Clinician and Group Care Coordination Survey Form
Please complete the Clinician and Group Care Coordination Survey Form to help us evaluate coordination practices and identify areas for improvement.
Your role in the care team
*
Please Select
Physician
Nurse
Social Worker
Care Coordinator
Behavioral Health Specialist
Other
How would you rate overall coordination among care team members?
*
1
2
3
4
5
Please indicate your level of agreement with the following statements about care coordination in your group.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Communication between team members is clear and timely
1
2
3
4
5
Roles and responsibilities are well understood
6
7
8
9
10
Care transitions and handoffs are well managed
11
12
13
14
15
Team members collaborate effectively to solve problems
16
17
18
19
20
Patients and families are included in care planning
21
22
23
24
25
How effective are current communication tools and processes (e.g., EHR, meetings, messaging) for coordinating care?
*
Very ineffective
Ineffective
Neutral
Effective
Very effective
How frequently do you participate in interdisciplinary care planning meetings?
*
Never
Rarely
Sometimes
Often
Always
What are the most significant barriers to effective care coordination in your group?
Lack of time
Inadequate communication tools
Unclear roles/responsibilities
Limited patient/family involvement
Insufficient training
Other
How easy is it to access patient information needed for coordinated care?
*
Very difficult
Difficult
Neutral
Easy
Very easy
How confident are you that patients receive consistent care across different providers in your group?
*
Not at all confident
Slightly confident
Moderately confident
Very confident
Extremely confident
What changes would most improve care coordination in your group?
Additional comments or suggestions
Submit Survey
Should be Empty: