3 Appendix C: Pre-Test Interview Protocol

Appendix C – Pre-test Interview Protocol

Form Approved
OMB No. xxxx-xxxx
Exp. Date xx/xx/20

AHRQ – Building Diagnostic Safety Capacity – Measurement

Pre-test Interview Protocol for Quality and Safety Personnel

MedStar Health Research Institute (MHRI) will conduct interviews with personnel at 20 implementation sites during the pilot testing of the Diagnostic Safety Measurement Resource. The pre-test interviews will be conducted toward the beginning of implementation (approximately 2-3 weeks after delivery of the Resource to the sites).

Interviews will be conducted virtually with participants individually or in small groups of 2 to 3 (2-3 participants per site x 20 sites, maximum of 60 interviews in total). Participants will include clinicians and quality and safety personnel. Each interview will last approximately 60 minutes.

Recruitment Criteria

We will aim to recruit participants in the following manner:

• Clinicians and other personnel who routinely participate in organizational quality and safety activities

• Personnel with and without prior experience specific to diagnostic safety measurement

• Diversity among practice staff and clinicians

MHRI staff will work with the site coordinators to identify individuals to participate in the interviews.

Interview Goals

The goals of the focus groups/interviews will be to:

• Obtain preliminary feedback on the resource materials

• Obtain feedback on the anticipated barriers and facilitators for the resource

• Assess participants’ understanding of materials and instructions

• Obtain feedback on needs for additional information or guidance to facilitate implementation

• Provide participants with additional information or clarification to implement the Resource

Materials

• Copies of the Diagnostic Safety Measurement Resource materials

• Informed consent documents

• Digital recorder

Location

Interviews will take place at the setting at a time convenient to the participants and may be conducted remotely via videoconference.

Informed Consent Procedures

Participants will complete the informed consent process prior to starting the interview.

Participant Stipends

None.

Each interview is expected to take no more than 60 minutes.

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 (0935-0179) AHRQ, 5600 Fishers Lane, Mail Stop Number 07W41A, Rockville MD 20857

Form Approved
OMB No. xxxx-xxxx
Exp. Date xx/xx/20

AHRQ – Building Diagnostic Safety Capacity – Measurement

Pre-test Interview Protocol for Quality and Safety Personnel

WELCOME AND INTRODUCTION

• Thank you for agreeing to speak with me!

• My name is [INSERT NAME OF INTERVIEWER] and I am here to ask you a few questions about the Diagnostic Safety Measurement Resource.

• With your permission we will also be audio recording the session. This will help make sure that I don’t miss anything that you say and can share with other people who are working on this project.

• TODAY/TONIGHT I will be asking you questions about your impressions of the Resource so far and any plans you might have to implement the Resource.

• Everything you say here will be kept confidential and included as part of our assessment of the feasibility of implementing the Resource and its materials into practice. We will not share your name or attribute any of your words directly to you.

• Do you have any questions before we begin? Ok, great. Let’s get started.

BACKGROUND AND CURRENT PRACTICES

1. What is your current job title? Are you a healthcare professional? What is your professional background?

2. What are your job responsibilities?

3. Tell me about how your organization currently addresses diagnostic safety.

   1. Are there dedicated individuals, teams, or programs at your organization with defined roles to address diagnostic safety?

      1. IF YES  How do they coordinate activities for improving diagnosis?

      2. IF NO  What teams or programs currently address issues related to diagnostic safety? [IF UNCLEAR, PROBE MORE ABOUT WHERE DIAGNOSTIC SAFETY INITIATIVES MIGHT FIT IN THE ORGANIZATION’S PATIENT SAFETY INFRASTRUCTURE.]

   2. How does the [INDIVIDUAL/TEAM/PROGRAM] become aware of diagnostic safety issues in your organization? How do they investigate or respond to that information?

   3. How does your organization use information about diagnostic safety events to make improvements? Who is typically involved in this?

4. Why is it important to your organization to begin working on measurement to improve diagnosis?

INITIAL REACTIONS TO THE RESOURCE

1. Now that you have had a chance to look over the Diagnostic Safety Measurement Resource, what are your thoughts about using it in your organization?

• How user friendly is the resource? How easy is it to understand?

• What do you think about the flow or layout of information?

• Is there information you expected to find that seems to be missing?

• What sections of the Resource do you think will be most useful to your organization? Which will be least useful?

• Who else in your organization have you talked to about using the Resource? What have their reactions been?

• Who do you think in your organization is going to lead the implementation of this Resource? Who else will be involved?

2. Now let’s talk about the measurement strategies specifically [ORIENT PARTICIPANT TO THE STRATEGIES SECTION OF THE RESOURCE IF NECESSARY.] Which specific measurement strategy(ies) is your organization most likely to implement?

___ Strategy A ___ Strategy B ___ Strategy C

1. How likely is it that your organization will try this strategy?

2. What influenced your decision to choose Strategy [A, B, C]?

3. Are the steps for using Strategy [A, B, C] clear?

   1. IF NO  What could be explained better? Is there missing information that you need to use this strategy?

4. I’d like you to ask you to think now about how your team will go about implementing Strategy [A, B, C]. You may not have all the information right now, but think about what is likely to happen based on your review of the Resource. Can you walk me through how you think your team will implement Strategy [A, B, C], who will need to be involved, and so forth? [ASK PARTICIPANT TO ENVISION AND DESCRIBE THE LIKELY SEQUENCE OF STEPS. USE PROMPTS SUCH AS ‘AND THEN WHAT WOULD YOU DO?’ AND ‘WHAT WOULD HAPPEN NEXT?’]

5. IF UNSURE OF CHOICE OF STRATEGY  What information or help do you need to decide on a strategy to implement?

IMPLEMENTATION PLAN

1. Have you had an opportunity yet to use any sections of the Resource?

   1. IF YES  What have you done so far?

   2. IF NO  Do you have the information you need to get started using the Resource? What information is missing? What additional resources do you need to get started?

2. What are your next steps for implementing the recommendations in the Resource?

   1. What is your time frame for [NEXT STEPS]?

   2. What do you think will make it challenging to implement these next steps?

3. What do you think you might learn as a result of using the Resource? What do you plan to do with new information you obtain, such as new cases of diagnostic safety events?

QUESTIONS AND CLOSING

1. Are there any questions we can answer at this point that would help you begin your implementation of the Resource?

2. Is there anything else you would like to add on any of the topics we discussed today?

Thank you for your time and participation in this interview. Your comments will be very helpful to this project!

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 (0935-0179) AHRQ, 5600 Fishers Lane, Mail Stop Number 07W41A, Rockville MD 20857

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