Clinical Managers Protocol

Attachment A

MOPS-HP (Management and Organizational Practices Survey – Hospitals)
Clinical Managers

April 20, 2018

DRAFT

Research Questions

• Are respondents able to provide information from 2012 with the same quality as 2017?

• What extra burden would respondents have for providing data from 5 years in the past?

• Could the survey requests for the CFO and clinical manager’s pieces be sent together?

• How can we target the right respondent for the CFO and clinical manager forms?

• Do the respondents understand the questions and can they provide responses that match the intent of the inquiry?

• Do you respondents have access to the necessary records that may be required for this form?

Introduction

• Thank you for your time today.

• Purpose of meeting – We are currently in the process of evaluating the content that is being proposed for this new survey that asks about management and operational practices at hospitals.

Our purpose today is to have you review the proposed content and provide your feedback about how you would go about answering these questions.

• I want to emphasize that our goal is to look for ways to improve this survey.

• All of your responses will be completely confidential and not shared with anyone not directly involved in this research project. You are free to decline any question you’re not comfortable answering.

• Is it OK to audio record our discussion? This is strictly for note-taking purpose. (Ask to sign consent form)

Background questions

• What is your role in the hospital? How long have you been in that role?

• (Middle manager only) Are you employed by the hospital?

• Are you responsible for any surveys that are requested by the government? Which ones?

• Are you familiar with the Services Annual Survey? Have you completed it in the past for your hospital?

Section A – Management Practices

1. In your own words, what does care delivery mean?

   1. Can you give me examples of the problems in care delivery that you experienced in 2012?

   2. Can you give me examples of the problems in care delivery that you experienced in 2017?

   3. How did you go about answering this question for 2012? Would you have to consult with any others?

2. In your own words, can you define what a ‘key performance indicator’ is?

   1. Does your hospital use this terminology? If not, what terminology do you use?

   2. Where were the key performance indicators that your hospital monitored in 2012? 2017?

   3. How did you come up with your answer for both years?

3. How does your hospital define a manager?

   1. How did you go about answering this question for 2012?

   2. How did you go about answering this question for 2017?

   3. Would you need to work with any others to answer these questions?

4. In your own words, what does frontline clinical workers mean to you? What are some examples?

   1. Would you have to work with others to get these answers?

   2. Would you have the information available for 2012?

5. Tell me more about your display boards. What did they show?

   1. Did you have boards that showed clinical quality?

   2. Did you have boards that showed other key performance indicators? If yes, please give me some examples.

   3. Where were these displayed?

   4. Who had access to them?

   5. Tell me how you would go about answering this for 2012.

   6. What has changed in how you display clinical quality or other KPIs since 2012?

6. Tell me more about your clinical targets.

   1. Tell me more about your operational targets.

   2. What are some examples of each for your hospital?

   3. How would you go about answering this for 2012?

   4. In your own words, what does the response option ‘combination of short-term and long-term clinical and operational targets’ mean?

7. Tell me how you came up with your answer for this question.

   1. How would you define ‘normal effort?’ What does that term mean to you?

8. How did you come up with your answer for 2017? 2012?

   1. Were you knowledgeable about these activities in 2012? If not, how would you go about answering this?

9. What are your experiences with financial targets?

   1. Who sets these targets?

   2. Would you answer this for just your area or the entire hospital?

   3. Would you have to work with anyone else within the hospital to get this information?

   4. How would you go about gathering this information in 2012?

10. How did you come up with your answer to this question?

    1. Would you answer this for just your area or the entire hospital?

    2. Would you have to work with anyone else within the hospital to get this information?

    3. What would you define as a ‘normal amount of effort?’

11. How did you come up with your answer?

    1. Would you answer this for just your area or the entire hospital?

    2. Would you have to work with anyone else within the hospital to get this information?

12. Tell me more about promotions in your area?

    1. Are you familiar with the procedures for promotion in this area?

    2. How did you come up with your answer from 2012?

    3. What has changed, if anything from 2017 to 2012 in the procedures for promotion?

13. Are you familiar with the way in which managers are promoted within the hospital? Tell me more about that.

    1. Would you have to talk to anyone else in order to answer this question?

14. What were the procedures for dealing with under-performing frontline clinical workers in your area in 2017? 2012?

15. Are you familiar with the procedures for dealing with under-performing managers in 2017? 2012? Tell me about them.

    1. Are you the most knowledgeable person about this topic?

16. Have you worked in other locations within the hospital since you began working here?

17. n/a

Section B - Management Training

18. n/a

19. Tell me more about the training you participated in.

    1. Besides MBA or executive courses, is there any other management training you have participated in?

Section C - Use of Standards and Protocols

20. Tell me more about the types of protocols that were used for clinical and operational practices?

    1. Are there different protocols for clinical and operational protocols?

    2. Tell me more about how these protocols are being used.

    3. In your own words, what is the difference between a standardized and non-standardized protocol?

    4. How did you go about answering this for 2012?

21. Tell me more about the creation of these protocols.

    1. Has this process changed from 2012 to 2017?

22. How would you define ‘appropriate use?’

    1. Is there any information tracked at the hospital or in your area related to the appropriate use of any protocol?

    2. Are you familiar with how they went about monitoring the use of protocols?

23. How did you go about answering this question?

    1. How would you go about answering this for 2012?

Section D - Management of Team Interactions

24. Tell me more about these meetings.

    1. What outcomes were typically discussed?

25. Were there any other staff members that were typically present for these meetings that aren’t listed here?

    1. If so, what was their interest in this information?

26. Tell me more about any of the data that were involved in these discussions.

    1. What type of data were staff reviewing?

    2. Has the type of data being reviewed changed between 2012 and 2017? If so, what has changed and why?

27. Were there any other reasons for discussing clinical outcomes besides discussing past performance and talking about ways to improve future performance?

28. How would you go about answering this question for 2017? 2012?

    1. In your own words, what does ‘actively monitored’ mean to you?

Section E – Staffing and Allocation of Human Resources to Problems

29. How did you go about answering this question for 2017? 2012?

    1. Would you need to work with anyone else to get this information?

30. Where did you access this information? Was this information readily available for 2012?

31. Tell me more about this.

32. Where did you access this information? Was this information readily available for 2012?

33. Tell me more about this.

Section F – Validation Questions

34. How did you determine this answer?

    1. Did you have to access records for this information? What records did you use? Were they easily accessible?

35. Did you have to access records for this information? What records did you use? Were they easily accessible?

    1. Did you have any temporary or contract employees?

    2. Were those employees excluded from the figure you accessed from records?

    3. Are there any other types of employees not listed that you have excluded?

Wrap-Up Questions

• How long would it take you to complete this form including any time that you would need to consult with others?

• What would be the biggest challenges in completing these questions?

• How many others would you have to work with to complete this?

• Would you be the best person to answer this questionnaire? If not, who would be and why?

• Other than obtaining the information for the staffed beds and employees, would you need to look at records to answer any questions?

• We want to ask these questions of top-level clinical managers (for example – the Chief Medical Officer or Chief Nursing Officer) or middle-level clinical managers (such as the head of your hospital’s surgical or cardiac unit).

  • Does your hospital have a cardiac unit? Are you familiar with the head of that unit?

  • Does your hospital have a surgical unit? Are you familiar with the head of that unit?

  • If we wanted to survey department heads or nurse managers from both your cardiac and/or surgical units,

    • What would be the best way to collect these data from them?

    • (Based on suggested language for CFO protocol) Is mail marked ‘[CMO, CNO or Head of (insert name of department)? Nurse Manager]’ routed to you? What other mail without a name would be routed to you, if any?

  • Is there another person besides you that fills out government paperwork, for example, (quality) statistics for the Centers for Medicare and Medicaid (CMS)?

  • Do you have any other comments or suggestions for this survey?

Thank you for your time