none given.]

Q9. In your own words, what is question 9 saying?

(What does duplicate work mean to you?) (Do you think it would be easier to understand this item if it asked about repeated work?)

(What are examples of this?)

(Why would staff have to duplicate/repeat the work?)

How did you arrive at your answer to Q9?

4. Measurement & data monitoring

How often do the following statements apply to your WORK AREA/UNIT?	Never 	Rarely 	Sometimes 	Most of the time 	Always 	Does Not Apply or Don’t Know 
This unit uses data to see how well improvement efforts are working	1	2	3	4	5	9
This unit collects and reviews data to guide our work processes	1	2	3	4	5	9
This unit uses data/information to make changes to improve our work	1	2	3	4	5	9

Probes:

Now let’s move on to the next set of items – Set 4.

The response scale changed back to Never/Always. Did you notice that, and did it cause any problems for you?

Q1. For question 1, please tell me more about your answer.

(What data do you use? What improvement efforts were you thinking about?)

(PAY ATTENTION TO WHETHER R IS ANSWERING ABOUT SPECIFIC IMPROVEMENT EFFORTS)

How easy or hard was it to answer this question? (Why?)

Q2. In question 2, what work processes were you thinking about?

IF POSITIVE ANSWER: What data were collected? Who reviewed the data?

IF NONPOSITIVE ANSWER: Tell me more about why you answered ______?

Q3. Tell me more about your answer to question 3.

4. Measurement & data monitoring (continued)

How often do the following statements apply to your WORK AREA/UNIT?	Never 	Rarely 	Sometimes 	Most of the time 	Always 	Does Not Apply or Don’t Know 
This unit uses visual displays or graphs to show us how well we are performing	1	2	3	4	5	9
This unit examines costs when evaluating the success of improvement initiatives	1	2	3	4	5	9

Probes:

Q4. In your own words, what is question 4 saying?

(How did you interpret the words how well we are performing?)

How did you arrive at your answer?

(IF ANSWER WAS SOMETIMES/MOT/ALWAYS): Can you describe the type(s) of visual displays and where staff could see them?

Q5. How easy or difficult was it to answer question 5? Why?

What costs were you thinking about?

How did you arrive at your answer?

5. Patient centeredness

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Patients/caregivers participate in our workflow redesign efforts	1	2	3	4	5	9
We consider what patients value when we change our workflow	1	2	3	4	5	9
We remove steps in the care process that don’t add value for patients	1	2	3	4	5	9

Probes:

The response scale changed back to Agree/Disagree. Did you notice that, and did it cause any problems for you?

Now let’s look at Item Set 5.

Q1: In question 1, what does “workflow redesign efforts” mean to you?

How did you arrive at your answer?

(IF POSITIVE RESPONSE: Can you give me an example?)

Q2: In your own words, what is item 2 saying?

In your experience, what do patients value?

Can you tell me more why chose the answer ____________?

DID R SAY THEY HAVE NOT CHANGED THEIR WORKFLOW?

Q3. For question 3, what does “add value for patients” mean to you?

You answered ___. Tell me more about that.

5. Patient centeredness (continued)

How much do you agree or disagree with the following statements? Think about your WORK AREA/UNIT when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
We take steps to reduce patient wait time	1	2	3	4	5	9
We obtain patient input on ways to make patient visits more efficient	1	2	3	4	5	9

Probes:

Q4: Tell me more about your answer also for question 4.

(Any examples?)

Q5: In your own words, what is item 5 saying?

6. Senior leadership support for value/efficiency/waste reduction

How much do you agree or disagree with the following statements? Think about your HOSPITAL when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Senior leaders send a clear message that it is everyone’s job to look for ways to improve work processes	1	2	3	4	5	9
Senior leaders provide time and resources for staff to identify ways to make their work processes more efficient	1	2	3	4	5	9

Okay. Let’s start with question 1 in item set 6.

Probes:

Q1. In question 1, thinking about your hospital, what do the words “Senior leaders” mean to you?

In the same question, what were you thinking about when you read the words “work processes”?

Whom were you thinking about when you read everyone’s job? (All persons working in the hospital, including non-staff physicians and senior leadership as well as kitchen staff and those maintaining the facilities and grounds?)

Can you tell me more about your answer?

Q2. In question 2, when you read “identify ways to make their work processes more efficient” what were you thinking about?

Please tell me more about your answer. (If positive answer: Ask for examples).

6. Senior leadership support for value/efficiency/waste reduction (continued)

How much do you agree or disagree with the following statements? Think about your HOSPITAL when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
Senior leaders support staff efforts to reduce waste in systems and procedures	1	2	3	4	5	9
Senior leaders are committed to reducing waste in the way we do things	1	2	3	4	5	9

Probes:

Q3. In question 3, what things came to your mind when you read “reduce waste in our systems and procedures”?

IF POSITIVE ANSWER: What are some examples of how senior leaders visibly support efforts to reduce waste in your systems and procedures?

IF NONPOSITIVE ANSWER: Does your hospital engage in efforts to reduce waste?

Tell me why you answered _____.

Instead of “waste in systems and procedures”, would the phrase “waste in our work” be better?

Q4. For question 4, tell me how you arrived at your answer.

[DID R SAY SOME SENIOR LEADERS ARE COMMITTED BUT OTHERS ARE NOT? IF SO, DID R FACTOR THAT INTO CHOICE OF ANSWER?]

(How did R interpret reducing waste and the way we do things?)

Wrap up: If items 1 through 4 had asked about Managers in your hospital unit instead of Senior leaders in your hospital, would you have answered any of the items differently? IF YES: Which ones and why? IF NO: Why not?

6. Priority on value and efficiency

How much do you agree or disagree with the following statements? Think about your HOSPITAL when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
This hospital places a high priority on finding cost-effective ways to improve patient care	1	2	3	4	5	9
A major goal in our hospital is to increase efficiency without compromising patient care	1	2	3	4	5	9
This hospital pays attention to both costs and quality outcomes when we implement changes in work processes	1	2	3	4	5	9

Probes:

Now let’s look at Item Set 7.

Q1: In your own words, what do you think this item is saying?

Please tell me more about your answer.

Q2: In your own words, what is item 2 saying? How do you know what the goal(s) of your hospital are?

(How are the goals communicated to you?)

Tell me more about your answer.

Q3: For item 3, you answered ____________. Can you tell me more about that?

IF POSITIVE RESPONSE: What are some examples?

7. Priority on value and efficiency (continued)

How much do you agree or disagree with the following statements? Think about your HOSPITAL when answering:	Strongly Disagree 	Disagree 	Neither Agree nor Disagree 	Agree 	Strongly Agree 	Does Not Apply or Don’t Know 
In this hospital, we continually look for more efficient ways to do our jobs	1	2	3	4	5	9
We strive to improve patient flow throughout our hospital	1	2	3	4	5	9

Probes:

Q4: For item 4, what does “continually look” mean to you? (How often?)

Tell me about your answer.

Q5: In your own words, what is item 5 saying?

IF POSITIVE RESPONSE: Tell me more about your answer.

7. Experience/Involvement with quality or process improvement activities

In the past 12 months, have you done the following activities to improve efficiency, add value, or reduce waste in your WORK AREA/UNIT?	Yes 	No 
I mapped a workflow process.	1	2
I shadowed/followed patients to identify ways to improve their care experience.	1	2
I made a suggestion to management about something that needed improvement.	1	2

[BE SURE TO PROBE MORE ON ALL ITEMS]

Probes:

Now let’s look at Item Set 8.

Q1. Item 1 - What does map a workflow process mean to you?

(IF YES: Please describe what you did.)

IF NO: Do you know of anyone in your hospital unit who has participated any of these things in the past 12 months? (IF YES TO KNOWING SOMEONE: Were they trained to do them?)

Q2. In your own words, what is question 2 asking?

IF YES: Can you tell me more about that experience?

IF NO: Do you know of anyone who has ever done this in your hospital?

Q3. In your own words, what is question 3 asking?

IF YES: Can you tell me more about a suggestion you made to management?

IF NO: Do you know of anyone who has ever done this in your hospital unit?

8. Experience/Involvement with quality or process improvement activities (continued)

In the past 12 months, have you done the following activities to improve efficiency, add value, or reduce waste in your WORK AREA/UNIT?	Yes 	No 
I identified inefficient work processes.	1	2
I identified ways to reduce waste in work processes.	1	2
I identified opportunities to standardize work processes.	1	2

Probes:

Q4. IF YES: For question 4, tell me more about when and how you identified inefficient work processes.

IF NO: What might be an inefficient work process?

Q5. IF YES: For question 5, please tell me more about this; can you give an example?

IF YES: Were you trained to do this?

IF NO: What do you think question 5 is saying?

Q6. IF YES: For question 6, please tell me more about this; can you give an example?

IF NO: What do you think question 6 is referring to?

(What does standardizing a work process mean to you?)

8. Experience/Involvement with quality or process improvement activities (continued)

In the past 12 months, have you done the following activities to improve efficiency, add value, or reduce waste in your WORK AREA/UNIT?	Yes 	No 
I participated in an improvement project in my work area.	1	2
I implemented an improvement activity.	1	2
I served on a team or committee to improve a work process.	1	2

Probes:

Q7. IF YES: For question 7, please describe the improvement activity you participated in.

IF NO: Was there an improvement project in your work area in the past 12 months? IF YES: What staff participated – did they volunteer or were they asked or assigned to participate?

Q8. IF YES: For question 8, please describe the activity you implemented.

(Did you do this on your own or as a team leader or a team member?)

IF NO: In your own words, what is question 8 asking?

Q9. IF YES: Tell me more about your answer for question 9.

IF NO: Did anyone else in your unit serve on such a team or committee in the past 12 months? (Can you say more about the work process they improved?)

8. Experience/Involvement with quality or process improvement activities (continued)

In the past 12 months, have you done the following activities to improve efficiency, add value, or reduce waste in your WORK AREA/UNIT?	Yes 	No 
I collected data on the progress of an improvement activity.	1	2
I tracked costs to determine if there were savings.	1	2
I reviewed data to determine if an improvement activity was successful.	1	2
I made a change to an improvement activity to make it better.	1	2

Probes:

Q10. Tell me more about your answer to question 10.

(What data were collected? How did you collect the data? How were the data used?)

Q11. In your own words, what is question 11 asking?

(What kinds of savings might be achieved?)

IFYES: What costs did you track?)

Q12. IF YES: Tell me more about your answer.

IF NO: Are you aware of someone else in your unit who has done this? IF YES TO AWARE OF SOMEONE ELSE: Can you say more about that?

Q13. IF YES: For question 13, please describe the change in the activity.

IF NO: Are you aware of someone else in your unit who has done this? IF YES TO AWARE OF SOMEONE ELSE: Can you say more about that?

NOTE IF R SAYS THERE HAVEN’T BEEN ANY UNSUCCESSFUL IMPROVEMENT ACTIVITIES.

Wrap-up: How easy or hard was it to answer this series of questions in Item Set 8? (Why?)

9. In my experience, improvement efforts in this WORK AREA/UNIT tend to result in:

Mark ONE answer

1	Long-term or lasting change
2	Initial or temporary changes, but the changes don’t last
3	No change—no noticeable improvement

Probes:

Q9. How did you arrive at your answer to question 9?

How easy or hard was it to choose an answer? (Why?)

(What improvement efforts were you thinking about?)

9. Overall rating

Thinking back on your survey answers, what overall rating would you provide for your hospital on value, efficiency, and waste reduction?

Poor ▼	Fair ▼	Good ▼	Very good ▼	Excellent ▼
1	2	3	4	5

Probes:

Please tell me how you arrived at your rating of _____________.

(Are they answering for hospital or work area/unit?)

(What would need to be different to get a higher rating?)

Closing Probes

(For Rs who did not select DK/DNA): Now I have a general question about the response scales. I noticed you didn’t select Does Not Apply or Don’t Know - the response option in the last column. Did you notice it?

[Note to interviewer: If you know R has worked in other hospitals or other units in the hospital: Would you have answered any differently for any other hospitals or units you have worked in?]

That’s all of my specific questions. Our goal is to shorten this series of questions. In your opinion, which of the questions were the hardest for you to understand or answer? (Why?)

Thanks. Do you have any additional comments?

Thank you very much for participating in this pretest. Your comments have been helpful.

TURN OFF RECORDER

To show our appreciation for your time and help, we will send you a check for [$100/$175]. Please [confirm/tell me] your mailing address [DOCUMENT ON NEXT PAGE]:

 

Mailing address:

(Say we will send by FedEx but they do not have to be there to sign for it.) Note: We have to submit info to accounting by COB Monday or Thursday for Tuesday and Friday processing - let person know approximately when to expect check.

Immediately after the interview, notify Vicki that the interview has been completed and provide her with the following:

Participant ID#

First and last name of the participant

Participant’s gender

Indicate if the participant is a physician

Mailing address

Phone number (for FedEx form)

Incentive amount

Name of lead interviewer

NOTE: After Vicki has the new address, remove this page from the Interview Guide and shred it.

HOSPITAL VALUE AND EFFICIENCY SURVEY, DRAFT 1-4-13 5