Form 2 Appendix B – Moderator Guide

Agency for Healthcare Research and Quality

TeamSTEPPS® for Long-Term Care

Focus Group Moderator’s Guide

Purpose: To identify materials and content that resonate with long-term care professionals to convey lessons from the TeamSTEPPS® for Long-Term Care curriculum in a clear and effective manner.

Time: 75 minutes per session

1. Introduction:

I want to thank you all for taking the time to be with us today. My name is [NAME], and I work for a private research firm. To get us started, I want to first mention a few guidelines for our discussion.

• I am an independent market researcher. I am not here to sell you anything or lend a particular point of view. I’m open to both positive and critical views. We have asked you here today because we want to hear your candid thoughts and reactions to the materials we are going to show you.

• Our session today will last for one hour and 15 minutes, and I will make every effort to keep the discussion focused and within our time frame. If too much time is being spent on one question or topic, I may move the conversation along so we can cover everything.

• We are recording this discussion. We will use the recording only as a reference point as we write our report, and your contributions will be completely anonymous. We will not hold onto the recording after we write our report, which will not contain your name or any identifying information, and we will not broadcast or share your footage outside of our small research team.

2. About AHRQ and TeamSTEPPS:

The session we are about to begin is a discussion about TeamSTEPPS for Long-Term Care, which is an evidence-based set of teamwork tools developed by the Agency for Healthcare Research and Quality (AHRQ) in the U.S. Department of Health and Human Services.

• How many of you have heard of the Agency for Healthcare Research and Quality?
  
  

• How many of you have heard of TeamSTEPPS before?

To give you some additional background information, TeamSTEPPS is a system created to improve patient care by increasing communication and teamwork skills among health care professionals, including frontline staff. It includes a set of ready-to-use materials and a training curriculum to integrate the principles of the system into a variety of settings.

• The original TeamSTEPPS was developed with hospital practitioners in mind, and has been revised to meet the specific needs of long-term care professionals. We’re asking you to review these materials to help us determine how effective those revisions were and how closely they mirror your experiences in the long-term care field.

Are there any questions before we get started?

3. Group reviews first half of the selected module:

I’m going to show you some PowerPoint slides and accompanying videos from the curriculum. Then we’ll discuss your reaction to this information, with a focus on whether or not it accurately captures the realities of your work in the long-term care field.

Think about the layout and presentation of information, as well as its language and terminology. Don’t assume that anything you’re noticing is obvious or that others have already thought of it. We are interested in how the materials look to everyone in the room.

As we progress through the curriculum, please take note of anything that you’d like to review during our discussion break at the halfway point of the module.

Moderator conducts a TeamSTEPPS training of the selected module.

4. Group shares and discusses initial thoughts about the selected module:

Now that we’re halfway through the course, let’s take five or ten minutes to go over any initial impressions you have about the curriculum. Did anyone take any notes on the subject matter that they’d like to discuss with the group?

Questions to prompt responses (additional questions listed in appendix):

• What do you think was the key lesson being presented in the slides?

• Do you think the slides did a good job of laying out that information clearly?

• If yes, why?

• If not, what was it about the slides that made the information difficult to understand? How would you change that to make it more understandable?

• Do you think the video was effective in teaching that lesson?

• If yes, why?

• If not, what was it about the video that made it challenging to understand? (If needed, prompt with suggestions: Was the language, situation, or course of action inaccurate?)

• How would you say that could be improved?

5. Group reviews second half of the selected module:

Now we’ll keep moving on to the second half of the module. As with the first half, I will show you some PowerPoint slides and accompanying videos from the curriculum. As we progress through the curriculum, please take note of anything that you’d like to discuss at our next break for conversation.

Moderator continues TeamSTEPPS training of the selected module.

5. Group shares and discusses final thoughts about the selected module:

Now that we’re done with the module, let’s take five or ten minutes to go over any initial impressions you have about the curriculum. Did anyone take any specific notes on the subject matter that they’d like to discuss with the group?

Questions to prompt responses (additional questions listed in appendix):

• After concluding this session, do you feel like you understand the content being presented in the slides?

  • If not, what content are you having trouble with? Is there anything that could be done to make the information easier to understand?

• Focusing on the scenarios that were included, were any of them particularly applicable or not applicable to your experiences in the long-term care field?

  • Why, or why not? What was it about that scenario that stood out to you most?

• Would this module be easier to understand if it were longer? Shorter?

  • If so, in what way(s)?

6. Conclusion and thank you

I’d like to thank you all again for your time and contributions to the focus group. Before I let you go, I’ll just ask that you all take a couple of minutes to fill out an exit survey, in case there was anything that we didn’t have a chance to discuss during our conversation.

That concludes our session. Thank you.

Appendix – Sample Questions

Sample questions for Type 1 focus groups (CNAs):

Instructional Tools:

• If you were teaching the TeamSTEPPS^® for Long-Term Care curriculum to someone else, what would be the most useful tools (for example: lists, infographics, pictures, anecdotes) in helping to explain concepts? You can suggest tools that are not included here.

Length:

• [After one full module:] Would this module be easier to understand if it were longer? Shorter? If so, in what way(s)?
  
  

• For any materials or concepts discussed today, is there anything that stood out as needing more time for explanation and discussion for you to adequately understand or implement it?

Teaching Scenarios:

• Can you identify an example of a scenario presented in these materials that you found to be highly applicable to your experience and needs?
  
  

• Can you identify an example of a scenario presented in these materials that was not at all applicable to your experience and needs?

Value:

• Do these tools help you understand ways to effectively describe your concerns about a resident’s condition and care and discuss them with your supervisor and team?
  
  

• Do these tools help you better define and understand your role on your team and within your environment?
  
  

• Do these tools provide constructive ways to respond to feedback from team leaders?
  
  

• Do these tools provide strategies for bridging communications gaps specific to certain situations, such as the transfer of residents to hospice care?

• How relevant is this [material name] to you? Use a scale of 1 to 5, with 1 being least relevant and 5 being most relevant. What does and does not make this material relevant?

Sample questions for Type 2 focus groups (mixed LTC professionals):

Appeal:

• How interested would your organization be, overall, in implementing TeamSTEPPS for Long-Term Care? Use a scale of 1 to 5, with 1 being not interested and 5 being very interested.

• Which members of your care team (by professional title) would be the most enthusiastic about implementing TeamSTEPPS for Long-Term Care? Why?

• Which members of your care team (by professional title) would be the least enthusiastic about implementing TeamSTEPPS for Long-Term Care? Why?

Instructional Tools:

• If you were teaching the TeamSTEPPS for Long-Term Care material to someone else, what would be the most useful tools (for example: lists, infographics, pictures, anecdotes) in helping to explain concepts? You can suggest tools that are not included here.

Length:

• Can you talk about how these materials could be revised to increase the appeal of implementing TeamSTEPPS for Long-Term Care?

• [After one full module:] Would this module be easier to understand if it were longer? Shorter? If so, in what way(s)?

• For any materials or concepts discussed today, is there anything that stood out as needing more time for explanation and discussion for you to adequately understand or implement it?

Teaching Scenarios:

• Can you identify an example of a scenario presented in these materials that you found to be highly applicable to your experience and needs?

• Can you identify an example of a scenario presented in these materials that was not at all applicable to your experience and needs?

• Based on your experience, are there any high-risk or recurring scenarios or problems that the materials do not, and should, specifically address?

Sample questions for Type 2 focus groups (mixed LTC professionals) continued:

Value:

• Do these tools provide specific actions that would encourage your team members to effectively speak up to raise concerns or offer information during day-to-day activities?

• Do these tools offer constructive ways to provide feedback to team members?

• Do these tools provide strategies for bridging communications gaps specific to certain situations, such as the transfer of residents to hospice care?

• How relevant is this [material name] to you? Using a scale of 1 to 5, with 1 being the most relevant

• How relevant is this [material name] to you? Use a scale of 1 to 5, with 1 being least relevant and 5 being most relevant. What makes this material relevant (or not)? If you don’t think it’s relevant to you, might it be relevant to other types of health care professionals?