Deploying High Reliability across Providence - 4 hour (Physician sessions) Question Title * 1. Please share your contact information: First Name Last Name Job Title Email Address Work Phone Question Title * 2. Please select the date of the session you attended from the drop down menu:(If the date of the meeting is not listed, it was not approved for CME) 01/09/2019 12:30 pm - 4:30 pm 01/18/2019 12:30 pm - 4:30 pm 01/25/2019 12:30 pm - 4:30 pm 02/06/2019 12:30 pm - 4:30 pm 02/22/2019 12:30 pm - 4:30 pm 03/04/2019 12:30 pm - 4:30 pm 03/22/2019 12:30 pm - 4:30 pm 04/12/2019 12:30 pm - 4:30 pm 04/26/2019 12:30 pm - 4:30 pm 05/16/2019 12:30 pm - 4:30 pm 05/24/2019 12:30 pm - 4:30 pm 06/28/2019 12:30 pm - 4:30 pm 07/10/2019 12:30 pm - 4:30 pm 07/26/2019 12:30 pm - 4:30 pm 08/05/2019 12:30 pm - 4:30 pm 08/23/2019 12:30 pm - 4:30 pm 09/18/2019 12:30 pm - 4:30 pm 09/27/2019 12:30 pm - 4:30 pm 10/16/2019 12:30 pm - 4:30 pm 10/25/2019 12:30 pm - 4:30pm 11/05/2019 8:00 am-12:00 pm 11/06/2019 12:30 pm- 4:30 pm 11/07/2019 8:00 am-12:00 pm 11/22/2019 12:30 pm - 4:30 pm Question Title * 3. Are you a... MD/DO RN PA-C NP PT Other (please specify) Question Title * 4. How many credit hours are you claiming for this session? (The maximum is 4.0) Attended the full session for 4.0 credit hours Attended a part of this session (enter credit hours in .25 increments below if you are claiming in "Other"): Other: Please indicate the number of credits you are claiming for this activity using 0.25 increments (rounding up to the nearest 0.25). Do not exceed the maximum listed above. Ensuring Independence of CME Activities: Providence Health & Services Alaska is committed to providing education that is free from bias of commercial interests. In an effort to assist us in ensuring this is always the case, please complete the following question. Question Title * 5. Did you find the information presented in the session you attended to be fair, objective, and free of commercial bias? Yes No If no, please describe: Program Efficacy: The following questions help Providence Health & Services Alaska evaluate the efficacy of the various programs. As an accredited provider, it is critical that we measure and evaluate changes in Competence, Performance and Patient Outcomes. Please assist us in fulfilling our educational mission by answering the following questions. Question Title * 6. Assessment of Expected Learner Outcomes: On a scale of 1-5, with 5 being the highest, please rate the degree to which you intend to do or apply the following to your practice/ for the benefit of your patients: 1 - I do not intend to make any changes 2 3 - I will make a few changes 4 5 - I intend to make a lot of changes Describe and apply the 12 tools of high reliability. Describe and apply the 12 tools of high reliability. 1 - I do not intend to make any changes Describe and apply the 12 tools of high reliability. 2 Describe and apply the 12 tools of high reliability. 3 - I will make a few changes Describe and apply the 12 tools of high reliability. 4 Describe and apply the 12 tools of high reliability. 5 - I intend to make a lot of changes Take steps to reduce the SSER (Serious Safety Event Rate), Major v Minor Near Harm Event Ratio, number of unusual occurrence reports filed, and staff injury rate. Take steps to reduce the SSER (Serious Safety Event Rate), Major v Minor Near Harm Event Ratio, number of unusual occurrence reports filed, and staff injury rate. 1 - I do not intend to make any changes Take steps to reduce the SSER (Serious Safety Event Rate), Major v Minor Near Harm Event Ratio, number of unusual occurrence reports filed, and staff injury rate. 2 Take steps to reduce the SSER (Serious Safety Event Rate), Major v Minor Near Harm Event Ratio, number of unusual occurrence reports filed, and staff injury rate. 3 - I will make a few changes Take steps to reduce the SSER (Serious Safety Event Rate), Major v Minor Near Harm Event Ratio, number of unusual occurrence reports filed, and staff injury rate. 4 Take steps to reduce the SSER (Serious Safety Event Rate), Major v Minor Near Harm Event Ratio, number of unusual occurrence reports filed, and staff injury rate. 5 - I intend to make a lot of changes Question Title * 7. Assessing changes in Competence (potential impact on Performance): What did you learn at the session that you plan to take back and apply to practice? Please highlight what you found valuable and how you plan to apply it to practice. Question Title * 8. Assessing potential impact on Patient Outcomes: Please describe how the information you obtained during the presentation will directly impact patient care/outcomes. Speculation is encouraged! Question Title * 9. What barriers may prevent you from applying knowledge and/or techniques to practice? Question Title * 10. Please let us know what future topics you would like to see presented: Done