Understanding Patient Perceptions of Access in VISN 22

Understanding Patient Perceptions of Access in VISN 22

OMB No. 2900-0770
Estimated Burden: 30 minutes

Expiration Date: 9/30/2020

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 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. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

Veterans Assessment and Improvement Laboratory for Patient Centered Care (VAIL-PCC)

VISN 22 Patient Interviews about Access to Primary Care

INTRODUCTORY SCRIPT:

Hello, I’m [STATE YOUR NAME]. I’m from the VA Greater Los Angeles. We’re calling you today to find out if you would like to participate in an interview about your experiences as a VA patient with accessing VA primary care at [CLINIC NAME]. When we talk about access, we are talking about the ability to get the care you need when you need it, and in a way that best meets your needs. You should have received a letter in the mail with some information about the project, which is called the VA Primary Care Patient Experience Interview project. Do you remember receiving the letter? [IF NO, BRIEFLY DESCRIBE THE PROJECT USING THE Q&A] Would you be willing to be interviewed about your experience? The interview will last about 30 minutes, depending on how much you have to say, and will be audio-recorded. For participating in the interview, we will send you a $20 CVS gift card.

IF YES:

Great! First, I need to ask you a question to see if you are eligible to participate.

SCREENING QUESTION: Has there been a time in the past 6 months or so that you have tried to get into [SITE NAME] clinic to see your primary care doctor right away?

Yes  CONFIRM THE VISIT WAS FOR A MEDICAL CONCERN/CONDITION THAT THEY NEEDED HELP WITH RIGHT AWAY. IF PATIENT SEEMS LIKE HE/SHE CAN ARTICULATE EXPERIENCE WITH ACCESS, THEN Continue

No  Thank you for your time, but we want to know about experiences with trying to be seen right away for an urgent medical concern/condition at this clinic.

IF NO [NOT INTERESTED IN PARTICIPATING]:

Thank you for your time. Good bye.

IF SCREEN ELIGIBLE, CONTINUE: Are you available now to do the interview by phone?

Yes  CONTINUE WITH THE INTERVIEW

No  INTERVIEWER SCHEDULE A DAY/TIME THAT WORKS FOR THE PATIENT

Thank you for agreeing to participate in this interview…

Before we begin, let me just review some general information. This interview is part of a quality improvement project to improve Veterans’ access to primary care in this region, which includes Southern California, Arizona, and New Mexico. We are interviewing you and other patients that have used this clinic recently to understand your experiences with trying to access primary care for a health problem or issue that you needed care for right away. We’ll combine the information you provide with information from other Veteran patients to make changes that will improve your access to primary care in the future.

With your permission, the interview will be audio-recorded and transcribed. For confidentiality reasons, I will not refer to you or any of your healthcare workers by name. For that same reason, it would be helpful if you could refer to any people you mention by title rather than name during the interview. For example, please refer to your doctor, or nurse as “my doctor” or “my nurse”, but do not use their names.

The recording and transcription will be assigned a code and stored under lock and key or on a password-protected encrypted VA server.

Taking part in this interview is entirely voluntary. You may refuse to participate and can withdraw at any time.

Can I answer any questions before we begin?

OK, thank you. I am going to turn on the recorder, and say the code number, and then we can begin, if that’s OK?

1. Thinking about a time when you really needed to be seen by your primary care provider right away, what was your experience with that? Can you walk me through what you did and what happened?

Probes:

- Did you call into the VA to try to talk to your provider or make an appointment?

- Were you connected directly to your provider/ teamlet, or did you have to leave a message?

- If you left a message for your provider/teamlet, how long did it take for someone to call you back?

- Who did you talk to? Were they helpful?

- If you made an appointment, how long did you have to wait to see your PCP?

- If your primary care provider said you needed to see a specialist, how long did you have to wait to get an appointment?

- Were you able to get the care you needed for your issue/problem?

2. There are many types of things that can be described as part of “access to care”. For example, it can be the time it takes for clinic staff to return a phone call; the time it takes to get to talk to clinic staff; your ability to get your questions answered, and so on. Which of those things are most important to you? Why?

- When you want an appointment (not urgent), can you make the appointment easily? For when you want care?

- When you have a question between appointments, what do you do? Were you able to get the information you need?

3. Sometimes you might have a visit with another team member, like a nurse or pharmacist, instead of your primary care doctor. Has this ever happened to you? How was this experience for you? When might it be important to you to see your primary care doctor instead of another team member?

4. Have you ever received any information about how to navigate the VA health system, for example, instructions on what you should do and what number to call when you need to be seen? (If yes): Was this helpful? (If no): Do you think Veterans should receive information about how to navigate the VA? If so, what would be most helpful to know?

INTERVIEWER, ASK THE NEXT TWO QUESTIONS IF NOT ALREADY DISCUSSED ABOVE:

5. One way to access care that you may have used is calling the VA on the telephone, or your doctor or nurse might call you for a telephone appointment, or to tell you about test results or check up on you. Tell me about your experiences of trying to access care by telephone, and what made it good or bad.

- When you call VA, can you get the help you need?

- Have you had telephone appointments with your primary care provider or another team member? What was that like?

- When or for what types of things would a telephone visit be a good substitute for an in-person visit to your primary care provider?

6. Another way of accessing VA care is to use MyHealtheVet. This is VA’s online patient portal that you can use to schedule or cancel appointments, to get prescription refills, and to send secure messages to your primary care team. What has been your experience with using MyHealtheVet?

- IF NEVER USED MHV: Would you be interested in communicating with or getting care with your primary care team through the web?

- When you think about access to VA care, do you think using MyHealtheVet is useful for some kinds of care you might need? What have you used it for?

- When or for what types of things would using MyHealtheVet be a good substitute for an in-person visit to your primary care provider?

Understanding Patient Perceptions of Access in VISN 22

Patient Perceptions of Access Interview Guide ver. 1.10.18