TBC Group Discussion Guide

Form Approved

OMB No. 0920-xxxx

Exp. Date XX/XX/20XX

4f. TBC Group Discussion Guide – TBC/MTM

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Date of Focus Group	MM/DD/YYYY
Facilitator
State:
Strategies Implemented (select one):	☐ B3	☐ B4	☐ B3 & B4
Discussion Facilitator
Number of participants in group:

Introduction

Thank you for taking the time to participate in this discussion. My name is [Insert name] and I am with the Deloitte evaluation team. Our team is working with the CDC Division for Heart Disease and Stroke Prevention to evaluate the DP18-1815 Cooperative Agreement, Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke, which we will refer to as the 1815 program. As part of the larger national evaluation of 1815, we are conducting a case study focused on Team-Based Care and Medication Therapy Management to better understand how health departments are supporting the development or implementation of guidelines and policies to promote team-based care and medication management therapy within healthcare settings, as it related to the prevention and management of high blood pressure and high blood cholesterol.

We have convened this group to hear your perspectives on how well the implementation of the 1815 Team-Based Care strategies is progressing within your partner sites, challenges encountered, factors outside of the 1815 program that influence the implementation of these strategies, and your thoughts about the effectiveness of these strategies in changing organizational level processes and their contributions to patient care and management. The information gathered from this discussion will be analyzed together with information gained from individua interviews we conducted with some of you as well as your colleagues within partner sites, and other health departments. The information you share will provide valuable insights on different approaches for promoting team-based care and medication therapy management for improved patient management and help us understand which approaches seems to work well in specific contexts.

This discussion is expected to take no longer than 2 hours. Your participation in this group discussion is completely voluntary. You may choose not to respond to questions at any time and it will not in any way impact the funding or technical assistance your organizations receives from CDC. All information will be kept secure and any personally-identifiable information will be removed when results are aggregated for analysis.

If at any time during the group discussion you are not clear about what we are asking, be sure to let me know. Please answer questions based on your own knowledge and experience. We appreciate your candid answer.

With your permission, we would like to record this group discussion for transcription purposes.

Do we have your permission to record? (ask everyone)

☐ Yes

☐ No

Do you have any questions or concerns before we start the discussion?

Welcome and Participant Introductions (10 mins)

We would like to welcome you all to this group discussion. Thank you for agreeing to participate. So we can get to know who is in the room, let’s go around and introduce ourselves. Please tell us your name, your position, and your role with the team-based care strategies within your health department.

Verifying the Logic Model (90 mins)

We will start our discussion today by reviewing and validating a theory of change of how TBC/MTM strategies are supported by your health department, how they are implemented at the partner-site level, the organizational and behavioral changes observed at the partner-site level because of these activities, and how these changes support patient care and management. We would also like to understand other programs/initiatives beyond 1815 that contribute to TBC/MTM efforts within healthcare organizations and how these other initiatives interact with the 1815 activities. We will walk through each of the strategy-specific logic models as a framework for our discussion.

For Health Departments implementing Strategy B3

[Show the B3 Logic Model on the screen]

HD-supported Activities [Activities]

Starting on the left-hand side of the team-based care logic model…

1. Can you describe to me the types of activities that your health department is supporting regarding the engagement of non-physician team members in the management of hypertension/cholesterol in clinical settings?

Perspective on site-level changes [Short-Term outcomes]

2. As a result of these activities, what types of changes are taking place at the organizational level within these sites?

Probe: Are there other organizational-level changes not reflected in the logic model?

3. To what extent do you think these organizational-level changes are affecting the quality of patient care and management amongst their patients?

4. How might those changes be affecting the identification of patients with high blood pressure? How about patients with high blood cholesterol?

5. How might those changes be affecting the management of patients with high blood pressure? How about patients with high blood cholesterol?

External Factors [Inputs/Context]

6. What types of state policies related to TBC/MTM that might influence these activities and organizational level processes?

7. What are other initiatives that may also affect the engagement of non-physician team members in high blood pressure and high blood cholesterol management?

8. Are there any other contextual influences that need to be taken into consideration regarding these strategies amongst the sites that you currently partner with?

Probe [Year 3]: What has been the effect of the COVID-19 pandemic on this strategy?

Impact [for the Y4 and Y5 discussion only]

9. Over the past three years, since implementing these interventions, what changes have you seen in the identification or diagnosis of patients with high blood pressure or high cholesterol?

10. What other outcomes have come out because of these 1815-funded activities?

1. Were these surprising?

2. Why or why not?

Exit

11. Is there anything else you would like to add about the promotion of these TBC/MTM approaches or its outcomes?

Close

Thank you so much for your time. This concludes our group discussion about the 1815-funded activities related to the team-based care strategies. If you have any additional questions, please feel free to contact Gizelle Gopez, ggopez@deloitte.com.

Welcome and Participant Introductions (10 mins)

We would like to welcome you all to this group discussion. Thank you for agreeing to participate. So we can get to know who is in the room, let’s go around and introduce ourselves. Please tell us your name, your position, and your role with the team-based care strategies within your health department.

Verifying the Logic Model (90 mins)

We will start our discussion today by reviewing and validating a theory of change of how TBC/MTM strategies are supported by your health department, how they are implemented at the partner-site level, the organizational and behavioral changes observed at the partner-site level because of these activities, and how these changes support patient care and management. We would also like to understand other programs/initiatives beyond 1815 that contribute to TBC/MTM efforts within healthcare organizations and how these other initiatives interact with the 1815 activities. We will walk through each of the strategy-specific logic models as a framework for our discussion.

For Health Departments implementing Strategy B4 (60-90 mins)

[Show the B4 Logic Model on the screen]

HD-supported Activities [Activities]

Starting on the left-hand side of the logic model…

1. Can you describe to me the types of activities that your health department is supporting regarding the adoption of MTM between pharmacists and physicians?

Perspective on site-level changes [Short-Term Outcomes]

2. As a result of the support your team is providing to healthcare organizations, what types of changes are taking place at the organizational level within these partner sites?

Probe: Are there other organizational-level changes not reflected in the logic model?

3. To what extent do you think these organizational-level changes are affecting the quality of patient care and management amongst their patients?

4. How might those changes be affecting the identification of patients with high blood pressure? How about patients with high blood cholesterol?

5. How might those changes be affecting the management of patients with high blood pressure? How about patients with high blood cholesterol?

External Factors [Inputs/Context]

6. What types of state policies related to TBC/MTM might influence these activities and organizational level processes?

7. What are other initiatives that may also affect the adoption of MTM between pharmacists and physicians?

8. What are other initiatives that may also affect the adoption of a MTM for the management of patients with high blood pressure or high blood cholesterol?

9. Are there any other contextual influences that need to be taken into consideration regarding these strategies amongst the sites that you currently partner with?

Probe [Year 3]: What has been the effect of the COVID-19 pandemic on this strategy?

Impact [for the Y4 and Y5 discussion only]

10. Over the past three years, since implementing these interventions, what changes have you seen in the identification or diagnosis of patients with high blood pressure or high cholesterol?

11. What other outcomes have come out because of these 1815-funded activities?

1. Were these surprising?

2. Why or why not?

Close

Thank you so much for your time. This concludes our group discussion about the 1815-funded activities related to the team-based care strategies. If you have any additional questions, please feel free to contact Gizelle Gopez, ggopez@deloitte.com.

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