T
Form
Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX
July 1, 2010
The purpose of this call is to check in on your progress during the implementation period of the Guide and gather information on successes and challenges thus far.
Please describe what you have done related to the project over the past two weeks.
What components and strategies were you working on?
What tasks have you completed?
What materials from the Guide did you use? What part of the Guide were you focusing on?
Please describe any interactions with senior management about Guide implementation. How did these interactions affect Guide implementation?
Please describe any interactions with clinical staff about Guide implementation. How did these interactions affect Guide implementation?
What were the goals or targets of the Guide implementation over the past two weeks? Were these goals or targets met? Why or why not?
Did you make any changes to your plans for using the Guide during the past two weeks? If so, please describe the change(s).
What was the reason for the change?
What staff were involved in deciding on the change? Describe their role and response.
What are the implications, if any, that the changes will have on your efforts?
Did
you encounter any challenges to implementing the Guide during the
past two weeks? If so, please describe the challenges(s).
[If
necessary, probe for: system level factors (e.g., top leadership
support, project visibility, availability of resources for Guide
implementation), unit level factors, staff level factors (e.g.,
clinical champion), or patient/family level factors (e.g., types of
patients seen, positive response to intervention overall or aspects
of it)]
Public
reporting burden for this collection of information is estimated to
average 30
minutes per response, the estimated time required to complete
the interview. 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-XXXX) AHRQ,
540 Gaither Road, Room # 5036, Rockville, MD 20850.
To what extent did you anticipate these challenges, if at all?
How did you try to overcome the challenges described above? To what extent have you overcome these challenges?
What
helped you achieve your goals during the past two weeks? What other
resources did you use?
[If
necessary, probe for: system level factors (e.g., top leadership
support, project visibility, availability of resources for Guide
implementation), unit level factors, staff level factors (e.g.,
clinical champion), or patient/family level factors (e.g., types of
patients seen, positive response to intervention overall or aspects
of it)]
Have any unintended consequences or effects (positive or negative) of the Guide implementation surfaced during the past two weeks (e.g., staff morale improved or got worse)? If so, please describe.
Based on what you have learned over the past two weeks, what improvements would you make to the Guide?
Based on what you have learned/experienced to date, what are the lessons learned for implementing this Guide in a medical-surgical unit? If you were advising others about the Guide and its implementation, what would you most want them to know? What should they be aware of, what should they do, what should they NOT do?
What do you have planned for the Guide implementation for the next two weeks? Please briefly describe.
Please share anything else you think may be important for us to know about the Guide and its implementation and use.
| File Type | application/msword |
| Author | Ushma Patel |
| Last Modified By | william.carroll |
| File Modified | 2011-01-27 |
| File Created | 2011-01-27 |