NR 707A Week 6 Staff Feedback Write-Up Example

Staff Feedback Write-Up: Seventeen Staff on the Same-Day Behavioral Health Introduction, Grouped by Step and Counted, With Requests That Would Change the Design

Student Name

College of Nursing, Chamberlain University

NR 707A: DNP Project & Practicum III

Instructor Name

Month Day, Year

Staff Feedback Write-Up: Seventeen Staff on the Same-Day Behavioral Health Introduction, Grouped by Step and Counted, With Requests That Would Change the Design

Method

This was a quick, deliberately modest collection, not the planned survey. Brief structured conversations, five to ten minutes each, held at the site between 5 and 9 April 2027, week 6 of the test. Asked: all 16 medical assistants, all 9 primary care clinicians and the three behavioral health staff, 28 people in all. Answered: 17. Not reached: 6 medical assistants on evening shifts who were not on during my hours and 5 clinicians who were fully booked that week. Questions: what part of the change works, what part does not and what one thing they would change. Notes were taken by hand; no names were recorded beside comments, and the notes were kept on the clinic's network drive with the other project files. The structured survey planned for May will follow; this is a shorter, earlier collection.

Comments, Grouped by Step

The comments are arranged by the part of the change they concern. Messaging the consultant, 7 of 17 raised it. Most said it was quick and fit the rooming routine. One said: "Takes ten seconds. I'd have said no if it took more."

Asking the patient, 5 of 17. Four, all bilingual medical assistants, said the Spanish wording on the pocket card sounded formal and some patients did not understand "consejero de salud conductual." They had started saying "la consejera" instead.

The consultant's arrival, 6 of 17. Waits of up to 25 minutes when the consultant was with another patient; clinicians said they sometimes finished the visit and left the patient waiting in the room, which blocked the room.

The open slots, 4 of 17. The front desk booked over the 14:00 slot in the first week; two said it still happened occasionally when the hold was overridden by a supervisor.

The next-day call, 3 of 17. The behavioral health assistant said the calls were easier because patients had already met the consultant: "They know who I'm calling for."

Requests That Would Change the Design

Some requests could be met within the design; two could not. Two requests would alter the design. First, the consultant asked to join by video from their office when busy, rather than walking over, which would shorten waits but change the in-person introduction the design relies on. Second, two clinicians asked to include patients with a PHQ-9 of 8 or 9 "who look like they need it," which would change the population and the measure. Both are recorded, both are reasonable and neither will be adopted mid-test; both go to the evaluation term as candidates for the next cycle.

Requests that do not change the design: rewording the Spanish phrase on the pocket card, which was done on 12 April, and moving waiting patients to the behavioral health waiting area rather than holding the exam room, which was agreed at the operations meeting on 13 April.

Said Against Done

What staff said can be checked against what the data show, at least in part. Staff said the messaging step was easy; the process data agree, with 92% of eligible visits in behavioral health hours generating a message. Staff said patients rarely declined; the data show 13% declined. Staff said waits were sometimes long; the data cannot confirm this, since nobody records waits, which is a gap the evaluation should note.

What the Feedback Changed

Two changes were made within a week. The Spanish phrase on the pocket card was replaced on 12 April with the wording the bilingual medical assistants were already using. Waiting patients now move to the behavioral health waiting area rather than staying in the exam room, which frees rooms for the next patient. Both were within the design's limits, so neither needed committee approval. The two requests that would change the design were recorded for the evaluation term.

Who Was Not Heard

The gaps in who answered matter as much as what was said. Evening medical assistants, who handle the screens that fall after behavioral health hours, were not reached. Their view matters most for the next-day call, since they are the ones telling patients a call will come. The May survey will reach them online, and a second round of conversations will be held on two evening shifts in early May.

How This Fits the Planned Survey

The staff survey planned for May uses items modeled on brief validated measures of acceptability and feasibility (Weiner et al., 2017). These conversations are not a substitute; they are an early check that lets small problems be fixed before the survey and the evaluation.

Limits

The findings should be read with their limits in view. Seventeen of 28 answered, and evening staff were under-represented. People who chose to talk may be more positive than those who did not. The conversations were held by a colleague, which may have softened criticism. The May survey, anonymous and online, will check these findings with a larger and less self-selected group, and its results will be compared with these comments.

What Surprised Me

That the behavioral health assistant found the next-day calls easier because patients had already met the consultant. I had expected the calls to be unchanged, since they reach patients who did not have a same-day contact. In fact, many of those patients had been told about the counselor by the medical assistant and clinician, even if they did not meet them, and recognized the name. The design's effect may reach further than its same-day part.

What I Would Ask Differently

I would ask about waiting time directly, with a rough count rather than an impression, since that was the most common complaint and the one the data cannot check. I would also ask the consultant separately about the load of open slots, since the consultant's view of capacity matters most for whether the change can last.

What This Adds

Acceptability and feasibility are implementation outcomes that a change's own data cannot show (Proctor et al., 2011). Staff saw the messaging step as feasible and the waits as the main burden. The finding that patients knew who was calling them fits the logic behind warm handoffs, though one study warns the effect may vary by patient group (Horevitz et al., 2015).

References

Horevitz, E., Organista, K. C., & Arean, P. A. (2015). Depression treatment uptake in integrated primary care: How a "warm handoff" and other factors affect decision making by Latinos. Psychiatric Services, 66(8), 824-830. https://doi.org/10.1176/appi.ps.201400085

Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76. https://doi.org/10.1007/s10488-010-0319-7

Weiner, B. J., Lewis, C. C., Stanick, C., Powell, B. J., Dorsey, C. N., Clary, A. S., Boynton, M. H., & Halko, H. (2017). Psychometric assessment of three newly developed implementation outcome measures. Implementation Science, 12, Article 108. https://doi.org/10.1186/s13012-017-0635-3