If but fewer than 10 cases met the inclusion criteria for the “yes,” denominator, skip questions #8-10. Number of cases measured against the guideline, either all cases ______ or a sufficient sample of them (denominator) Number of cases in question #8 that adhere to the clinical process ______ guideline (numerator) Yes Do the responses in questions #8 and #9 represent a sample of No cases? 4F:High-Risk Deliveries High-Risk Deliveries Does your hospital ? Yes No If skip questions #2-17, and move on to the next section. “no,” Does your hospital operate a neonatal ICU, or is it with a hospital that operates a NICU, that admits or accepts transfers of ? If answer questions #12-17, and skip questions #3-11. “no,” Yes If the NICU is co-located in another hospital and your hospital No immediately transfers all complicated newborns there, answer question #3 and either questions #4-5 or #6-11 based on information pertaining to the co-located hospital’s NICU. Hospitals that participate in the Vermont Oxford Network (VON), and have a recent 12-month or 36-month report available, may elect to report your facility’s Volume (questions #4-5) OR the (questions #6-11). Volume Hospitals that do not participate in the Vermont Oxford Network, should report your facility’s Volume (questions #4-5). VON National Performance Measure Please indicate which measure the hospital will report on: If you elect to report on Volume, answer questions #4-5, and skip questions #6-11. If you elect to report on the VON National Performance Measure, skip questions #4-5, and report on questions #6-11.
If “yes,” but fewer than 10 cases met the inclusion criteria for the denominator, skip questions #8-10. Number of cases measured against the guideline, either all cases or a sufficient sample of them (denominator) ______ Number of cases in question #8 that adhere to the clinical process guideline (numerator) ______ Do the responses in questions #8 and #9 represent a sample of cases? Yes No 4F:High-Risk Deliveries High-Risk Deliveries Does your hospital ? If “no,” skip questions #2-17, and move on to the next section. Yes No Does your hospital operate a neonatal ICU, or is it with a hospital that operates a NICU, that admits or accepts transfers of ? If “no,” answer questions #12-17, and skip questions #3-11. If the NICU is co-located in another hospital and your hospital immediately transfers all complicated newborns there, answer question #3 and either questions #4-5 or #6-11 based on information pertaining to the co-located hospital’s NICU. Yes No Hospitals that participate in the Vermont Oxford Network (VON), and have a recent 12-month or 36-month report available, may elect to report your facility’s Volume (questions #4-5) OR the (questions #6-11). Hospitals that do not participate in the Vermont Oxford Network, should report your facility’s Volume (questions #4-5). Please indicate which measure the hospital will report on: If you elect to report on Volume, answer questions #4-5, and skip questions #6-11. If you elect to report on the VON National Performance Measure, skip questions #4-5, and report on questions #6-11. Volume VON National Performance Measure
2016Survey_Final_1.docx