CONDUCTING CONVERSATIONS ABOUT HEALTH CARE IN YOUR COMMUNITY: HOSPITAL LEADER DISCUSSION GUIDE
Enclosed is a simple moderator’s guide for your use as you conduct conversations about health care in your community. Don’t worry; this is easier than you think.
Separate, slightly different topics/questions have been structured for each demographic group in this exercise: 1) patients, families, the public; 2) physicians and nurses; and 3) business people. The guide begins with a set of talking points to help you set up the discussion and to make the participants as comfortable as possible. Here are some things to consider as put your group together and lead it.
· Limit the group to five to seven people. Most focus groups are 10-12 people, but given time constraints and the brevity of the questions, the smaller number may work better. Perhaps you could have your Strategic Planning or Community Relations department do the recruiting. For consumer/public groups, early evening works best for good turnout. For physicians and nurses, before or after their shift … otherwise they may be distracted. For business folks, the top of the day often works well with a light breakfast.
· Mix the participants in terms of age, gender, race and economic status. If you are talking with consumers, try to have some with a recent hospital experience, either directly themselves or in support of a family member.
· If possible (and, in fact, it may not be possible), try to have in the group individuals who do not know each other or have a working relationship. It may stifle or change the nature of an open conversation.
· Allow at least one hour for the discussion. Have someone there to take notes for you or tape record the conversation. (See the introduction for explaining to participants.) Make sure each participant has a pad and pencil at their place.
· Focus groups are conversations, not question and answer sessions. Encourage people to relate their personal experiences. Encourage them to talk to each other, not to you … to agree or disagree. In focus groups, there are no right or wrong responses.
· Keep the conversation moving and try to get everyone to speak up … sometimes people feel reluctant to talk and need a nudge. Don’t let one person dominate each topic or question … it kills the atmosphere.
Moderator’s Guide
Introduction
· Thanks to all of you for agreeing to participate … this discussion is part of an effort by the American Hospital Association to see what needs to be done at the national level to make health care work better. They’ve asked each of us to listen to people in our community … hear how they view the way people get health care today and what changes are most important to them.
· Have any of you ever participated in a focus group?
· Many focus groups test products or services or ideas. This one is about your experiences, your feelings and your opinions.
· That means there are no right or wrong answers on any of the topics I’ll ask you to talk about. My questions are meant to spark a discussion among you … so feel free to agree or disagree with each other and to raise other points. And remember, I’m not part of the discussion … I want to listen to you.
· As you can see the conversation is being recorded by (identify note taker or note tape recording). Don’t worry your name will never be used or the recording never heard by anyone other than me. It’s to help me remember what everyone said when I share this information with the American Hospital Association. Any questions?
· Let’s start by quickly going around the table … so we all know each other and a little bit about ourselves. I’ll start …
(Intros … then on to the appropriate questions)
Topic/Discussion Questions For Patients, families, public
1. Most Americans would agree that we have the best health care in the world in our country. Yet we all are aware that there are many problems with our system. Many Americans have no health insurance … we have a shortage of some kinds of health care workers … costs are rising … and government is worried it will have trouble in the future covering the elderly and the poor. What do you think are the greatest strengths of health care in America?
2. What do you think are its greatest weaknesses?
3. When you think about getting medical care for you or someone in your family, what worries you the most? (If slow response … probe … coverage, personal cost, safety, etc.)
4. How would you grade – A, B, C etc. – the quality and availability of health care in our community?
5. Do you think the quality of health care is getting better … staying the same … or declining? Why do you think it is _____?
6. With all of the other problems facing our nation, do you think it’s possible to make major changes in health care? What should be done first? Who or what should take the lead?
7. (Picking up your pencil) Everybody have a pencil at his or her place? Good! Pick yours up … for a moment, pretend it’s a magic wand. Wave it and you can make any change in health care you want … here in our community or all across America … any change. What would it be?
(Go around the table.)
Closing
Thank you all for helping me with this experiment. Before we adjourn, does anyone have any other point or comment you’d like to make about anything we’ve talked about today? Thank you again.
Topics/Discussion Questions Physicians and nurses
1. Americans are proud to say that we have the world’s best health care system … now all of you who are on the frontlines of care everyday know all of the problems we face … but it is the best. What do you think are the greatest strengths of health care in America?
2. What are the greatest weaknesses?
3. As you work every day taking care of people, what barriers do you think get in the way of doing more and doing better for patients and families?
4. Do you feel there is a difference in your relationship with patients and families today than … say five or ten years ago?
5. Can you describe that? What do you think would help you build more trust and confidence with them?
6. Do you think the quality of health care is getting better … stay the same … or declining? Why?
7. With all the other problems facing our nation, do you think it’s possible to make major changes in health care? What should be done first? Who or what should take the lead?
8. Everybody have a pencil at his or her place? Good! Pick yours up … for a moment, pretend it’s a magic wand. Wave it and you can make any change in health care you want … here in our community or all across America … any change …what would it be?
(Go around the table.)
Closing
Thank you all for helping me with this experiment. Before we adjourn, does anyone have any other point or comment you’d like to make about anything we’ve talked about?
Thank you again.
Topics/Discussion Questions Business Folks
1. Most Americans would agree that we have the best health care in the world in our country. Yet we all are aware that there are many problems with our system. Many Americans have no health insurance … we have a shortage of some kinds of health care workers … costs are rising … and government is worried it will have trouble in the future covering the elderly and the poor. What do you think are the greatest strengths of health care in America?
2. What are its greatest weaknesses?
3. Most working American get health care coverage through the workplace … do you think that will or will not be true in the future? Why or why not?
4. When you think about the coverage you provide for workers, what would prove to you that you were getting value for the investment? (May want to probe … employee satisfaction, healthier employees/higher productivity, contained costs?
5. How would you grade – A, B, C etc – the quality and availability of health care in our community?
6. Do you think the quality of health care is getting better … staying the same … or declining?
7. Why do you think it’s ______?
8. With all of the other problems our nation faces, do you think it’s possible to make major changes in health care? What should be done first? Who or what should take the lead?
9. Everybody have a pencil at his or her place? Good! Pick yours up … for a moment, pretend it’s a magic wand. Wave it and you can make any change in health care you want … here in our community or all across American … any change … what would it be?
(Go around the table.)_
Closing
Thank you for helping me with this experiment. Before we adjourn, does anyone have any other point or comment you’d like to make about anything we’ve talked about?
Thank you again.