Clinic Staff Qualitative Interview Guide - Att 11

Attachment 11

Form Approved

OMB No. 0920-New

Expiration Date: XX/XX/XXXX

Positive Health Check Evaluation

Aim 2: Implementation Analysis

Instrument: Clinic Staff Qualitative Interview Guide

Public reporting burden of this collection of information is estimated to average 40 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)

Data Collection Details:

• Participant: Staff who also completed the clinic survey the month prior

• Frequency of Data Collection: Every 3 months, one month after the staff survey

• Participant Time Required: 40 minutes

First, I would like to say thank you for taking the time to speak with us today. I’m _________, and I’ll be leading the discussion today. In addition, with me is ___________, who will be timekeeping as well as taking notes throughout the interview process. The purpose of today’s interview is to get your feedback on the implementation of Positive Health Check in your clinic during the past three months. This should take no longer than 40 minutes. We will be recording the discussion to help with analysis of feedback across all the clinics using Positive Health Check. Your names will not be linked to your answers. If at any point you rather not answer any questions it is OK to let me know you rather skip that question.

Impact

I would first like to talk about the impact of implementing Positive Health Check in your clinic over the last 3 months. During this discussion, think about your overall impressions related to implementing the intervention.

1. What have been some of the positive impacts of implementing Positive Health Check?

Probe with:

• For example, what have been the impacts on:

  • Clients

  • You or other staff

  • [INSERT ORGANIZATION NAME] (e.g., organizational efficiency, workflow, etc.)

• Do you get the sense that Positive Health Check is helping clients? What makes you say that?

2. What have been some of the negative impacts of implementing Positive Health Check?

Probe with:

• For example, what have been the impacts on:

  • Clients

  • You or other staff

  • [INSERT ORGANIZATION NAME] (e.g., organizational efficiency, workflow, etc.)

• Do you get the sense that Positive Health Check may be harming clients? What makes you say that?

Implementation Fit & Fidelity

Next I would like to talk about some of the nuts and bolts of the implementation process within your clinic workflow, what’s working well, what’s not, and suggestions you have for how things could be improved.

Overall Implementation

3. Thinking about the process overall, what are some activities related to clinic workflow that are facilitating the implementation of Positive Health Check?

   • Can you provide specific examples?

4. What barriers, if anything, have gotten in the way of the overall implementation of Positive Health Check?

Probed with:

• Can you provide specific examples?

5. [If barriers are mentioned in Q4] Can you provide specific examples of what you have done to address these barriers?

PHC Outreach

[This section is for PHC Project Staff Only]

6. Now thinking just about the patient outreach process (which includes collecting data from clinic’s EMR’s, the state’s inmate database, the Social Security Death Index, patients’ emergency contacts, case managers, pharmacists, and individual patients to try to reach patients and encourage them to return to the clinic) what are some activities related to clinic workflow that are facilitating conducting patient outreach to get patients out of care into the clinic?

Probed with:

• Can you provide specific examples?

7. What barriers, if anything, have gotten in the way of conducting the patient outreach?

Probed with:

• Can you provide specific examples?

8. [If barriers are mentioned in Q7] Can you provide specific examples of what you have done to address these barriers?

Onboarding

[This section is for PHC Project Staff Only]

9. Thinking just about the onboarding process (which includes inviting patients to use the intervention; giving patients the tablet, headphones, and patient ID card with their user ID and temporary password; assisting patients with logging into the intervention; and logging which device is given to which patient) what are some clinical workflow activities that are facilitating onboarding patients?

Probed with:

• Can you provide specific examples?

10. What barriers, if anything, have gotten in the way of the onboarding process?

Probed with:

• Can you provide specific examples?

11. [If barriers are mentioned in Q10] Can you provide specific examples of what you have done to address these barriers?

PHC Delivery

[This section is for PHC Project Staff Only]

12. Thinking about the PHC delivery process (which includes how, when and where patients use Positive Health Check; and collecting tablets back from patients) what are some clinical workflow activities that are facilitating the delivery of Positive Health Check?

Probed with:

• Can you provide specific examples?

13. What barriers, if anything, have gotten in the way of the delivery process?

Probed with:

• Can you provide specific examples?

14. [If barriers are mentioned in Q10] Can you provide specific examples of what you have done to address these barriers?

Handouts

15. [For PHC Project Staff] Thinking about the PHC handout printing, delivery and delivery tracking processes, what are some clinical workflow activities that are facilitating these Positive Health Check handout processes?

Probed with:

• Can you provide specific examples?

16. [For PHC Project Staff] What barriers, if anything, have gotten in the way of these handout processes?

Probed with:

• Can you provide specific examples of what you have done to address these barriers?

17. What kinds of comments have you heard from patients about the handout?

18. [For PHC Project Staff] What kinds of comments have you heard from providers about the handout?

19. [For non-PHC clinicians] What have patients said to you about their PHC handout during their visit with you?

20. [For non-PHC clinicians] In what ways do you think the handout is useful?

Clinic Web Application

[This section is for PHC Project Staff Only]

21. Thinking about the clinic web application (CWA) and its features, what are some clinical workflow activities that are facilitating the integration of the CWA into the overall PHC implementation process?

Probed with:

• Can you provide specific examples?

22. What, barriers, if anything, have gotten in the way of integration of the CWA into the implementation process?

Probed with:

• Can you provide specific examples of what you have done to address these barriers?

• Are additional resources needed facilitate these handout processes?

23. What aspects of the CWA do you find most useful?

Probed with:

• What about the Patient List (Track patients on-boarded progress)?

• What about the Detailed Patient View (for patient specific functions)?

• What about the Report Generation?

24. Have you experienced any technical difficulties while using the CWA?

Probed with:

• [If yes] Please provide me with details of what you experienced and how you resolved the issue.

The PHC Intervention

25. What are patients saying about the intervention itself?

Probed with:

• Have you observed anything or received feedback that may help us moving forward?

26. [For PHC Project Staff Only] What are providers saying about the intervention itself?

Probed with:

• Have you observed anything or received feedback that may help us moving forward?

27. [For Non-PHC Providers Only] What do you think of the PHC intervention itself?

Probed with:

• What, if anything, do you like about it?

• What, if anything, would you change about it?

Implementation Climate & Readiness

Let’s move on a talk about your clinic’s organizational climate and readiness to implement Positive Health Check.

[If Interviewing Clinic Staff] First I want to talk a little about your clinic’s leadership involvement in PHC, then move on to discuss the clinic environment and climate more broadly as it relates to implementing PHC.

[If Interviewing Provider or Clinic Champion] First I want to talk a little about your leadership in implementing PHC then move on to discuss the clinic environment and climate more broadly as it relates to implementing PHC.

Leadership Engagement

28. [If Interviewing Clinic Staff] Over the last 3 months, how involved has [INSERT ORGANIZATION NAME]’s leadership been during the implementation of Positive Health Check? By leadership, I mean people such as the medical director or department leads.

Probe with:

• To what extent was leadership engaged with planning or supporting Positive Health Check?

• How does leadership show support for the implementation of Positive Health Check?

• Do you have any suggestions of ways we can help leadership engagement with PHC?

29. [If Interviewing Provider or Clinic Champion] Over the last 3 months, how involved have you been in the implementation of Positive Health Check?

Expectations for PHC Staff

30. Have expectations for staff been clearly communicated about how Positive Health Check should be implemented within your clinic?

Probe with:

• [If yes] By whom?

• [If yes] How are these expectations communicated? (e.g. emails, in-person conversations)

Support for PHC Staff

31. How, it at all, are project staff supported to make sure PHC is implemented as it needs to be? (e.g. kept in the loop about clinic issues)

Probe with:

• Can you provide specific examples of how this takes place?

Perceptions of Adoption and Maintenance

Finally I would like to talk about thoughts on disseminating Positive Heath Check in the future. When answering these questions, think about your experience as a whole implementing PHC to date.

32. Do you think other clinics like yours would want to use Positive Health Check?

Probe with:

• Why or why not?

• What types of clinics would benefit from using PHC the most?

33. What do you think would make it appealing to them? Not appealing?

34. Is there anything that could be done to increase its appeal?

35. If other clinics used Positive Health Check what types of resources would they need to maintain this type of program?

Exit Questions

36. Is there anything else you would like to share with us that we have not yet talked about?