3 Attachment E: Nursing Home Key Informant Interview

Attachment E

Interview Guide: Nursing Homes

Date and Time
Zoom
Lead
Participants

• Introduce members of group.

• Thank you very much for your time today.

• NORC at the University of Chicago is a not-for-profit research organization, and we are working with the Agency for Healthcare Research and Quality (AHRQ) to assist in operating the AHRQ National Nursing Home COVID-19 Coordinating Center. Part of the Coordinating Center’s role is to assess AHRQ’s National Nursing Home COVID-19 Action Network (Network) by examining whether and how the Network activities covered by the Provider Relief Funds (PRF) aided nursing homes’ efforts to mitigate the challenges posed by the COVID-19 pandemic. Our conversation with you today is primarily to hear your perspectives on your work with the Network.

• I’m going to be leading this interview, but others may chime in with follow-up questions.

• Just a few things before we get started.

  • In terms of confidentiality, we won’t attribute anything you share during this interview as coming from you personally or your nursing home specifically. We will keep your name confidential in any summaries or reports we make available to other agencies or to the public.

    • In general, our reports are a summary of what we’ve heard from you and others about the experiences of nursing homes.

  • We’ve scheduled this meeting to last 60 minutes. If you need to stop for any reason, that’s fine. We know you are busy. If possible, we may schedule a follow up interview or e-mail you for any additional information needed or clarification. Do you agree to participate in this interview? [obtain verbal consent] Thank you. We appreciate your participation.

• We have a member of our team taking notes. With your permission, we’d like to make an audio recording to help make sure we capture everything correctly. The notes and recording will only be used by NORC to write our reports. Are you okay with us recording our conversation?

• Do you have any questions before we begin?

Background and Context

Now that I’ve told you about NORC and our study, before we begin with our questions, I’d like to go around the virtual room and introduce ourselves. If you could just tell us your name and your position at [NURSING HOME NAME] and a bit about your responsibilities at [NURSING HOME NAME].

1. Can you tell me about your facility’s experiences over the last year in managing the COVID pandemic?

• Did your facility experience resident infections?

• What about infections among staff?

• Have you experienced resident and/or staff losses?

2. Thinking back to the start of the pandemic (March or April 2020), what challenges did your nursing home face? How did the challenges evolved over time? What challenges remain?

• Examples of challenges may relate to testing equipment; financial; lack of resources on best practices; access to lab and timely test results; infection control protocols; dealing with resident isolation; staffing challenges, etc.

3. What initiatives is or was your nursing home involved with to address the challenges of the COVID-19 pandemic?

4. Is there anything else we should know about your state or local context that has made your nursing home’s experience with the COVID-19 pandemic unique (e.g., COVID-19 severity, urban/rural location, proportion of vulnerable residents? National chain? For-profit vs. not-for-profit?)

Reach, Retention, and Engagement of the Network

Next, I’d like to turn to getting your feedback on the Network provided by the University of New Mexico ECHO program (trainings were offered from October 2020 through XXX 2021).

5. How did your nursing home/facility get involved with the Network?

• What information or communication did you receive about it?

• How was your nursing home recruited into the Network?

• What appealed to you about joining the Network?

6. Why did you decide to participate in the Network training program?

7. Can you talk a bit about your facility’s experience participating in the training program?

• Who from your nursing home participated in the Network trainings and activities?

• How many and what types of sessions have you or other staff attended?

• What session(s) were most helpful? Least helpful? [Note to moderator: list session topics]

8. Your facility was affiliated with [TRAINING CENTER NAME]. Can you share a bit about the interactions with [TRAINING CENTER NAME]?

• How often did you communicate with them outside of the sessions?

• Did you find that the training center adapted the sessions to meet the needs of your facility? If so, how?

9. As part of participating in the Network, your facility had access to a variety of technical assistance resources. These could have included access to nursing home experts, quality improvement tools, etc. What Network resources did your facility use?

• How did you access these resources? Through the IHI community page? Other means? How did you use these resources?

• Which resources did you find to be the most useful?

10. Did the Network sessions provide a forum for you or other participating nursing homes to discuss common issues and share strategies to overcome them?

• For example, were you able to share your facility’s experiences with other facilities to get advice or support?

• Can you describe the topics discussed among facilities?

• Have you maintained a relationship with any of the facilities that were part of your training sessions?

11. Thinking back to the session topics, technical assistance used, and relationships formed, did you adopt any of what you learned through the Network into practice in your facility?

• If yes, how?

• Are any of these practices or resources still being used?

12. Thinking back to your facility’s time participating in the network, what, if any, were the challenges of participating in the Network’s activities and utilizing its resources?

Impacts of Network Activities and Resources

13. Thinking back on the time you spent attending the network trainings and using the technical assistance, what have been the biggest impacts of participating in the Network’s activities and utilizing its resources?

• For example, have you noticed any improvements in knowledge, confidence, or behaviors related to:

• patient safety procedures?

• infection control protocols?

• quality improvement activities?

• vaccine rollout?

• staffing shortages and wellness?

• capacity to obtain protective equipment?

• capacity to obtain resources to frequently test all current residents and staff?

Gaps and Barriers

14. Are there any gaps in COVID-related knowledge, skills, or resources at your nursing home?

• How can the Network model (virtual training and technical assistance) best help with filling those gaps?

Wrap-up

15. Is there anything else you’d like to share about your participation in the Network that I didn’t ask about?

Thank you for your time.

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