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Smooth Transitions Participating Facility Annual Audit

Smooth Transitions is interested in hearing from hospitals participating in the program. Have your transfer experiences from community midwives improved?  Are your relationships with community midwives more respectful and collegial?  We want your feedback.  Please take 5-10' to answer these questions.  Your responses will inform and guide the program going forward.  Thank you! 
1.For what year are you completing the audit?(Required.)
2.What is the name of your facility?(Required.)
3.In your best estimation, how many intrapartum, immediate postpartum, and neonatal transfers from community midwives does your facility receive annually?
Intrapartum
Immediate Postpartum
Neonatal
4.In your opinion, how has Smooth Transitions affected:
Significantly improved
Moderately improved
Minimally improved
No change
Worsened this aspect of community midwife transfers
The transfer process for the pregnant person
The transfer process for the newborn
The initial communication between the community midwife and receiving provider
The initial communication between the community midwife and the charge nurse
Patient satisfaction
Patient safety
Receiving provider satifaction with community midwife transfers
Nursing satifaction with community midwife transfers
The communication between the discharging provider and the community midwife
5.Does your facility have working transfer protocols with community midwives?
6.Does your facility have a Perinatal Transfer Committee that meets with the local community midwives?
7.Does your facility collect statistics on community birth transfers?
8.Do receiving providers and nurses at your hospital fill out Smooth Transitions surveys?
9.What are the barriers (if any) to survey participation by receiving providers or nurses?
10.Does your facility ever invite community midwives to participate in educational or training opportunities?
11.Has your facility developed resources or tools to better support community midwife transfers?
12.What are the most significant challenges when working collaboratively with your local community midwives?  Please select all that apply.
13.In reference to the previous question (#10), what has the facility done to correct these abovementioned challenges?
14.What are the greatest successes when working collaboratively with your local community midwives?  Please select all that apply.
15.Would your facility be willing to share your protocols, resources, tools, and "lessons learned" with other facilities or organizations interested in participating in Smooth Transitions?
16.Please describe any additional assistance needed from the Smooth Transitions QI Program.
17.Reporter Information(Required.)