TABLE 1

Semistructured Focus Group Guide

  • Topics to be covered in focus group sessions: the topics that will be discussed in focus groups include the following:

  •  1. Experiences during which the person providing care requested something that was needed for a patient from a member of the health care team

  •  2. Disagreements between health care team members

  •  3. Training/preparation for handling disagreements on the health care team

  •  4. Bad patient outcomes related to communication failures

  •  5. Disruptive, rude, and disrespectful behavior among health care team members

  •  6. Responses to requests for something a nurse, intern, or resident thinks are needed for a patient’s care

  • Initial focus group questions:

  •  1. When you think about communication with care team members about the patients you care for, what comes to mind for you?

  •  2. Think of a time when you needed something in order to provide direct patient care and you didn’t get what you needed when you asked a member of the care team? Tell me about the scenario, what went well? What didn’t go well? If it didn’t go well, what got in the way of you getting what you needed on behalf of the patient?

  •  3. How do you feel when you know you have to ask a member of the care team for something you think they might not agree with? What makes those conversations go well? What makes those conversations difficult? What keeps you from having those conversations? What might help make those conversations go better? What communication styles shut you down or keep you from speaking up?

  •  4. What kinds of things go into your thought process when you know you need to contact someone on the care team for something you need for a patient? What makes you decide to call? How do you get to the point of deciding to make contact? What kinds of things make it easier for you to initiate contact? What kinds of things make it difficult for you to initiate contact?

  •  5. What training have you had to handle situations that we are discussing here? What kind [specific models]? Was it helpful? How have you used the skills you learned during that training? Examples?

  •  6. Think of a time when you’ve needed to act on behalf of a patient’s needs and it went very well. Tell me about the scenario. What made it go particularly well (people involved, roles, training, etc)? Is there anything about that that could be used to help others be more effective with assertion?

  •  7. Think of a time when a patient suffered a bad outcome because communication with a doctor/provider didn’t go well. What happened? What could have been done differently to avoid the scenario? What could we do at our organization to prevent this from happening again?

  •  8. Think of a time when you experienced any disruptive, rude, or disrespectful behavior from any care team member at CHC. What happened? How has this impacted your ability to communicate with this person in the future? What do you think could be done to help prevent similar situations like this from happening in the future at CHCO?

  •  9. Now think of a time when you were the receiver of a request for help. What makes you realize that the person asking for help needs something? What cues you in to the fact that a response is needed from the person asking for help? What things make you more inclined to be more responsive? What things make you less inclined to be responsive?

  • CHCO, Children's Hospital Colorado.