ED Service Assessment

ED Service Assessment

Validation of service excellence for physicians in an ED setting. Form Preview
  • ED Service Assessment

    • Provider Info  
    • Whiteboard  
    •   Yes No N/A
      Wrote name of self and attending physician on whiteboard
      Completed 'you are waiting for' section of whiteboard
    • Provider Communication  
    •   Yes No N/A
      ACKNOWLEDGE Addressed any other team members in the patient room
      ACKNOWLEDGE Addressed family/visitors with the patient
      INTRODUCE Introduced self
      INTRODUCE Explained role
      DURATION Told how long testing would take
      DURATION Told anticipated length of ED visit/possible disposition
      DURATION Told when provider would return with a specific timeline
      EXPLANATION Explained testing, plan of care, diagnosis
      EXPLANATION Avoided medical jargon
      THANK YOU Thanked patient/family for coming in today, talking with you, etc OR showed appreciation to patient/family
    •   Yes No N/A
      Knocked and asked for permission to enter room
      Sat down
      Explained use of computer
      Turned off TV with appropriate explanation of why
      Maintained appropriate eye contact
      Displayed engaging body language/smiled when appropriate
      Arms not crossed
      Displayed appropriate use of touch
      Made small talk or a personal connection with the patient
      Allowed patient/family to converse
      Invited patient/family to ask questions (open ended)
      Displayed empathy
      Provider spent adequate time with patient
      Managed up self, staff, hospital, practice
    • Pain  
    •   Yes No N/A
      Addressed patients pain
      Gave a specific plan for pain
    • Improvement Plan  
    •    
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    • Should be Empty: