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Question:
Hello! I work for a safety-net community health clinic in Berkeley, CA. We are trying to more fully engage our highly diverse community of patients in how we plan and deliver our health services. In an effort to make our care more patient-centered, more culturally appropriate, and more aligned with our patients' real life experiences, we established a patient advisory council at one of our Oakland clinics, with promising results. We are hoping to build on this success, yet keep things sustainable for our struggling non-profit, by bringing patients into the patient satisfaction process. We're hoping to train patient advisory council members to develop and conduct patient surveys, one-on-one interviews and facilitate focus groups to address Quality Improvement initiatives. I am wondering if you know of any other community health clinics who have tried to do this. I am also wondering if you are aware of any training programs or literature that we could use to help orient and train our patient advisers so that they feel more confidant and can fully participate in this process. Thank you for your help!
Answer:

We responded to a similar situation recently. Graduate students, with supervision from faculty and a health center manager, conducted a community needs assessment, including many focus groups and individual interviews, for the only health center in a rural community. The purpose was to assist the health center to better serve the needs of the community. The students began by learning about the community, reading previous reports, talking with community residents, and analyzing census data. In their interviews and focus groups, students assessed the community's health issues, access to health care, needed services, knowledge of available health services, and quality of available services, and solicited advice for health providers. Two students were used in each interview/group and the sessions were recorded and then transcribed. Qualitative data were analyzed using a qualitative software program and reported with the quantitative data they gathered. The community was compared using state and national data. Their report was presented orally to community residents and leaders, and submitted in written form to the health center. Training for the students included reading a book on conducting focus groups (there are several excellent ones), practicing with faculty, and conducting the procedures with a small pilot sample. In each interview/group session topics, such as those above, were introduced and participants encouraged to respond. A question and answer format was deliberately not used. In the groups, participants often responded to the comments of others and the discussion provided useful information. In addition to the center's clients, a sample of community residents who did not use the center was recruited. They provided information on where they obtained health services and why they didn't use the center. Best wishes for your project!

Question Date: ثلاثاء, 10/14/2008