Focus groups can pinpoint problems
A good moderator is key
When surveyors want to pilot a patient satisfaction survey or zero in on some specific trouble spots, they should consider holding a focus group, says Nancy Mihevc, PhD, director of measures of system performance for the Lahey Hitchcock Clinic in Lebanon, NH, and Boston. Mihevc also teaches a course for focus group moderators.
It will yield specific information on a process, such as pain relief for surgical care, Mihevc says. Using a list of surgical patients from the past three months, a surveyor can invite a dozen or so of those patients for a focus group. Or if comments about hospital stays are needed, the surveyor should look to patients who have been inpatients during the last three months.
Participants can be recruited with a letter telling them to expect a telephone call. Follow up the letter by calling the patient and explaining what the group is about and where it will be held, and find out whether he or she will participate, Mihevc says. If the patient agrees to take part, a follow-up letter can confirm participation, date, time, and place.
It may take some mining to collect enough participants, Mihevc cautions. On average, 10 calls must be made to obtain one participant. Mihevc recently conducted a focus group in Boston where she called 20 people for every one participant, she says.
Expect to reimburse patients for travel and/or parking, says Allyson Ross Davies, PhD, a health care consultant in Newton, MA. Depending on the time of day the group meets, plan to feed participants anything from breakfast to lunch or tea. Offer some sort of reward, such as a free blood pressure screening, she advises.
Sessions are usually audiotaped or videotaped with participants' permission, Davies adds. You may also allow others to watch behind a screen, but participants must give their consent, she says.
Questions posed will depend on research objectives, Mihevc says. The moderator will usually begin with an open-ended question, such as:
* Can you tell me about your last inpatient hospital stay?
* What comes to mind first when you think about your hospital stay?
* Was your stay better or worse than experiences you've had here or other places?
* What was the best and worse thing about your stay?
* If you had to rate your stay on a scale of one to 10, how would you rate it?
* If we did not rate a 10, what would it take to make the experience a 10?
This approach allows participants to set the agenda and tell you what's important, Mihevc says.
As participants begin mentioning specific likes or dislikes, a moderator can probe with more specific questions, she says.
The key to a successful focus group is a good moderator, Mihevc says. Someone can be trained internally. Market research companies, which can be found in the telephone book, often offer moderator training, she says. *
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