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Design Research & Ethnography Workbook

CONFIDENTIAL


PROJECT NAME: OWNER: In found, please contact:

This material is the confidential and proprietary property of Becton Dickinson and Company and shall not be used without permission

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Guidelines Observation

Interviews

- Be Unobtrusive - Limit your talk. Try to ask your questions during “down time” - Always have your note book. Capture data as accurately as possible - Take pictures and video when allowed - Wear scrubs. Preferably a conservative color - Obey hospital rules and regulations - Don’t perform any procedure (even when asked or when you know how). Only observe! - Don’t give your opinion. Only observe! - Avoid talking to other people besides the person you are observing. Though it is wise to observe other people simultaneously as well - Wear comfortable shoes

- Tolerate Silence - Avoid revealing your opinion - Listen more, interrupt less - Turn participant’s questions back on them - Probe, when necessary. Get to the bottom of the issue - Ask lots of “Whys” - Encourage stories - Don’t contradict, but point out inconsistencies - Ask one questions at a time - Avoid yes or no questions. - Ask follow up questions such as “Tell me more”, “How so”, “Give me an example” - Try looking at the interviewee as much as possible, but also try to write down their answers as close as possible

Observation Guide (Prompts and Key Questions) 4 P’s

(and *Key Insights)

People: What is their Attitudes Any unusual Behaviors? What is the person’s responsibilities based on your observation? What is the person’s emotional state based on your observation? How attentive this person is with his/her multiple daily tasks? Does he/she remember tasks that are assigned unexpectedly how does he/she changes her behavior throughout the day? How does this person handles adversity? How old? Experience? Strengths? Weaknesses? Process: Catheter selection, skin preparation, insertion, maintenance, and removal work-flow location of supplies? (how far and how easy to get?) What and where takes the longest time? When is busiest? When is most stressful? Forgetting any steps? When and where he/she differs from hospitals best practices? Place: Overall layout and impression (draw)? How easy to maneuver? How easy to find what they need? Overall feeling of the environment with conjunction with the people in it? Stress levels? Organization levels? Overall cleanliness? Product: Products being used? (especially catheters and related products) How are they being used? How he/ she seem to handle/like the product? Product preference?Why? (If multiple products available) Perception of product effectiveness ow often product is replaced and changed? Key Insights: Work-arounds? Compensatory behaviors? Out of the ordinary attitudes and actions? Reactions to unusual situations, commonly unknown facts, and any other data point that may be relevant.

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Interview Guide (Hospital Leadership and Management Team) Note: The interview guide is meant to be a guide and not a script nor an “all encompassing, over exhaustive set of questions”. Effective qualitative interviews are usually full of “why” inquiries rather than “yes or no” questions. 1 Introductions (2min) a. Purpose of interview: (Script) “As you may know BD is collaborating with your institution via a BD consultancy program we call “Signature Solutions” where we seek to understand and improve practice within a specific clinical area. Today, we are working to understand and improve HAI-related practices specifically focusing on CRBSI. As part of this discussion, we would like to understand your perspectives as an institutional leader on:” I. How your institution approaches and thinks about infection risk and prevention II. Your expectations and implementation of practices to reduce CRBSI III. Your expectations of this initiative for the institution and IV. Your envisioned future and ideal state for the institution and how you see healthcare changing in the next few years.” b. “Before we start, may we record this conversation? This information will not be publicly distributed and It will only be utilized for research purposes.” 2 General Background Questions (8min) “We will start with a few background questions about you and the institution” a. Please define your role and responsibilities within the institution, specifically as they pertain to quality improvement and/or infection prevention b. How long have you been in this position? c. What keeps you up at night with regards to your current responsibilities in the work environment? Why? d. What are some or your administrative and leadership challenges? What tools or services would help with these challenges? e. In your opinion, how would you describe your organization today in terms of quality improvement and infection control? - Can you tell me about the challenges you are facing? - How about your institution’s strengths? 3 Hospital Priorities (HAI/CRBSI) (15 min) “As you know, BD is working with your institution to understand your HAI and CRBSI practices. We will start with HAI first and get more specific later.” a. How has the way your institution thinks about or prioritizes HAI prevention changed in the last 5 years? [has it become a bigger (more urgent priority) priority as a result of never events? Lower priority because they are doing well?] Higher than before Why?

Lower than before

The same

b. Where does HAI stack up in the hospital’s priorities today? #1 Priority Top 5 Top 10 Why? c. How would you describe to us your hospital’s efforts and initiatives with regards to the topic HAI and CRBSIs (in particular? d. Among infection concerns, what are the issues/areas of top concern? e. How would you prioritize your institutions efforts around HAI? SSI VAP CRBSI Why?

Not priority

CAUTI

4 Transition to CRBSI questions (25 min) a. What is the hospital doing about CRBSIs? Why? b. How is CRBSI measured within the organization? What quality metrics are in place? How often are these measured? c. Can you describe to me your process/protocol or initiatives to reduce and prevent HAI in general and CRBSIs? [past or present, in case this is not a priority today] d. When measuring or evaluating CRBSIs, which catheter types do you evaluate? Why? e. Who are all the stakeholders involved in preventing and managing CRBSIs? Would you explain their roles? f. How do you make sure that your leadership expectations are being communicated and implemented with regards to CRBSIs? g. With regards to the financial impact: i. In your opinion, what are the direct and indirect costs associated with occurrences and prevention CRBSI? ii. How are you accounting for these costs? iii. What are the implications of those costs to the institution? iv. What are some financial metrics that are included in this cost? h. Concerns regarding CRBSI” i. How does your institution manage issues pertaining to CRBSIs? ii. Where do you see the biggest difficulties in terms of managing CRBSIs? Is it products? people? process? iii. What tools do you have at your disposal when working on CRBSI? [people? IT? Products/companies? Consultants?] i. Maintaining Success: i. What are some of the products/services that help you the most in terms of HAI and CRBSIs? Why? ii. What are other products that you don’t currently have but you might be interested in that helps with HAI/CRBSIs? iii. How does best practice for prevention of CRBSI disseminated in your hospital? Who sets the goals? Who communicates the goals? How are protocols created and updated? How effective implementation of guidelines is ensured? (surveillance? Education? For all catheters? Where do you see gaps?) iv. Who is responsible to assure compliance with CRBSI protocols? v. How is this measured? vi. What tools and services do you offer to ensure compliance?

j. What does an ideal industry partner provider look like to you? What does an ideal industry partner provide or deliver to best assist you in reducing the risk of CRBSI? Does anyone come to mind in being close to your expectation? Can you give an example of good collaboration? 5 Future (vision, trends, partnerships, etc.) (10min)

a. What is your ideal vision of best delivery of care to reduce the risk of HAI and CRBSIs? b. What is an envisioned ideal state for CRBSI for your institution? c. What kind of solutions do you think will address the issue of HAI/CRBSI? (a. innovation, b. best practice advancements and c. services) d. What are you particularly interested to see and understand as a result of our research in your institution? e. Based on your understanding, what does the future look like for the issue of HAI and CRBSI?

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Institution: Notes:

Date:

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Observation and interview guides compliance innovation cell