ILPQC OB Teams Survey

Question Title

* 1. Please review this survey with your Maternal Hypertension Initiative quality improvement team and designate a team member to complete this survey for your hospital.

Hospital Name

Hospital City

Labor & Delivery Survey Designee Name

Labor & Delivery Survey Designee Email

Question Title

* 2. Please provide the name and contact information of your hospital administrator. This information will be used to share news of the accomplishments of and awards received by your team.

Hospital Administrator Name

Hospital Administrator Title

Hospital Administrator Street and Number

Hospital Administrator City

Hospital Administrator State

Hospital Administrator ZIP CODE

Hospital Administrator E-mail Address

Question Title

* 3. Do you have a patient/family team member on your hospital team for the Maternal Hypertension Initiative?

Yes

Other (please specify)

Question Title

* 4. If you answered "No" to Q3, what assistance would be most helpful to engaging a patient advisor? Select all that apply.

Identifying interested patients

Making the case for patient advisors with hospital administration

Training on how to incorporate patient advisors in the work of the hospital QI team

Other (please specify)

Question Title

* 5. What statement best describes your QI Team's focus on the Maternal HTN Initiative?

Working to achieve quality improvement goals

Goals achieved, developing a sustainability plan

Goals achieved, implementing a sustainability plan

Question Title

* 6. What elements of the Maternal Hypertension Bundle were most effective in reducing time to treatment?

Checklists

BP measurement protocol

Treatment algorithms

Order sets

Tools to promote awareness (e.g. Ghostbusters sign)

Debriefs

Patient education tools

Provider/staff education

Other (please specify)

Question Title

* 7. What steps have you taken to that are most effective to implement an education program for all nurses and providers on Severe HTN/Preeclampsia and the Severe HTN/Preeclampsia bundle elements and the unit-standard protocol that supports culture change?

Question Title

* 8. What barriers have you faced in implementing an education program for all nurses and providers on Severe HTN/Preeclampsia and the Severe HTN/Preeclampsia bundle elements and the unit-standard protocol that supports culture change?

Question Title

* 9. What steps have you taken that have been most effective to implement standard protocols for early warning signs, updated diagnostic criteria, monitoring and treatment of severe preeclampsia/eclampsia (include order sets and algorithms) across all units of your hospital to facilitate systems change?

Question Title

* 10. What barriers have you faced to implement standard protocols for early warning signs, updated diagnostic criteria, monitoring and treatment of severe preeclampsia/eclampsia (include order sets and algorithms) across all units of your hospital to facilitate system change?

Question Title

* 11. Please rate the QI support strategies from ILPQC in the second year of the Maternal Hypertension Initiative (5 being most helpful and 1 being least helpful)?

	1	2	3	4	5	N/A
Face-to-face meeting in May 2017	Face-to-face meeting in May 2017 1	Face-to-face meeting in May 2017 2	Face-to-face meeting in May 2017 3	Face-to-face meeting in May 2017 4	Face-to-face meeting in May 2017 5	Face-to-face meeting in May 2017 N/A
One-on-one QI support calls	One-on-one QI support calls 1	One-on-one QI support calls 2	One-on-one QI support calls 3	One-on-one QI support calls 4	One-on-one QI support calls 5	One-on-one QI support calls N/A
QI topic calls (e.g. engaging the ED)	QI topic calls (e.g. engaging the ED) 1	QI topic calls (e.g. engaging the ED) 2	QI topic calls (e.g. engaging the ED) 3	QI topic calls (e.g. engaging the ED) 4	QI topic calls (e.g. engaging the ED) 5	QI topic calls (e.g. engaging the ED) N/A
Monthly team webinars	Monthly team webinars 1	Monthly team webinars 2	Monthly team webinars 3	Monthly team webinars 4	Monthly team webinars 5	Monthly team webinars N/A
Team talks	Team talks 1	Team talks 2	Team talks 3	Team talks 4	Team talks 5	Team talks N/A
Reviewing ILPQC data reports with your team	Reviewing ILPQC data reports with your team 1	Reviewing ILPQC data reports with your team 2	Reviewing ILPQC data reports with your team 3	Reviewing ILPQC data reports with your team 4	Reviewing ILPQC data reports with your team 5	Reviewing ILPQC data reports with your team N/A
ILPQC Hypertension Toolkit Binder	ILPQC Hypertension Toolkit Binder 1	ILPQC Hypertension Toolkit Binder 2	ILPQC Hypertension Toolkit Binder 3	ILPQC Hypertension Toolkit Binder 4	ILPQC Hypertension Toolkit Binder 5	ILPQC Hypertension Toolkit Binder N/A
AIM/ACOG online emodules for provider/staff education	AIM/ACOG online emodules for provider/staff education 1	AIM/ACOG online emodules for provider/staff education 2	AIM/ACOG online emodules for provider/staff education 3	AIM/ACOG online emodules for provider/staff education 4	AIM/ACOG online emodules for provider/staff education 5	AIM/ACOG online emodules for provider/staff education N/A
ILPQC Grand Rounds Speaker Bureau	ILPQC Grand Rounds Speaker Bureau 1	ILPQC Grand Rounds Speaker Bureau 2	ILPQC Grand Rounds Speaker Bureau 3	ILPQC Grand Rounds Speaker Bureau 4	ILPQC Grand Rounds Speaker Bureau 5	ILPQC Grand Rounds Speaker Bureau N/A

ILPQC OB Teams Survey - 2017

Maternal Hypertension - Sustainability Plan Check-In

Question Title

* 1. Please review this survey with your Maternal Hypertension Initiative quality improvement team and designate a team member to complete this survey for your hospital.

Question Title

* 2. Please provide the name and contact information of your hospital administrator. This information will be used to share news of the accomplishments of and awards received by your team.

Question Title

* 3. Do you have a patient/family team member on your hospital team for the Maternal Hypertension Initiative?

Question Title

* 4. If you answered "No" to Q3, what assistance would be most helpful to engaging a patient advisor? Select all that apply.

Question Title

* 5. What statement best describes your QI Team's focus on the Maternal HTN Initiative?

Question Title

* 6. What elements of the Maternal Hypertension Bundle were most effective in reducing time to treatment?

Question Title

* 7. What steps have you taken to that are most effective to implement an education program for all nurses and providers on Severe HTN/Preeclampsia and the Severe HTN/Preeclampsia bundle elements and the unit-standard protocol that supports culture change?

Question Title

* 8. What barriers have you faced in implementing an education program for all nurses and providers on Severe HTN/Preeclampsia and the Severe HTN/Preeclampsia bundle elements and the unit-standard protocol that supports culture change?

Question Title

Question Title

* 10. What barriers have you faced to implement standard protocols for early warning signs, updated diagnostic criteria, monitoring and treatment of severe preeclampsia/eclampsia (include order sets and algorithms) across all units of your hospital to facilitate system change?

Question Title

* 11. Please rate the QI support strategies from ILPQC in the second year of the Maternal Hypertension Initiative (5 being most helpful and 1 being least helpful)?

Question Title

* 12. What additional feedback do you have on the Maternal Hypertension Initiative for ILPQC?