3rd Annual Wisconsin Perinatal Quality Collaborative Summit

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* 1. Patient Voices in Perinatal Quality Improvement.
Please rate LaToshia Rouse on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

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* 2. AIM & Maternal Hypertension in Wisconsin.
Please rate Nikita Desai, MPH, on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

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* 3. AIM & Maternal Hypertension in Wisconsin.
Please rate Beth Dibbert on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

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* 4. NAS & NOWS: What Can Perinatal Quality Collaboratives Do?
Please rate Munish Gupta, MD, MMSc, on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

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* 5. Lessons Learned from the Louisiana Perinatal Quality Collaborative.
Please rate Amy Ladley, PhD, on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

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* 6. Lessons Learned from the Louisiana Perinatal Quality Collaborative.
Please rate Kerrie Redmond, BSN, RNC-OB, on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

Question Title

* 7. A Wisconsin Mother's Preeclampsia Story.
Please rate Amy Dean on each of the following:

	Agree strongly	Agree	Disagree	Disagree strongly	N/A
Knowledgeable	Knowledgeable Agree strongly	Knowledgeable Agree	Knowledgeable Disagree	Knowledgeable Disagree strongly	Knowledgeable N/A
Well Prepared	Well Prepared Agree strongly	Well Prepared Agree	Well Prepared Disagree	Well Prepared Disagree strongly	Well Prepared N/A
Articulate/Good Teacher	Articulate/Good Teacher Agree strongly	Articulate/Good Teacher Agree	Articulate/Good Teacher Disagree	Articulate/Good Teacher Disagree strongly	Articulate/Good Teacher N/A
Use Appropriate Teaching Methods	Use Appropriate Teaching Methods Agree strongly	Use Appropriate Teaching Methods Agree	Use Appropriate Teaching Methods Disagree	Use Appropriate Teaching Methods Disagree strongly	Use Appropriate Teaching Methods N/A

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* 8. Please rate how well the program objectives were met.

At the end of the Summit, I am able to:

	Extremely well	Well	Fairly well	Poorly
Describe the value of including people with lived experience in quality collaborative work.	Describe the value of including people with lived experience in quality collaborative work. Extremely well	Describe the value of including people with lived experience in quality collaborative work. Well	Describe the value of including people with lived experience in quality collaborative work. Fairly well	Describe the value of including people with lived experience in quality collaborative work. Poorly
Explain one challenge faced by a statewide quality collaborative and a strategy for overcoming the challenge.	Explain one challenge faced by a statewide quality collaborative and a strategy for overcoming the challenge. Extremely well	Explain one challenge faced by a statewide quality collaborative and a strategy for overcoming the challenge. Well	Explain one challenge faced by a statewide quality collaborative and a strategy for overcoming the challenge. Fairly well	Explain one challenge faced by a statewide quality collaborative and a strategy for overcoming the challenge. Poorly

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* 9. Please estimate the extent to which you think you will:

	A great deal	A fair amount	Some	Not at all
Apply the content of this webinar in your work.	Apply the content of this webinar in your work. A great deal	Apply the content of this webinar in your work. A fair amount	Apply the content of this webinar in your work. Some	Apply the content of this webinar in your work. Not at all

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* 10. Will you change your practice based on this presentation?

Yes

Please explain:

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* 11. Please add any suggestions for quality improvement topics for future educational activities.

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* 12. Please add any other comments here.

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* 13. This year's summit featured the stories of two women with lived experiences. Their voices are necessary for understanding how care is received. The CDC stresses the importance of engaging women with lived experience in every aspect of planning and implementing care, including quality improvement initiatives.

Do you engage people with lived experience in the work you do?

Yes

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* 14. Do you plan to engage people with lived experience in the work you do in the next six months?

Yes

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* 15. Please answer the following questions.

	Yes	No
Did you attend the full session?	Did you attend the full session? Yes	Did you attend the full session? No
Did you perceive the session to be balanced and free from commercial bias?	Did you perceive the session to be balanced and free from commercial bias? Yes	Did you perceive the session to be balanced and free from commercial bias? No
Did you see or hear the speaker disclosure statements at the beginning of the presentation?	Did you see or hear the speaker disclosure statements at the beginning of the presentation? Yes	Did you see or hear the speaker disclosure statements at the beginning of the presentation? No

If you answered "No" to any of the questions, please explain.

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* 16. What is your profession? (WAPC is approved to provide continuing education for nurses and physicians. This information is collected to aid completion of continuing education re-accreditation requirements.)

Nurse

Physician

Other (please specify)

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* 17. Please indicate which continuing education certificate you are requesting?

2.5 Contact Hours (nurse)

2.5 CMEs (physician, CNM)

I do not need a continuing education certificate

N/A, but in the future I am interested in the following certifications:

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* 18. Please enter information about where to send the continuing education certificate:

Name:

Email:

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* 19. Check here if you do not have an email address and wish to receive the continuing education certificate by mail. Enter your address below.

I don't have an email address.

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* 20. Enter your address below.

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Question Title

* 1. Patient Voices in Perinatal Quality Improvement. Please rate LaToshia Rouse on each of the following:

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* 2. AIM & Maternal Hypertension in Wisconsin.Please rate Nikita Desai, MPH, on each of the following:

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* 3. AIM & Maternal Hypertension in Wisconsin.Please rate Beth Dibbert on each of the following:

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* 4. NAS & NOWS: What Can Perinatal Quality Collaboratives Do?Please rate Munish Gupta, MD, MMSc, on each of the following:

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* 5. Lessons Learned from the Louisiana Perinatal Quality Collaborative. Please rate Amy Ladley, PhD, on each of the following:

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* 6. Lessons Learned from the Louisiana Perinatal Quality Collaborative. Please rate Kerrie Redmond, BSN, RNC-OB, on each of the following:

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* 7. A Wisconsin Mother's Preeclampsia Story. Please rate Amy Dean on each of the following:

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* 8. Please rate how well the program objectives were met. At the end of the Summit, I am able to:

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* 9. Please estimate the extent to which you think you will:

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* 10. Will you change your practice based on this presentation?

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* 11. Please add any suggestions for quality improvement topics for future educational activities.

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* 12. Please add any other comments here.

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* 14. Do you plan to engage people with lived experience in the work you do in the next six months?

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* 15. Please answer the following questions.

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* 16. What is your profession? (WAPC is approved to provide continuing education for nurses and physicians. This information is collected to aid completion of continuing education re-accreditation requirements.)

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* 17. Please indicate which continuing education certificate you are requesting?

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* 18. Please enter information about where to send the continuing education certificate:

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* 19. Check here if you do not have an email address and wish to receive the continuing education certificate by mail. Enter your address below.

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* 20. Enter your address below.

* 1. Patient Voices in Perinatal Quality Improvement.
Please rate LaToshia Rouse on each of the following:

* 2. AIM & Maternal Hypertension in Wisconsin.
Please rate Nikita Desai, MPH, on each of the following:

* 3. AIM & Maternal Hypertension in Wisconsin.
Please rate Beth Dibbert on each of the following:

* 4. NAS & NOWS: What Can Perinatal Quality Collaboratives Do?
Please rate Munish Gupta, MD, MMSc, on each of the following:

* 5. Lessons Learned from the Louisiana Perinatal Quality Collaborative.
Please rate Amy Ladley, PhD, on each of the following:

* 6. Lessons Learned from the Louisiana Perinatal Quality Collaborative.
Please rate Kerrie Redmond, BSN, RNC-OB, on each of the following:

* 7. A Wisconsin Mother's Preeclampsia Story.
Please rate Amy Dean on each of the following:

* 8. Please rate how well the program objectives were met.

At the end of the Summit, I am able to: