Do not Low High Domain Element2 know Information / Web portals provide specific resources for PF 1 2 3 4 5 Education Clinician email access from PF is encouraged and 1 2 3 4 5 safe PF serve as educators/faculty for clinicians and 1 2 3 4 5 other staff PF access to / encouraged to use resource rooms 1 2 3 4 5 Careful collection and measurement; race / 1 2 3 4 5 Diversity & ethnicity / language Disparities PF provided timely access to interpreter services 1 2 3 4 5 Navigator programs for minority and underserved 1 2 3 4 5 patients Educational materials at appropriate literacy levels 1 2 3 4 5 PF have full and easy access to 1 2 3 4 5 Charting and paper/electronic record Documentation Patient and family are able to chart 1 2 3 4 5 Care Support Families members of care team, not visitors, with 1 2 3 4 5 24/7 access Families can stay, join in rounds & change of shift 1 2 3 4 5 report PF find support, disclosure, apology with error 1 2 3 4 5 and harm Family presence allowed/ supported during rescue 1 2 3 4 5 events PF are able to activate rapid response 1 2 3 4 5 systems Patients receive updated medication history at each 1 2 3 4 5 visit Care PF engage with clinicians in collaborative goal setting 1 2 3 4 5 PF listened to, respected, treated as partners in 1 2 3 4 5 care Actively involve families in care planning and 1 2 3 4 5 transitions Pain is respectively managed in partnership with 1 2 3 4 5 patient and family
Domain Element2 Low High Do not know Information / Education Web portals provide specific resources for PF 1 2 3 4 5 Clinician email access from PF is encouraged and safe 1 2 3 4 5 PF serve as educators/faculty for clinicians and other staff 1 2 3 4 5 PF access to / encouraged to use resource rooms 1 2 3 4 5 Diversity & Disparities Careful collection and measurement; race / ethnicity / language 1 2 3 4 5 PF provided timely access to interpreter services 1 2 3 4 5 Navigator programs for minority and underserved patients 1 2 3 4 5 Educational materials at appropriate literacy levels 1 2 3 4 5 Charting and Documentation PF have full and easy access to paper/electronic record 1 2 3 4 5 Patient and family are able to chart 1 2 3 4 5 Care Support Families members of care team, not visitors, with 24/7 access 1 2 3 4 5 Families can stay, join in rounds & change of shift report 1 2 3 4 5 PF find support, disclosure, apology with error and harm 1 2 3 4 5 Family presence allowed/ supported during rescue events 1 2 3 4 5 PF are able to activate rapid response systems 1 2 3 4 5 Patients receive updated medication history at each visit 1 2 3 4 5 Care PF engage with clinicians in collaborative goal setting 1 2 3 4 5 PF listened to, respected, treated as partners in care 1 2 3 4 5 Actively involve families in care planning and transitions 1 2 3 4 5 Pain is respectively managed in partnership with patient and family 1 2 3 4 5
PFCC_organizational_self_assessment.docx