Conduct Discharge Board Questionnaire Form
Conduct Discharge Board Questionnaire Form
What is your role on the discharge board?
*
What department or service do you represent?
*
How often do you participate in discharge board activities?
*
Daily
Several times a week
About once a week
Several times a month
About once a month or less
How would you rate these discharge-planning process areas?
*
Rows
Needs significant improvement
Needs some improvement
Adequate
Good
Excellent
Timeliness of discharge planning
1
2
3
4
5
Clarity of assigned responsibilities
6
7
8
9
10
Coordination of discharge tasks
11
12
13
14
15
Consistency of planning across teams
16
17
18
19
20
How would you rate overall coordination within the discharge board?
*
1
2
3
4
5
How would you rate communication among the teams involved in discharge planning?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
Which process barriers commonly affect discharge planning? Select all that apply.
Unclear roles or ownership
Delayed communication or responses
Incomplete or inconsistent planning information
Limited coordination between teams
Unclear procedures or decision pathways
Resource or capacity constraints
Other process barrier
What are the most common process-related causes of discharge delays? Select all that apply.
Discharge decisions or approvals take longer than expected
Coordination between teams is delayed
Discharge instructions or documents are prepared late
Transportation arrangements are not ready
Follow-up services or community support arrangements are delayed
Equipment or other logistical arrangements are delayed
Other process-related cause
What changes would most improve the discharge planning and coordination process?
Additional comments
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