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Harms to Patients Survey
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Harms to Patients Survey
Harms to Patients Survey
2018-11-12T20:53:57+00:00
Harms to Patients Survey
Service
*
Acute Care Surgery
BEST
General Surgery
Pediatric Surgery
Surgical Oncology
Transplant Surgery
Urology
Vascular Surgery
Provider Type of Survey Respondent
*
Advanced Nurse Practitioner
Attending Physician
Physician Assistant
Physician Fellow
Resident Physician
Other
Over the past 7 days, how often did you receive a problematic handoff? (e.g., information that was clinically important was not given to you, or you received inaccurate information)
*
Never (0 times)
Rarely (1 or 2 times)
Sometimes (between 3 and 5 times)
Often (more than 5 times)
Please keep these definitions in mind when answering the next set of questions
Minor Harm-
Limited clinical consequence—such as a need for more frequent monitoring or transient discomfort, without prolongation of hospitalization, significant organ dysfunction or worsening of clinical condition.
Major Harm-
Significant clinical consequences such as deterioration in clinical status, organ dysfunction, prolonged hospitalization, disability beyond discharge, or death.
Harms to Patients
*
0
1
2
3
4
>4
Over the past 7 days, please estimate the number of your patients who experienced a MINOR harm as a result of a problematic handoff.
Over the past 7 days, please estimate the number of your patients who experienced a MAJOR harm as a result of a problematic handoff.
Over the past 7 days, how many days did you work?
*
0
1
2
3
4
5
6
7