Appendix 15The focus group interview topic guide
Preamble
The facilitator will introduce themselves, including their position within the HiSLAC project.
Explain the objectives of HiSLAC and the focus group.
Ensure that participants have read and understand the information sheet and have been given the opportunity to ask any questions.
State we will digitally record the focus groups so that we capture the thoughts, opinions and ideas from the group. No names will be attached to the focus groups and the recordings will be destroyed as per University of Birmingham guidelines.
Remind participants that all information will be treated in confidence and taking part in the focus group is voluntary.
Remind participants to please keep any information shared in the group confidential, and not discuss outside the focus group.
Time frame – inform participants that the focus group is likely to take around two hours and lunch will be provided after the meeting.
Iterate that the HiSLAC team will either email or post a one page summary with the key themes/topics and search terms generated from the focus group. Participants will then be asked to comment if any important areas have been excluded from the summary.
Inform participants that the role of the facilitator is to guide the discussion and that there are no right or wrong answers, only differing points of view.
Warm up questions
Clinicians
Can you tell me how long have you been working in the NHS and your job title?
What department do you work in?
Main questions
Reiterate the area of interest – there is evidence that mortality rates are higher for patients admitted to hospital at weekends than weekdays – the so-called ‘weekend effect’. We are interested in the ‘in hospital’ factors that might result in this weekend–weekday mortality gap.
Do you think there are differences between the way care is organised and delivered at the weekend as opposed to a weekday? What differences are there?
What impact does this have on patients who are admitted over the weekend?
Can you tell me any stories from your own experience, about the care of patients admitted to hospital at weekends, and what the problems can be?
What factors do you think have an effect on patient mortality, for patients admitted at the weekends? (Discuss, then agree a list using a flipchart.)
Can you explain how you think each of these factors can contribute to increasing mortality? (what are the underlying mechanisms).
Are any of the factors linked with each other (e.g. lack of specialists and quality of decision-making) (use flip chart to illustrate links)
Which of the factors do you think have the most impact?
Are there any factors that you think mitigate or reduce the weekend effect (e.g. care planning, escalation plans)? What are these and why?
What changes could improve care for patients admitted at weekends?
Concluding remarks
Ask if participants have any questions.
Remind participants that we will circulate (either by email or post) a one page summary with the key themes/topics and search terms that were generated from the focus group. Participants will then be asked to comment if any important areas have been excluded from the summary.
Ensure participants are happy with the way the focus group has been conducted.
Thank participants for their participation in the focus group and adjourn for lunch.
