10-10169 PIM Patient INterview Guide

OMB Number 2900-0770

Estimated Burden: 30 mins

EXP Date: 08/31/2017

PACT Intensive Management National Evaluation: Patient Experience Interview Guide

OMB 2900-0770

Estimated burden: 30 minutes

Expiration Date 08/31/2017

The Paperwork Reduction Act of 1995: This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average thirty (30) minutes. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery by helping to achieve services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

PIM Key Stakeholder Interview Guide – Patient version

NOTE: REPLACE “PIM” WITH SITE-SPECIFIC NAME THAT VETERAN MIGHT KNOW PROGRAM BYTHROUGHOUT THE INTERVIEW GUIDE.

Introduction

Hello, my name is [NAME]. I’m calling you today from the VA to ask if you would like to participate in a telephone interview about the care you have been receiving at [NAME OF VA FACILITY]. Is now a good time to talk? This will take about 20-30 minutes, depending on how much you have to say.

[IF YES, CONTINUE WITH INTERVIEW. IF NO, ASK IF THERE IS A BETTER TIME TO CALL BACK WHEN RESPONDENT WILL HAVE 20-30 MINUTES TO TALK. IF RESPONDENT ASKS WHAT THIS IS ABOUT, USE SCRIPT BELOW TO EXPLAIN WHAT INTERVIEW IS ABOUT. IF NO, NOT INTERESTED, THANK THE VETERAN AND SAY GOODBYE.]

Thank you for agreeing to talk to me today.

The services that I’m going to ask you about at your VA are called PIM. It involves a special team of people working intensively with patients like you. You may have met with one or more of these people at the VA clinic, or they may have visited you in your home. Some of the members of your team include [FILL IN PROVIDERS/CLINICIANS WHO THIS PATIENT HAS HAD ENCOUNTERS WITH]. Do any of these names sound familiar?

[IF DOESN’T KNOW ANYTHING ABOUT IT, CONCLUDE THE INTERVIEW]

Everything you tell us today will be kept confidential, and your participation is entirely voluntary. This means you can stop the interview at any time, and you can skip any questions you don’t want to answer.

[INTERVIEWER: HAVE ON HAND THE SITE SPECIFIC NAME OF THE PROGRAM AND THE NAMES OF THE PIM TEAM MEMBERS. VETERAN MAY NEED TO BE REMINDED FREQUENTLY BY REFERENCING THE NAME OF THE PROGRAM AND/OR TEAM MEMBER NAMES.

If it’s OK with you, we would like to record this interview. Would that be OK?

If veteran agrees to be recorded: Thank you. I will turn on the recorder now. [Turn on Recorder] This interview is being recorded. I just need to ask you again, do you grant permission to record this interview? [Pause for “Yes” answer] Thank you. You may ask me to pause or turn off the recorder at any time.

Interviewer speaks to recorder: This is code number XX, and the date is XX-XX-XXXX.

If veteran does not agree to be recorded: Since this interview will not be recorded, I will be taking notes.

General Experience of PIM program

INTERVIEWER: SOME PATIENTS WILL NEED CONSISTENT REDIRECTION AS THE INTERVIEW GOES ON, REITERATING USING “PIM”, PIM TEAM MEMBERS’ NAMES, OR WHATEVER TRIGGERS PATIENTS TO RECALL THAT YOU ARE ASKING ABOUT THE PIM PROGRAM. IT PROBABLY WILL NOT BE ENOUGH TO ESTABLISH WHAT TEAM YOU ARE TALKING ABOUT AT THE BEGINNING OF THE INTERVIEW.

1. First we would like to know overall how satisfied you are with the services you have received from [PROGRAM NAME]? Please choose one of the following answers (read the first three out loud):

Extremely Satisfied	Somewhat Satisfied			Not at all Satisfied	I have not used these services
						

[IF DOESN’T KNOW ANYTHING ABOUT IT, CONCLUDE THE INTERVIEW AND MARK BOX FOR “I HAVE NOT USED THESE SERVICES”]

[INTERVIEWER: YOU DO NOT NEED TO ASK EVERY PROBE, ONLY WHERE IT SEEMS APPROPRIATE OR WHERE R HAS TROUBLE ANSWERING THE QUESTION]

2. And why are you [extremely satisfied/somewhat satisfied/not satisfied] with [PROGRAM NAME]?

___ Please tell me why you answered “somewhat satisfied” rather than extremely satisfied? Or “somewhat satisfied” instead of “not at all satisfied”? Etc.

___Can you give me an example of a time when the team did something really good for you?

___How about an example of something the team did that you did not like?

Specific Experiences of PIM

IF NECESSARY: For this part of the interview, I want you to think about NAME PIM TEAM MEMBERS, and your experiences working with them.

3. Now please tell me what the PIM team members have been doing for you?

3a. Would you have liked them to do more of any of these things?

3b. Would you have liked them to do less of any of these things?

3c. What did you like about what they did for you?

3d. What didn’t you like about what they did for you?

3e. Was there anything else they didn’t do that you wish they would have done for you?

PROBES, IN CASE R HAS TROUBLE ANSWERING:

___Have you had telephone visits with any of the members of your PIM team?

- Would you have preferred more or fewer telephone visits?

___Have you had in-person clinic visits with any of the members of your PIM team?

- Would you have preferred more or fewer in-person clinic visits?

___Have any PIM team members come to your home for a visit?

- Would you have preferred more or fewer home visits?

___Have any PIM team members gone with you to other doctor’s appointments?

- Do you wish they had gone with you to other doctor’s visits at the VA?

4. How well do you feel the PIM team members know you?

4a. How well do you feel they understand your health goals?

4b. Do you feel they really tried to understand you and your concerns?

4c. Was there anything they didn’t know that you thought they should have?

Engagement in Care and Impact on Health

Now I’m going to ask you about your health and how you care for yourself.

5. Has your health changed since you started working with the PIM team? If so, in what ways?

5a. What do you think caused these changes?

5b. Who on the team has made a difference in your health? How?

5c. What is it about your relationship with your team that made a difference in your health?

6. Have you changed how you take care of yourself since you have been part of PIM?

(ASK FOR EXAMPLES)

6a. Are you using the VA differently than you did before you started working with the [PIM] team?

6b. Has the PIM team been able to meet your needs in a timely way? Why or why not?

7. Have there been any times when you felt it was difficult to be in PIM? If so, please explain /tell me about what made it difficult.

PROBES, IN CASE R HAS TROUBLE ANSWERING:

___Working with a new team of healthcare workers

___Having to attend more appointments

___Additional transportation costs and/or difficulties

___Including family or caregivers in decisions about your care

___Keeping track of all your appointments with your healthcare providers

8. If you were going to tell your friends and family about this program, what would you say?

8a. How would you say you have benefitted from being in this program?

8b. What have been the drawbacks of being in this program?

Topic Area: Future Directions and Wrap-up

9. What suggestions would you make to improve the services you get from your PIM team?

10. Is there anything else you’d like us to know about your experiences with your PIM team? Anything you’d like us to know about your experiences with health care at the VA in general?

We are so grateful for your willingness to share your knowledge and experiences with us today. Thank you again for all your help. Goodbye.

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