Program Description and Confidentiality Statement

Smooth Transitions is a statewide quality improvement effort under the Foundation for Health Care Quality. The program’s mission is to improve hospital transfers from planned community-based births to promote greater patient safety and satisfaction. The goals of Smooth Transitions are to:

1. Improve the safety and efficiency of the transfer process through the establishment of system-wide protocols.
2. Collect and analyze transfer outcome data for the purpose of quality improvement.
3. Build greater collaboration between community-based midwives, EMS, and hospital care team.
4. Enhance the patient experience of care when transfers occur.

We are eager to hear from you about your recent hospital transfer experience and appreciate your honest feedback. Your responses are protected and confidential. They will be used to help improve the transfer process for others.  It takes about 6 minutes to complete the survey.

Thank you!

Question Title

* 1. Date of transfer?

Date

Question Title

* 2. Receiving Facility and County

Question Title

* 6. What was/were the indication(s) for transfer?

Question Title

* 11. Did you:

  yes no
Provide a verbal report to the receiving provider, including details on client's current health status?
Provide a copy of client's relevant prenatal and labor medical records?
Answer questions from the receiving provider about the client and what led to the transfer?
Use a transfer form?

Question Title

* 13. Please use the following scale in responding to the statements below:

  strongly agree agree undecided/neutral disagree strongly disagree
The interactions between me and the receiving provider were professional.
The communication between me and the receiving provider was respectful.
The receiving staff and I worked well together.
The hospital staff were sensitive to the psychological/emotional needs of my client.
The hospital staff accommodated my presence according to my client's wishes and/or the hospital's protocols.
The receiving provider participated in shared decision-making with my client to create a care plan.
The receiving provider and I made a plan for postpartum care.

Question Title

* 14. Do you feel your interactions with the hospital staff were impacted by any of the following: race, gender identity, sexual orientation, or disability status?

Question Title

* 15. What went well during this transfer process?  And how could this experience help inform future transfers?

Question Title

* 16. Do you have any comments about the interactions between providers or between the providers and your client, during the course of care?

T