La metodología PPT como propuesta para luchar contra la pobreza

This interview guide was developed to achieve the third aim of my master’s paper, “Community Paramedicine Models, Outcomes and Barriers in a Rural Setting.”

Aim 3. Identify barriers and facilitators to implementation of a Community Paramedicine program in a rural setting, including funding, workforce requirements and challenges in integrating such programs into the larger health system.

Welcome—Explain purpose of the interview

• Thank you for agreeing to do this interview. My name is Emily Gamble, and I’ll be talking with you today.

• As you know, I am in the process of obtaining my Master’s Degree from the University of North Carolina at Chapel Hill. As part of my degree, I am completing a Master’s Paper focusing on Community Paramedicine programs in rural communities.

• The purpose of this interview today is to learn more about your experiences with and recommendations related to the implementation of Community Paramedicine programs in rural communities.

• For the sake of clarity in this interview we are defining Community Paramedicine as “a model of care that trains EMTs and paramedics to deliver a broader range of services than traditional emergency response and transport of people to emergency

departments.” These programs may be highly personalized to meet the specific needs of their community, including: post-discharge care, chronic disease management,

providing a telemedicine link between patients at home and primary care providers, or to target particular vulnerable populations (mental health care, CHF, COPD care). Expectations

• Everything you tell me will be confidential. To protect your privacy, I won’t connect your name with anything that you say.

• At any time during our conversation, please feel free to let me know if you have any questions or if you would rather not answer any specific question. You can also stop the interview at any time for any reason.

• Is it OK if I audiotape this interview today?

Background

I’d like to begin by asking you some questions about your current job and experiences with rural health programs.

2. How long have you been with [organization]? Conceptualizing Community Paramedicine

3. Has the community paramedicine model of care delivery been shared or discussed in your organization? (If needed refer back to definition in the welcome section)

4. Based on your knowledge of Community Paramedicine (if needed again refer to welcome section) do you think that this model has the potential to benefit your community or the communities that you work with?

a. If not, why? b. If yes, how?

5. In your opinion, what entity (entities) could fund CP programs? 6. What entity should operate such a program?

7. In your community, or in the communities you serve, what types of collaborations do you think would be necessary to make a CP program successful?

8. What demographic or what type of patient do you feel would benefit most from Community Paramedicine?

9. What outcomes of a CP program do you think is most important in your community or in the communities you work with? (i.e. potential savings, reduced readmissions, improved health, increased access)

10.In what ways would operating a CP program benefit your hospital or the hospitals you work with?

Barriers/ Facilitators

11.In your opinion, are there any aspects of rural communities that would help to facilitate the operation of a Community Paramedicine program?

12.What about rural communities specifically would make operating a CP program more difficult?

Wrap-Up

13.Is there anything else that you would like to add about any of the topics that we’ve discussed or other areas that we didn’t discuss but you think are important?

Appendix B: Interview Guide 2

Interviewees with Community Paramedicine Interest

This interview guide was developed to achieve the third aim of my master’s paper, “Community Paramedicine Models, Outcomes and Barriers in a Rural Setting.”

Aim 3. Identify barriers and facilitators to implementation of a Community Paramedicine program in a rural setting, including funding, workforce requirements and challenges in integrating such programs into the larger health system.

Welcome—Explain purpose of the interview

• Thank you for agreeing to do this interview. My name is Emily Gamble, and I’ll be talking with you today.

• As you know, I am in the process of obtaining my Master’s Degree from the University of North Carolina at Chapel Hill. As part of my degree, I am completing a Master’s Paper focusing on Community Paramedicine programs in rural communities.

• The purpose of this interview today is to learn more about your experiences with and recommendations related to the implementation of Community Paramedicine programs in rural communities.

• For the sake of clarity in this interview we are defining Community Paramedicine as “a model of care that trains EMTs and paramedics to deliver a broader range of services than traditional emergency response and transport of people to emergency

departments.” These programs may be highly personalized to meet the specific needs of their community, including: post-discharge care, chronic disease management,

providing a telemedicine link between patients at home and primary care providers, or to target particular vulnerable populations (mental health care, CHF, COPD care). Expectations

• Everything you tell me will be confidential. To protect your privacy, I won’t connect your name with anything that you say.

• At any time during our conversation, please feel free to let me know if you have any questions or if you would rather not answer any specific question. You can also stop the interview at any time for any reason.

• Is it OK if I audiotape this interview today?

Background

I’d like to begin by asking you some questions about your current job and experiences with rural health programs.

15.How long have you been with [organization]? Conceptualizing Community Paramedicine

16.Has the community paramedicine model of care delivery been shared or discussed in your organization? (If needed refer back to definition in the welcome section)

17.Based on your knowledge of Community Paramedicine (if needed again refer to welcome section) do you think that this model has the potential to benefit your community or the communities that you work with?

a. If not, why? b. If yes, how?

18.In your opinion, what entity (entities) could fund CP programs? 19.What entity should operate such a program?

20.In your community, or in the communities you serve, what types of collaborations do you think would be necessary to make a CP program successful?

21.What demographic or what type of patient do you feel would benefit most from Community Paramedicine?

22.What outcomes of a CP program do you think is most important in your community or in the communities you work with? (i.e. potential savings, reduced readmissions, improved health, increased access)

23.In what ways would operating a CP program benefit your hospital or the hospitals you work with?

Barriers/ Facilitators

24.In your opinion, are there any aspects of rural communities that would help to facilitate the operation of a Community Paramedicine program?

25.What about rural communities specifically would make operating a CP program more difficult?

Wrap-Up

26.Is there anything else that you would like to add about any of the topics that we’ve discussed or other areas that we didn’t discuss but you think are important?

Appendix C: IRB Approval

To: Emily Gamble

Health Policy and Management Operations From: Office of Human Research Ethics Date: 2/06/2017

RE: Notice of IRB Exemption

Exemption Category: 2.Survey, interview, public observation

Study #: 17-0258

Study Title: Community Paramedicine in the Rural Setting

This submission has been reviewed by the Office of Human Research Ethics and was determined to be exempt from further review according to the regulatory category cited above under 45 CFR 46.101(b).

Study Description:

Purpose: This study aims to describe the barriers and facilitators of implementing Community

Paramedicine programs in a rural setting. The findings will be used for the purpose of future program development.

Participants: The participants of this study include: Program Managers at the North and South Carolina Offices of Rural Health, Hospital leadership team members (CNOs, Program Directors), and Community Paramedics

Procedures (methods): I will use in-person or telephone interviews that will be recorded and will not last more than one hour.

Investigator’s Responsibilities:

If your study protocol changes in such a way that exempt status would no longer apply, you should contact the above IRB before making the changes. There is no need to inform the IRB about changes in study personnel. However, be aware that you are responsible for ensuring that all members of the research team who interact with subjects or their identifiable data complete the required human subjects training, typically completing the relevant CITI modules.

The IRB will maintain records for this study for 3 years, at which time you will be contacted about the status of the study.

The current data security level determination is Level II. Any changes in the data security level need to be discussed with the relevant IT official. If data security level II and III, consult with your IT official to develop a data security plan. Data security is ultimately the responsibility of the Principal Investigator. Please be aware that approval may still be required from other relevant authorities or "gatekeepers" (e.g., school principals, facility directors, custodians of records), even though the project has determined to be exempt. .

CC:

Rebecca Slifkin, Health Policy and Management Operations IRB Informational Message - please do not use email REPLY to this address