Section A: List of Patient Safety and Quality Issues

In your best estimate, how often did the following things happen in your agency OVER THE PAST 12 MONTHS?

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1. Please select your agency

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2. Select your primary location of work

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3. A1: ACCESS TO CARE: A patient was unable to get admitted within 72 hours of hospital discharge or physician referral.

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4. A2: PATIENT IDENTIFICATION: The wrong chart/medical record was used for a patient.

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5. A3: CHARTS/MEDICAL RECORDS: A patient's chart/medical record was not available when needed.

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6. A4: CHARTS/MEDICAL RECORDS: Medical information was filed, scanned, or entered into the wrong patient's chart/medical record.

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7. A5: MEDICAL EQUIPMENT : Medical equipment was not available, working properly, or was in need of repair or replacement.

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8. A6: MEDICATION: I contacted a physician or pharmacy to clarify or correct a prescription.

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9. A7: MEDICATION: Medications needed were not available for administration as ordered.

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10. A8: MEDICATION: A patient's medication list was not updated during his or her visit by our staff.

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11. A9: DIAGNOSTICS & TESTS: The results from a lab or imaging test were not available when needed.

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12. A10: DIAGNOSTICS & TESTS: A critical abnormal result from a lab or imaging test was not followed up within 1 business day.

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