Form #1 Form #1 Focus Group Guide

0

A

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

ppendix B: Focus group questions

The system for referring patients between primary care and two specialties, OB and GI, has been redesigned and new tools and processes have been put into place to implement the new system. We would like to talk with you about how the new system is working.

1. How would you describe the redesigned referral system?

• What are the biggest changes?

2. Is the redesigned system being used as intended? Probe for:

   • What tools are being used?

   • Are there workarounds?

3. How well did the old processes work? Probe for:

• What were the major strengths and problems?

• Was redesign needed?

• Were you and your colleagues receptive to the changes?

4. Has the redesigned system improved the referral process? In what ways? Is the new system successful in terms of the following:

   • Tools and procedures working smoothly

   • Referral times shortened, higher proportion of patients see specialists when referred

   • Specialists receive adequate and timely information from the primary care physician about the referral

   • Primary care physicians receive timely information from specialists

   • Lapses and miscommunications are sharply reduced

   • Trust and joint accountability between primary care and specialty practices has increased

   • Patients know what to expect and what to do

   • Patients receive test results and other relevant feedback

5. Are there remaining problem areas or areas needing further improvement? What are they? How could they be addressed? Probe for:

   • Procedures and tools

   • Communication patterns

   • Resource support

   • Patient involvement

6. Was the process by which the redesigned system was put into place successful in terms of:

   • Way it was introduced

   • Training provided

   • Technical assistance provided

   • Other resources needed

7. Were there problems with the implementation process -- that is, the training provided, the way it was introduced, the technical assistance provided? If so, what were they? How could the process be improved?

8. What barriers and facilitators affect the referral process? Probe for:

   • Priorities competing for attention

   • Clinic/practice leadership support for the redesigned system

   • History of relationships between primary and specialty care

   • Organizational culture including receptivity to change in their clinic and practices

   • E

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     xperience with strategies used to successfully introducing new clinical tools and processes

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DRAFT 11-4-08