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Practice Operations and Potentially Avoidable Emergency Room Visit Survey

1.What is your practice's name?
2.What are your practice's standard operating hours?
3.Does your practice schedule appointments before 9 a.m. on any of the following days? Please check all that apply.
4.Does your practice accept walk-ins before 9 a.m. on any of the following days? Please check all that apply.
5.Does your practice schedule appointments after 5 p.m. on any of the following days? Please check all that apply.
6.Does your practice accept walk-ins after 5 p.m. on any of the following days? Please check all that apply.
7.Does your practice offer appointments or walk-ins on the weekend? Please check all that apply.
8.If your practice offers weekend appointments or walk-ins, do you see:
9.Does your practice contact patients who have been seen at an Emergency Department and were released?
10.If yes, how long after the Emergency Department visit are patients contacted by the practice?
11.How often does your practice log-in to accessCHOA to check admission or hospitalizations for your patients?
12.Does your website provide information on common injuries and illnesses and what families should do in each case?
13.In your practice, what should current patient families do if they need after-hours care (Ex: Contact CHOA Nurse Advice Line)?
14.How is your after-hours policy communicated? Check all that apply.
15.What barriers does your practice encounter with potentially avoidable emergency room visits?