Form #4 Form #4 Annual follow-up interview

A

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

ttachment D

AHRQ Health Care Innovations Exchange

Innovator Annual Follow-Up Guide

After reviewing the published profile, the followup general areas of discussion with the innovator are designed to capture any changes or updates.

What they did

1. Have you made any changes, modifications or adaptations to the innovation?

2. Guidelines: If applicable, have the guidelines or quality measures you use been updated? How has that affected the innovation?

Results

1. Do you have updated results (of key metrics, for example)?

2. Do you have new results (of a recent evaluation or of new metrics added in the past year, for example)?

Adoption considerations

1. Do you have any additional or revised suggestions for those wishing to adopt this innovation?

Public reporting burden for this collection of information is estimated to average 30 minutes per response, the estimated time required to complete the survey. 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. Form Approved: OMB Number 0935-XXXX  Exp. Date xx/xx/20xx. 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.

Possible Probes:

• What advice do you have for others who may want to implement the innovation?

• What worked based on your implementation experience, any surprises?

• Are there other lessons from your experience?

• What would you do differently?

• What training, supplies, resources, equipment, organizational support are necessary?

Sustainability

1. Do you have additional guidance for others for sustaining the innovation?

2. If applicable, has there been additional spread of this innovation in your organization?

3. Are you aware of any new organizations that have adopted this innovation?