Attachment 13 2019 Critical Incident Protocol_In&Out Site

CRITICAL INCIDENT PROTOCOL
Interviews Conducted at Health Center Sites

Overview

This document outlines the procedures for responding to critical incidents while conducting interviews at health center sites on the Health Center Patient Survey. Participants will include individuals aged 13 and older and interviews will be conducted by professional research staff.

Distressed Respondents

Interviewers will be trained to identify signs of distress by listening to verbal and non-verbal indicators (e.g., shakiness in the voice, changes in volume, crying, etc.). If an interviewer suspects the respondent is in distress, the interviewer will ask the respondent if he/she is okay and whether he/she wants to continue the interview, stop the interview, or continue it at a later date. If the respondent indicates that he/she is okay, the interviewer will then comply with the respondent’s wishes with respect to continuation of the interview (i.e., will continue, will stop, or will plan to continue later).

If the respondent indicates that he/she is NOT okay, the interviewer will ask the respondent if he/she wants the interviewer to alert anyone at the health center, so that the respondent can obtain some assistance. If the respondent declines, the interviewer will respect the respondent’s request. If the respondent requests that the interviewer contact health center staff, the interviewer will do so.

If the respondent is incapable of requesting or declining the assistance of health center site staff, interviewers will alert the appropriate health center site staff as to the respondent’s state of distress.

All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action may be required.

Respondent Poses Threat to Self

If during the course of an in-person interview, a respondent volunteers that he/she is thinking about killing himself/herself or is planning to kill himself/herself, interviewers will report the incident to the appropriate health center site staff. All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action may be required. However, because we do not have identifying information for the respondents interviewed on-site, RTI will not contact the authorities.

Respondent Poses Threat to Others

It is extremely unlikely, but someone may spontaneously tell an interviewer that they are planning to seriously hurt or kill someone else. If a respondent states that he/she intends or plans to kill or seriously harm a specific individual or individuals, interviewers will report the incident to the appropriate health center site staff. All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action may be required. However, because we do not have identifying information for the respondents interviewed on- site, RTI will not contact the authorities.

Suspected Abuse of a Minors

It is possible that interviewers will observe situations of juvenile abuse or neglect. Although there are no questions that ask respondents about physical abuse, it is possible that respondents may volunteer information that indicates that a juvenile is being abused or neglected, or that the interviewer may observe injuries that might indicate abuse. In this event, the interviewer will report the incident to the appropriate health center site staff. All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action may be required. Because we do not have identifying information for the respondents interviewed on- site, RTI will not make a report to Child Protective Services. Note: The status of a youth as homeless will not trigger a report of neglect.

Documentation

In all instances in which the critical incident protocol was activated, a critical incident form will be completed by the interviewer. This form will document what the interviewer witnessed, and what steps he or she took to address the situation.

CRITICAL INCIDENT PROTOCOL
Interviews Conducted Outside Health Center Sites

Overview

This document outlines the procedures for responding to critical incidents on the Health Center Patient Survey while conducting interviews outside health center sites (i.e., interviews which take place at a library with a private room or at the respondent’s home). Participants will include individuals aged 13 and older and interviews will be conducted by professional research staff. In the unlikely event of an off-site critical incident, interviewers will be instructed to ensure their safety is the first priority and, whenever necessary, leave an unsafe situation. Specific protocols for handling non-emergency situations are included in the next four sections followed by one section describing how to handle all emergency situations.

Distressed Respondents

Interviewers will be trained to identify signs of distress by listening to verbal and non-verbal indicators (e.g., shakiness in the voice, changes in volume, crying, etc.). In a non-emergency situation, if an interviewer suspects the respondent is in distress, the interviewer will ask the respondent if he/she is okay and whether he/she wants to take a short break. As needed, the interviewer will offer to continue the interview at a later date. Before leaving, either due to a rescheduled interview or at the end of an interview, the interviewer will provide the respondent with 1-800 ‘helpline numbers’. If the respondent would like someone to talk to, the interviewer will encourage the respondent to utilize the appropriate helpline number(s) provided.

All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action, if any, may be required.

Respondent Poses Threat to Self

It is extremely unlikely, but a respondent may spontaneously tell an interviewer something which implies the respondent is a threat to himself/herself. If the respondent does not pose an immediate risk to himself or herself, after completing the interview the interviewer will provide the respondent with 1-800 ‘helpline numbers’. If the respondent would like someone to talk to, the interviewer will encourage the respondent to utilize the appropriate helpline number(s) provided.

All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action, if any, may be required.

Respondent Poses Threat to Others

It is extremely unlikely, but a respondent may spontaneously tell an interviewer something which implies he/she is a threat to someone else. If the respondent does not pose an immediate risk to someone else, after completing the interview the interviewer will provide the respondent with 1-800 ‘helpline numbers’. If the respondent would like someone to talk to, the interviewer will encourage the respondent to utilize the appropriate helpline number(s) provided.

All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action, if any, may be required.

Suspected Abuse or Neglect of a Minor

It is possible that the field interviewers will observe situations of juvenile abuse and neglect. Although there are no questions that ask respondents about physical abuse, it is possible that respondents may volunteer information that indicates that a juvenile is being abused or neglected, or that the interviewer may observe injuries that might indicate abuse. Note: The status of a youth as homeless will not trigger a report of neglect.

In a non-emergency situation, after completing the interview the interviewer will provide the respondent with 1-800 ‘helpline numbers’

All incidents will be reported by the interviewers to their Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader, as soon as practically possible. Senior project staff will discuss the situation and decide on what further action may be required. Under no circumstances will the Field Supervisor, Regional Supervisor, or the Data Collection Task Leader tell the interviewer not to report instances of abuse/neglect, since the interviewer may have his or her own obligation to report abuse in accordance with state law. All project staff who are involved in decisions about the reporting of abuse will be trained in state-specific mandatory reporting laws for the states involved in data collection, and as noted, interviewers will comply with their state-specific mandatory reporting laws.

Emergency Situations

If an interviewer is in the field and encounters or witnesses an emergency situation (for example, a medical emergency, someone is being harmed right in front of the interviewer, someone poses an immediate risk to himself/herself or someone else) he/she will follow the steps listed below:

1) Determine if he/she is safe and leave if necessary.

2) Call 911 (from an area away from the respondent if appropriate).

3) Call his/her Field Supervisor, the Regional Supervisor, and the Data Collection Task Leader as specified in this protocol.

4) Document the incident via the critical incident protocol form.

5) Follow-up per any senior project staff request.

Documentation

In all instances in which the critical incident protocol was activated (regardless of whether it was for a non-emergency or emergency situation), a critical incident form will be completed by the interviewer. This form will document what the interviewer witnessed, and what steps he or she took to address the situation.

OMB# 0915-0368 Exp. XX/XX/XXXX