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Appendix A: Draft Key Informant Interview Protocol

Guide to Patient and Family Engagement: Environmental Scan Report

Topic Guide for Key Informant Interviews

November 24, 2009

Testing materials

  • Audio recording equipment.
  • Speaker phone.
  • Email or fax consent form and brief survey (attachment 1) to participant before interview.
  • Interviewer clock.

Procedures for obtaining informed consent

FOR TELEPHONE: Participant will be sent an informed consent form before the interview. At start of interview, interviewer will ask if participant has any questions about the consent form and if he or she agrees to be interviewed and audiotaped. A waiver of signed informed consent will be obtained from AIR's IRB.

Key informant interviews

(60 minutes total)

Introduction

(start at _____  2 min  end at _____)

Welcome—Explain purpose of the interview

  • Thank you for agreeing to do this interview. My name is [NAME], and I'll be talking with you today.
  • As you know, this project is being funded by the Agency for Healthcare Research and Quality, which is 1 of 12 agencies within the U.S Department of Health and Human Services. The Agency's mission is to improve the quality, safety, efficiency and effectiveness of health care for all Americans.
  • The purpose of this interview today is to learn more about your experiences with and recommendations related to patient and family engagement in patient safety and quality.
  • The interview will last about 1 hour.
  • Did you read the consent form that was sent to you? Do you have any questions?

Ground rules

  • Everything you tell us will be confidential. To protect your privacy, we won't connect your name with anything that you say.
  • At any time during our conversation, please feel free to let me know if you have any questions or if you would rather not answer any specific question. You can also stop the interview at any time for any reason.
  • Please remember that we want to know what you think and feel and that there are no right or wrong answers.
  • Is it OK if I audiotape this interview today?

[Turn on recording equipment.]

Background

(start at _____  3 min  end at _____)

I'd like to begin by asking you some questions about your current job.

  1. What is your position at [organization]? What are your major responsibilities in your current position?
  2. How long have you been with [organization]?
  3. Can you tell me a bit about your work and experience as it relates to patient and family engagement? (Probe particularly for aspects of current job that relate to patient and family engagement.)
  4. [FOR PATIENTS] How did you come to be involved in patient safety and quality issues?

Conceptualization of Patient and Family Engagement

(start at _____  15 min  end at _____)

A key goal of our project is to help promote patient and family engagement in patient safety and quality in a hospital setting.

  1. I'd like to get your opinions about the concept of "patient and family engagement." What do you think is meant by patient and family engagement? How would you describe it in your own words? What are the most critical components of patient and family engagement?
    • How, if at all, does patient and family engagement relate to patient- and family-centered care? Is it the same? Different?
    • What about shared decision-making? How does that relate to patient and family engagement?
    • In your opinion, what is the ultimate goal of patient and family engagement? From your perspective, what are the expected or hoped for outcomes of patient and family engagement?
  1. How would you describe the state of patient and family engagement in hospitals? Where is it now and where does it need to go? What do we need to do to make this happen?
  2. How do you think patients and families think about patient safety? What about quality? What does it mean for them? Do you think patients and families view themselves as having a role in patient safety and quality?
  3. How can patients and families contribute to patient safety and quality at an individual level (i.e., related to their own health care experience)
    • What can patients do to contribute to improved safety and quality in a hospital?
    • What can family members do? (Probe for specific behaviors and actions)
    • What facilitates or challenges those behaviors?
  1. How can patients and families contribute to patient safety and quality at a larger hospital policy level?
    • What can patients and family members do? (Probe for specific behaviors and actions)
    • What facilitates or challenges those behaviors?
  1. How can health care professionals contribute to patient and family engagement?
    • Which health care professionals have the most to contribute?
    • Which health care professionals currently contribute the most? Is this the way it should be?
    • What behaviors do health care professionals need to do to support patient and family engagement in safety and quality?
    • What facilitates or challenges those behaviors?
  1. What elements of organizational culture facilitate or challenge patient and family engagement in safety and quality?
    • Hospital leadership? Policies or procedures? Team work?
    • How would you define organizational culture?

Experience Engaging Patients and Families

(start at _____  10 min  end at _____)

Now, let's talk about your organization.

  1. What is your organization's experience with engaging patients and families in safety and quality? (Get details—with whom, what they know, what have they tried, how they assessed, etc.)
    • What staff, or who, from your organization have been involved in this effort?
    • What prompted your organization to get involved in this issue?
    • What was the goal of your effort? What did you hope to accomplish?
    • What resources does your organization have that are available for this effort (e.g., financial, staff expertise, etc.)?
    • How did you assess or evaluate these efforts?
  1. Specifically, what activities have you undertaken, and what did you expect patients and families to do? Which health care professionals were involved? What did you expect them to do?
  2. What have your experiences been? What did you do?
    • Tell me about the planning of this effort.
    • What tools or resources did you use? How effective were they?
    • Did you use tools or resources from the Agency for Healthcare Research and Quality? If so, what did you think of them?
    • Where did you go to look for information?
    • How did you engage patients, families, health care professionals?
  1. How did you disseminate information to patients and families? Health care professionals?
    • What types of messages have you created and/or delivered?
    • What medium(s) or mode of delivering information did you use? (e.g., flyers, posters, workshops, trainings, handouts, brochures, videos, and so forth)
    • What was the frequency of communication?
    • At what point in the hospital stay?
  1. What was the reaction to your efforts?
    • Did this differ for different types of patients, family members, or providers?
    • If so, what are the different types, and how do their information needs differ?
  1. Was there anything you did that you thought worked well? What, if anything, would you do differently next time?
    • Among the topics that you have addressed or considered addressing, what aspects of patient and family engagement seem to resonate most with patients and families?
    • What aspects resonate least?
    • What about with health care professionals?
  1. Can you please share any materials that you used?

Best Practices and Implementation

(start at _____  10 min  end at _____)

Now, let's talk about best practices in engaging patients and families in patient safety and quality.

  1. What are the best ways to engage patients and families in patient safety and quality?
    • Who is the best person/organization to deliver the information?
    • At what point in the hospital stay?
    • How should it be delivered?
    • How feasible is this?
    • When is the best time to begin to engage patients and families?
  1. What are the best ways to educate and change the behaviors of health care professionals? How feasible is this?
    • Which attitudes facilitate involvement in patient and family engagement?
    • Which attitudes hinder patient and family engagement?
    • What are the best ways to build on positive attitude? Address or neutralize negative ones?
  1. What are the best ways to bring patients, families, and health care professionals together around a common goal?
  2. To your knowledge, what organizations have engaged patients and families in patient safety and quality? Have any been successful in engaging patients and families?
    • What particular strategies have they used (or what factors were present) that were successful?
    • What strategies were not so successful?
    • Can you recommend any particular print documents or Web resources that these organizations have produced that we should review?
  1. What do you consider to be the best practices in patient and family engagement in safety and quality in a hospital setting?
    • What facilitates those best practices?
    • What are some challenges to those best practices?

Recommendations for the Guide

(start at _____  15 min  end at _____)

As you know, we are developing a Guide to help hospitals engage patients and families in patient safety and quality. We'd like to get your input on the content and format of the Guide. The Guide will contain tools, materials, and/or training for patients, families, hospital clinicians and staff, hospital leaders, and those who will implement the materials in the Guide.

  1. What do you think are the priority topics and content areas for the Guide?
    • With what topics do consumers and health care professionals need the most assistance?
    • Where can the Guide affect the most change?
    • What opportunities for engagement have not traditionally been used?
    • Are there target audiences that have been ignored?
  1. Which types of hospitals would be most important to reach?
    • Settings (urban versus rural)
    • Size
    • Readiness to change (those whom are interested but haven't done this before or those whom are already doing it)
  1. What is needed to get different participants to "buy in" to the Guide? Hospital leadership? Health care professionals? Patients? Families?
    • Is there anything that can be done during the development process?
    • What information or guidance should be included in the Guide?
  1. What points of communication in a hospital setting are most amenable to intervention, especially in medical–surgery units? (e.g., bedside rounds, change of shift, rapid response)

For the next few questions, we are interested in learning about the best ways to ensure that the Guide gets used.

  1. How would you foresee using the Guide? What format would be most useful? [If needed, for example, web-based, video, written materials, Power Point presentation.]
  2. What are the best ways to disseminate the Guide?
  3. What assistance would be needed to implement the tools and resources? What are the best ways to sustain those efforts?

Closing

(start at _____  5 min  end at _____)

  1. What is the most important message that you want us to take away from this interview?
  2. Is there anything else that you would like to add about any of the topics that we've discussed or other areas that we didn't discuss but you think are important?

If you know of any research, tools, or resources that may be useful to include or adapt for the Guide, please send them to me.

Thank you for your time and participation in this interview. The information that you provided to us will be very helpful in this project.

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Current as of May 2012
Internet Citation: Appendix A: Draft Key Informant Interview Protocol: Guide to Patient and Family Engagement: Environmental Scan Report. May 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/ptfamilyscan/ptfamilyapa.html