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Table 2 Post-encounter data collection for telephone appointment request

From: Development of an unannounced standardized patient protocol to evaluate opioid use disorder treatment in pregnancy for American Indian and rural communities

TELEPHONE APPOINTMENT REQUEST: coding team post-visit data entry form
1. Clinic name, location 2. Clinic staff member answering call (i.e. scheduler, nurse)
OUD treatment information
1. Had the person who answered the phone heard of Suboxone before?
[IF YES] level of familiarity
2. Asked the specific reason why patient needed to take the Suboxone?
3. OUD treatment available at this site?
[IF NO] Referral offered? Contact info provided?
4. Was an appointment offered for OUD treatment?
[IF YES] Provider and date_________________
[IF NO] Reason appointment not offered
[IF NO] Referral offered? Contact info provided?
History and context
1. Asked about duration of pregnancy or about patient's last menstrual period?
2. Asked for information about patient's previous care/provider?
3. Inquired about patient's own understanding of their medical conditions?
4. Asked about patient's insurance coverage?
5. Asked where patient is moving from?
Risk stratification/triage
1. Asked whether patient had a current supply of buprenorphine/Suboxone?
2. Probed when patient disclosed aberrant dosing practice?
3. Asked about patient's mental health risk factors?
4. Allowed patient to speak with clinical person (i.e. nurse) when scheduler's knowledge about their issues was limited?
5. Any clinic staff asked if patient had any other concerns?
Prenatal treatment information
1. Was a prenatal appointment offered?
[IF YES] Provider and date_________________
[IF NO] Reason appointment not offered
[IF NO] Referral offered? Contact info provided?
Other appointment information
1. Was patient's contact information requested?  
Medical disclosures
1. Asked if patient takes any medications/other medications?
[IF YES] Asked about depression after Zoloft disclosed?
[IF YES] Asked about suicidality after depression disclosed?
2. Inquired where current supply of medications were prescribed from?
Encounter flow
1. Was the patient cut off while explaining their situation, concerns, and requests? 2. Were any questions avoided from being answered?
Word choice
1. Were any of the following words used by the health care organization on the call? [list of terms]  
Call duration information
1. Total duration of call
2. Time speaking with scheduler
3. Time waiting/on hold
4. Number of times placed on hold
5. Other time
1. Call attempt # __________________
2. White or American Indian profile?
3. Appointment offered?
4. If no MOUD treatment offered: were you referred to another provider?
5. Based on your phone encounter, how comfortable would you feel receiving your care at this clinic?
I felt my scheduler/nurse…[level of agreement]
1. Greeted me warmly
2. Let me explain my problem without interruption
3. Did not seem distracted
4. Asked me if I had any questions
5. Used words that show care and concern throughout the call
6. Used a tone and pace that show care and concern
7. Summarized my information and gave me the opportunity to correct or add information
8. Transitioned effectively to additional questions when gathering information
9. Responded explicitly to my statements about ideas and feelings regarding my questions and concerns
10. Other comments (free text):________________