The Workforce Program Organizational Assessment Interview Protocol

Evaluation of Programs Supporting the Mental Health of the Health Professions Workforce

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Attachment 6

Evaluation of Programs Supporting the Mental Health of the Health Professions Workforce

Workforce Program Organizational Assessment Interview Guide

Workforce Program Organizational Assessment Interview Guide

Introduction

Welcome and thank you for participating in today’s discussion. My name is [Change Matrix Staff] and I am a/n [title] at Change Matrix. As you may be aware, NORC at the University of Chicago and Change Matrix are conducting an evaluation of programs that have been funded by HRSA to address burnout and improve resiliency in the healthcare workforce. As part of this evaluation, NORC and Change Matrix are interviewing each of the Promoting Resilience and Mental Health among Health Professional Workforce (PRMHW) awardees to learn more about their program.

Before we get started, I am going to read some information about the evaluation and your participation in this interview. It will only take a few minutes and then we will jump into the interview questions.

This interview is part of an evaluation NORC and Change Matrix are conducting on behalf of HRSA. We want to learn more about your experiences implementing your HRSA-funded program including lessons learned and barriers and facilitators to implementing your program. This is the first time that HRSA’s Bureau of Health Workforce has invested in resiliency programs of this kind, so your experience and feedback is incredibly valuable to HRSA. Your input, along with other awardees’, can inform future funding decisions about programs that address burnout and resiliency in the healthcare workforce.

The discussion today should last about an hour and a half. My colleague [name] from NORC is also on the phone. We will be working together to moderate the interview today. Information from this interview will be included in documents associated with the evaluation for HRSA. We will not use your name, or any others, in these reports. your organization may be identifiable in these reports. You can choose whether to participate in the interview, and you may stop at any time during the discussion. Please note that there are no right or wrong answers to interview questions.

This interview guide has been reviewed and approved by the Office of Management and Budget. Our OMB Control Number is 0915-XXXX and our expiration date is MM/DD/20XX. We estimate this interview will take approximately 90 minutes to complete. I am also sharing this information in the chat so you have it.

<Interviewer, please insert this text into the meeting chat: Public Burden Statement: The purpose of this information collection is to evaluate federal programs designed to support the mental health and resiliency of the healthcare and public safety workforce. 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. The OMB Control Number for this information collection is 0915-XXXX and is valid until MM/DD/20XX. Public reporting burden for this collection of information is estimated to average xx hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected].>

If you have questions about the project, feel free to contact HRSA’s contact for this project Carolyn Robbins (301-443-2291). If you have questions about your rights as a participant, you may call the NORC Institutional Review Board Manager toll-free at 1-866-309-0542.

Do you have any questions about the evaluation or your participation in the interview today?

If Yes– Moderator addresses the questions.

If No– Proceed to informed consent.

Do you consent to participate in this interview?

If Yes– Proceed to questions.

If No– Allow participant(s) to end the conversation.

Great. My colleague [name] will be on the phone to take notes during our conversation. We would also like to record the conversation to create a transcript to inform our report. We will delete the recording at the end of the project.

Do you agree to have this interview recorded?

If Yes from ALL parties – Proceed and begin recording the interview. [START RECORDING]

If No from ANY parties– That is fine. Please be patient as we take notes – we may stop and ask a question to confirm that we have your response correctly.

Workforce Program Organizational Assessment Interview Questions

Introductions and Awardee Program Overview

Let’s start with introductions and a quick overview of your program.

1. Could each of the staff members on the call please introduce yourself and provide some context about your role on the [AWARDEE PROGRAM NAME]?

2. Great, thank you. Now, can you please provide a brief overview of your program?

Organizational Change Interview Questions (Change Matrix)

Great, now I’ll begin by asking some questions about your organizational culture and work to create conditions of change. This part of the interview will take about an hour. After that, my colleague [name] will ask you some questions about your program’s impact.

Interview Guide 1: Project Manager/Project Director Questions

Section 1: Creating Conditions for Change

1. What is the shared vision your team developed for organizational wellness and resilience?

[In the Notice of Funding Opportunity, HRSA defines Culture of Wellness as fostering a workplace that encourages and promotes the well-being of your employees by availing programs, services, and resources for employees that encourages a healthy or wellness-oriented lifestyle and work environment. HRSA defines resiliency as the ability to bounce back from stressful situations, endure hardships, and repair your own well-being, while creating a positive adaptation in the face of disruptive changes]

1. How did the COVID-19 pandemic inform this vision?

1. What would success look like if you achieved your vision?

2. To realize this vision, what shifts will need to take place among your workforce or leadership?

   1. What values and expectations will need to shift across your organization?

   2. How will your organization need to change?

   3. How will you provide culturally competent services for your workforce?

3. What structures (e.g., guiding team, collaborative) has your team put in place to support this change process?

Section 2: Engaging and Enabling

1. How is your team embedding equity in your approach?

[In the Notice of Funding Opportunity, HRSA defines health equity as the absence of disparities or avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality]

1. In what ways are you considering the diversity among your workforce, in terms of demographics (e.g., urban, rural)? In what ways are you considering the diversity among your workforce, in terms of profession (e.g., physician, nurse, medical assistant, pharmacist)?

2. What voices feel important to elevate, in support of equity?

1. How have you used the evidence base to inform your approach?

   1. What rapidly deployed evidence-based or evidence-informed strategies is your team planning to implement?

2. How have you approached workforce engagement?

   1. What strategies are you using to communicate with your workforce? What does communication look like?

   2. What are you communicating to your workforce?

   3. To what extent are you creating a sense of urgency for change?

   4. What strategies are you using to incentivize participation?

3. What partners are supporting implementation?

   1. How did you determine what types of partners would be helpful? How did you develop these partnerships?

   2. How did partners support you in addressing specific underserved populations (e.g., rural, medically underserved)?

   3. How did partners support you in supporting culturally competent services?

   4. How did partners support you in sustaining changes, if any?

[In the Bureau of Health Workforce Glossary, HRSA defines cultural competence as the knowledge, interpersonal skills, behaviors, attitudes, and policies that allow health professions educators and practitioners to understand, appreciate, and respect cultural differences and similarities in cross-cultural situations. Cultural competency acknowledges these variances in customs, values, beliefs, and communication patterns by incorporating these variables in the assessment and treatment of people and in the training of all health professionals.]

Section 3: In-Process or Post Implementation

1. What is working well with the implementation of your organizational change?

1. How do you know? How are you evaluating this?

2. What quick wins did you implement to support organizational change?

The next set of questions will address how your plan to implement [reference evidence-based/evidence-informed strategies from earlier question] has been going.

2. What system-wide policies and protocols were created and implemented?

   1. How were the policies and/or protocols intended to promoted health equity?

   2. What challenges or barriers were encountered in creating and implementing the policies and protocols?

   3. What facilitators helped with creating and implementing the policies and protocols?

   4. What benefits (if any) have your workforce experienced from these policies and protocols (e.g., address burnout/compassion fatigue, mental health supports)?

   5. What changes (if any) have you seen among your workforce?

   6. Have you noticed differences among different demographic groups (e.g., by race/ethnicity, profession type)?

   7. Are you piloting (or considering) any other policy changes or protocol updates? If so, what are the changes/updates, and are you approaching them any differently than you did with the policies and protocols you have already implemented?

3. In what ways have partners or other collaborations supported implementation (e.g., provided cultural competence expertise, helped with barriers)?

   1. [if not already mentioned] What challenges have you experienced working with your partners?

   2. What challenging conversations are happening with partners?

   3. How are you keeping them engaged in this work?

4. What lessons are you learning through implementation?

   1. What barriers or challenges, if any, have you overcome in the implementation process?

   2. How are you using these learnings to improve your wellness project?

   3. How have your learnings impacted any changes in your organizational culture, practices, or policies?

5. During the implementation phase programs often have to pivot for a variety of reasons. Did your program have to pivot in any way? If so, could you please share with us…

   1. Why did you have to pivot?

   2. What changes did you make, and how did those changes affect the program?

6. [if not mentioned] How have your organization’s culture and practices changed to support wellness?

7. Can you describe how these changes will be sustained?

   1. What needs to be in place to support sustainability?

8. To what extent would you have been able to implement these wellness changes without HRSA funding?

9. Is there anything else you think we should know about, or do you have any final thoughts you would like to share?

Interview Guide 2: Partner Questions

Section 1: Creating Conditions for Change

1. Why did you agree to partner with [Organization Name]?

2. What is the shared vision your team developed for organizational wellness and resilience?

[In the Notice of Funding Opportunity, HRSA defines Culture of Wellness as fostering a workplace that encourages and promotes the well-being of your employees by availing programs, services, and resources for employees that encourages a healthy or wellness oriented lifestyle and work environment. HRSA defines resiliency as the ability to bounce back from stressful situations, endure hardships, and repair your own well-being, while creating a positive adaptation in the face of disruptive changes.]

3. If you are successful, what will be different? What will change?

4. To realize these changes, what shifts will need to take place among your workforce or leadership?

   1. What values and expectations will need to shift across your organization in order to provide community-based and culturally relevant services that support a culture of wellness?

   2. In what ways will your organizational capacity need to transform?

5. What structures (e.g., guiding team, collaborative) has your team put in place to support this change process?

Section 2: Engaging and Enabling

1. How is your team embedding equity in your approach?

[In the Notice of Funding Opportunity, HRSA defines health equity as the absence of disparities or avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality]

1. In what ways are you considering the diversity among your workforce, in terms of demographics and profession (e.g., doctor, nurse, medical assistant, pharmacist)?

2. What voices feel important to elevate, in support of equity?

1. How have you used the evidence base to inform your approach?

   1. What rapidly deployed evidence-based or evidence-informed strategies is your team planning to implement?

2. How have you approached workforce engagement?

   1. What are you communicating to your workforce?

   2. To what extent are you creating a sense of urgency for change?

3. How do you feel the partnerships have been working?

Section 3: In-Process or Post Implementation

1. In your opinion, what is working well with your programs?

1. How do you know? How are you evaluating this?

1. [If supporting implementation] What system-wide policies and protocols were created and implemented?

2. What benefits (if any) have been created for [reference health system] workforce (e.g., address burnout/compassion fatigue, mental health supports)?

3. What has been challenging? (e.g., stigma, resources, leadership or management support, communication)

4. In what ways (if any), have these challenges altered your initial implementation plans?

5. What challenging conversations are happening with partners?

6. What lessons are you learning through implementation?

   1. What challenges, if any, have you overcome in the implementation process?

   2. How do these learnings impact your organizational culture, practices, or policies?

7. [if not mentioned] How have your organization’s culture and practices changed to support wellness?

8. Can you describe how these changes will be sustained?

9. What needs to be in place to support sustainability?

10. To what extent would you have been able to implement these changes without HRSA funding?

11. Is there anything else you think we should know about, or do you have any final thoughts you would like to share?

Interview Guide 3: Workforce Questions

Section 1: Creating Conditions for Change

1. What is your organization's vision for wellness and resilience?

[In the Notice of Funding Opportunity, HRSA defines Culture of Wellness as fostering a workplace that encourages and promotes the well-being of your employees by availing programs, services, and resources for employees that encourages a healthy or wellness-oriented lifestyle and work environment. HRSA defines resiliency as the ability to bounce back from stressful situations, endure hardships, and repair your own well-being, while creating a positive adaptation in the face of disruptive changes]

2. If the organization is successful, what will be different? What will change?

Section 2: Engaging and Enabling

1. [if not supporting implementation] This initiative is focused on improving wellness across [reference health system] entire workforce. Considering the diversity of the workforce, what factors are important to consider when designing service delivery?

1. What partnerships were most useful in addressing specific underserved populations (e.g., rural, medically underserved)?

1. How have you (or your colleagues) been engaged in planning or implementation? [if involved] what has been your role?

2. What communication have you seen from [Organization Name ] regarding wellness efforts, if any?

   1. Because successful engagement of the workforce is critical for success, what engagement strategies do you think are most important?

   2. What strategies have been used to incentivize participation? To what extent have these been successful?

Section 3: In-Process or Post Implementation

1. When workforce members seek mental health support, what barriers do they face?

2. In your opinion, what is working well about accessing mental health support at your organization?

   1. How do you know?

3. What benefits (if any) have you seen for yourself or your colleagues (e.g., address burnout/compassion fatigue, mental health supports) since the HRSA-funded program began in early 2022?

1. What changes (if any) have you seen among your colleagues?

4. [if not mentioned] How have your organization’s culture and practices changed to support wellness?

5. What challenges to accessing wellness efforts (if any) have you observed?

   1. What additional resources are needed to support wellness and resiliency?

6. What needs to be in place to successfully sustain these wellness efforts?

7. To what extent do you think your organization would have been able to implement these wellness changes without HRSA funding?

8. Is there anything else you think we should know about, or do you have any final thoughts you would like to share?

Impact Interview Questions and COVID-19 Factors (NORC)

[These questions will be asked at the end of each of the protocols in the section above.]

Now we’d like to ask some questions about the impact of your program.

1. What aspects of this program do you think will have the biggest impact on your healthcare workforce?

1. What impacts do you think those aspects of this program will have?

2. Can you please share a few stories about the impact of your program?

1. What activities, or group of activities, do you think are most likely to:

   1. reduce burnout?

   2. improve resiliency?

   3. increase retention?

While this project is not focused on COVID-19, the COVID-19 pandemic caused significant increases in burnout in the healthcare workforce and we are interested in learning how COVID-19 may be continuing to impact burnout in your healthcare workforce, and how you see this relating to your program or your program success.

3. From your perspective, is the COVID-19 pandemic still impacting feelings of burnout in your health workforce? Do you think the rates of burnout in your health workforce have returned to what they were prior to the pandemic?

4. Please think about the time before COVID-19, then during the height of COVID-19, and now. Can you talk about how your organizations’ resiliency, mental health, and wellness resources and services has changed, or not, throughout these different points in time?

5. To what extent do you think your health workforce is prepared to respond to COVID-19 demands or future outbreaks, treat patients with COVID-19, and maintain patient and personal safety in the future?

   1. In what ways, if any, did your program help prepare them?

6. Those are all the questions that we have for you today. Is there anything else that we have discussed that you would like to share about this program?

Thank you for your time and for sharing your insights with us. We greatly appreciate it.

Workforce Program Organizational Assessment Interview Guide

OMB Control Number: 0915-XXXX

Expiration Date: MM/DD/20XX