Focus group discussions with AIM Team Leads and frontline staff

Safety Program for Perinatal Care II – Demonstration Project

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

This survey is authorized under 42 U.S.C. 299a. The confidentiality of your responses to this survey is protected by Sections 944(c) and 308(d) of the Public Health Service Act [42 U.S.C. 299c-3(c) and 42 U.S.C. 242m(d)].  Information that could identify you will not be disclosed unless you have consented to that disclosure. Your participation is voluntary and all of your answers will be kept confidential to the extent permitted by law. Public reporting burden for this collection of information is estimated to average 60 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 5600 Fishers Lane, # 07W41A, Rockville, MD 20857.

Follow-up / Wave 2 Focus Group Guide

Introduction

Thank you for agreeing to participate in this focus group regarding the Safety Program for Perinatal Care (SPPC-II) Teamwork Toolkit. We are interested in your opinions on the Toolkit and its utility, therefore, there are no right or wrong answers. With your approval, this interview will be recorded for note taking purposes and to ensure that we capture all your feedback.

Your responses will be kept confidential to the extent permitted by law, including AHRQ’s confidentiality statute, 42 USC 299c-3(c). That law requires that information collected for research conducted or supported by AHRQ that identifies individuals or establishments be used only for the purpose for which it was supplied unless you consent to the use of the information for another purpose.

Do you have any questions?

Questions

1. To get started, can you please share your current position and in what capacity are you involved with the implementation of the AIM patient safety bundles at your hospital.

   • What AIM bundle(s) is your hospital currently implementing or maintaining?

2. The SPPC-II Teamwork Toolkit consists of the following components [PROVIDE HANDOUT 1 (list of Toolkit components)]. Which components of the Toolkit did your Labor and Delivery Unit implement?

3. In thinking about the implementation of the Toolkit so far, what has gone well? [probe for specific components of the Toolkit mentioned in previous question]

   • What have you been most proud of?

   • Have you faced any obstacles or challenges? How were you able to address any of these?

4. Who has been leading the implementation of the Toolkit?

   • What kinds of behaviors or actions do you think this individual / champion used to support implementation? Or hinder implementation?

   • Was it the same lead coordinator throughout the SPPC implementation to date?

5. What level of endorsement or support have you seen or heard from leaders?

   • Who are these leaders and how has this affected things so far? Going forward?

6. Do you feel like the training [workshop for AIM Team Leads; online modules for frontline staff] prepared you to carry out the roles and responsibilities expected of you? [PROVIDE HANDOUT 2 (list of online modules)].

   • What additional resources or support did you need or do you still need? [If not mentioned in response, PROMPT: Would you benefit from reviewing one or more of the SPPC training modules online at any time in the future? If so, what module(s) would you like to re-take, and approximately when?]

   • [IF AIM TEAM LEAD]: How did providers at your hospital react to the SPPC-II online modules? Why do you think they reacted this way?

   • [IF AIM TEAM LEAD]: On what schedule have the online modules for frontline staff been completed?

7. Have you had facilitation sessions to discuss the tools you have learned of the SPPC-II toolkit?

   • Who typically attends?

   • How often do you meet? Has the frequency changed over time?

   • What is the typical agenda? / What topics have been covered?

   • How helpful are these facilitation meetings?

   • Have you discussed these tools at other meetings besides the SPPC-II facilitation sessions arranged by your AIM Team Lead? Or informally?

8. How well did the teamwork and communication tools recommended by the Toolkit fit with existing work processes and practices in you setting?

   • Are there any tools that are being consistently used by a majority of frontline staff?

   • Did you adapt the tools in any way to fit your setting?

     • Can you describe what was modified?

     • What were the reasons for adapting?

     • When did the adaptations occur?

     • Were the adaptations planned?

     • Who participated in the decision to modify?

       1. Were there any key individuals / groups who did not participate in modifications but should have?

   • Were there tools you started to implement and then decided to stop?

   • Has use of these tools been impacted by the COVID-19 pandemic? If so, how?

9. What additional resources from the SPPC-II program (e.g., PDFs of the scenarios, facilitation guide) have been available to help you implement and use the Toolkit?

   • What is your perception of the quality of these resources?

   • In what ways can the SPPC-II program be more helpful?

10. What has been the general level of receptivity in your Labor and Delivery unit to implementing the Toolkit and its recommended practices?

• How did the priority of implementing the Toolkit compare to other priorities in your organization? For your own work?

  • Did this change over time?

• What kinds of information have you collected during the implementation of the Toolkit?

  • Which measures do you track? For example, participation in online modules / facilitated sessions, perceptions of the Toolkit components (e.g., ease of access, length), levels of engagement, etc.

  • How do you track them?

  • How have you been using this information?

• Did your unit set goals related to the implementation of the intervention?

  • What are the goals?

  • Were you able to achieve any of the outcomes you were hoping for?

  • [IF YES] Were there any special recognitions or rewards for achieving these goals?

11. [IF AIM TEAM LEAD]: How are you planning to maintain focus on the Toolkit’s recommended practices?

    • Have you been sharing feedback about the Toolkit with anyone? With whom (e.g., frontline vs. executives) and in what format (e.g., meeting, email)?

    • How have you been training or orienting new people to the Toolkit’s practices?

12. Thinking back to when you first implemented the Toolkit, can you describe any barriers or facilitators that were important then but not as important now?

    • Are there factors that are more important now than in the early days of implementation?

    • Are there factors that have remained important throughout?

13. Can you describe any efforts your unit has made to support shared-decision making between providers and patients (i.e., to ensure that the treatment plan reflects patients’ values and goals)?

• Have you faced any obstacles or challenges trying to support shared-decision making? From the providers’ perspective? From the patients’ perspective?

• Do you have decision aids related to [insert AIM bundle] to share with patients and families? For example, pamphlets or web-based tools that describe the options available as well as possible benefits and harms?

• Do you think [insert AIM bundle] helps foster shared-decision making (e.g., by helping professionals in being well informed, not only about the best option, but other available options in specific decision contexts)?

14. Have you involved patients in the planning and/or implementation of the [insert AIM bundle]?

    • [IF YES]: What were you hoping to achieve by involving patients?

    • [IF YES]: What, if any, obstacles have you encountered?

    • [IF YES]: How did you go about involving patients? What did you invite them to do?

    • [IF YES]: How would you characterize the impact of involving patients in the implementation process?

      • Are there opportunities you may have missed if patients had not been involved?

      • Are there things your practice is doing differently because patients were involved?

    • [IF NO]: What do you think has prevented your unit from involving patients in this process?

Thank you for your time.

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