EasyPI Pre-Intervention Survey

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* 5. How many years have you been certified by the American Board of Family Medicine (ABFM)?

0-3

4-6

7-10

11-15

16-20

21-25

More than 25 years

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* 6. How have you been involved in past performance improvement activities? (check all that apply)

Participate passively and get data from my organization

Serve on QI committee

Topic selection

Activity design

Staff education

Implementation

Data collection

Serve as physician champion

Other (please specify)

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* 7. How comfortable are you with doing performance improvement activities in your practice?

Very uncomfortable

Uncomfortable

Neither uncomfortable nor comfortable

Comfortable

Very comfortable

Very uncomfortable

Uncomfortable

Neither uncomfortable nor comfortable

Comfortable

Very comfortable

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* 8. How comfortable are you with doing performance improvement for ABFM credit?

Very uncomfortable

Uncomfortable

Neither uncomfortable nor comfortable

Comfortable

Very comfortable

Very uncomfortable

Uncomfortable

Neither uncomfortable nor comfortable

Comfortable

Very comfortable

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* 9. How easy has it been for you to submit your performance improvement activities to ABFM for credit?

Very difficult

Difficult

Neither difficult nor easy

Easy

Very Easy

Very difficult

Difficult

Neither difficult nor easy

Easy

Very Easy

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* 10. How long has it taken you to complete an ABFM PI activity in the past (in hours of actual work time)?

Time to complete activity:

Time to submit activity to the ABFM:

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* 11. For you, how challenging is each of the following?

	Very difficult	Difficult	Neither difficult nor easy	Easy	Very easy
Finding/understanding background and current guidelines	Finding/understanding background and current guidelines Very difficult	Finding/understanding background and current guidelines Difficult	Finding/understanding background and current guidelines Neither difficult nor easy	Finding/understanding background and current guidelines Easy	Finding/understanding background and current guidelines Very easy
Finding/implementing point of care tools/clinical decision support	Finding/implementing point of care tools/clinical decision support Very difficult	Finding/implementing point of care tools/clinical decision support Difficult	Finding/implementing point of care tools/clinical decision support Neither difficult nor easy	Finding/implementing point of care tools/clinical decision support Easy	Finding/implementing point of care tools/clinical decision support Very easy
Finding resources to empower and activate patients to improve outcomes	Finding resources to empower and activate patients to improve outcomes Very difficult	Finding resources to empower and activate patients to improve outcomes Difficult	Finding resources to empower and activate patients to improve outcomes Neither difficult nor easy	Finding resources to empower and activate patients to improve outcomes Easy	Finding resources to empower and activate patients to improve outcomes Very easy
Performance improvement goal setting	Performance improvement goal setting Very difficult	Performance improvement goal setting Difficult	Performance improvement goal setting Neither difficult nor easy	Performance improvement goal setting Easy	Performance improvement goal setting Very easy
Selecting quality measures	Selecting quality measures Very difficult	Selecting quality measures Difficult	Selecting quality measures Neither difficult nor easy	Selecting quality measures Easy	Selecting quality measures Very easy
Selecting interventions	Selecting interventions Very difficult	Selecting interventions Difficult	Selecting interventions Neither difficult nor easy	Selecting interventions Easy	Selecting interventions Very easy
Implementing interventions	Implementing interventions Very difficult	Implementing interventions Difficult	Implementing interventions Neither difficult nor easy	Implementing interventions Easy	Implementing interventions Very easy
Determining current processes used in your practice	Determining current processes used in your practice Very difficult	Determining current processes used in your practice Difficult	Determining current processes used in your practice Neither difficult nor easy	Determining current processes used in your practice Easy	Determining current processes used in your practice Very easy
Involving the entire team in the PI planning process	Involving the entire team in the PI planning process Very difficult	Involving the entire team in the PI planning process Difficult	Involving the entire team in the PI planning process Neither difficult nor easy	Involving the entire team in the PI planning process Easy	Involving the entire team in the PI planning process Very easy
Involving the entire team in implementing performance improvement	Involving the entire team in implementing performance improvement Very difficult	Involving the entire team in implementing performance improvement Difficult	Involving the entire team in implementing performance improvement Neither difficult nor easy	Involving the entire team in implementing performance improvement Easy	Involving the entire team in implementing performance improvement Very easy
Accessing baseline and follow-up data for PI	Accessing baseline and follow-up data for PI Very difficult	Accessing baseline and follow-up data for PI Difficult	Accessing baseline and follow-up data for PI Neither difficult nor easy	Accessing baseline and follow-up data for PI Easy	Accessing baseline and follow-up data for PI Very easy

EasyPI Pre-Intervention Survey

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* 1. Name

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* 2. Email

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* 3. State AAFP chapter

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* 4. AAFP ID (optional)

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* 5. How many years have you been certified by the American Board of Family Medicine (ABFM)?

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* 6. How have you been involved in past performance improvement activities? (check all that apply)

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* 7. How comfortable are you with doing performance improvement activities in your practice?

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* 8. How comfortable are you with doing performance improvement for ABFM credit?

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* 9. How easy has it been for you to submit your performance improvement activities to ABFM for credit?

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* 10. How long has it taken you to complete an ABFM PI activity in the past (in hours of actual work time)?

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* 11. For you, how challenging is each of the following?

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* 12. Please share any comments on your experience with previous ABFM performance improvement activities.