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Harms to Patients Survey2022-06-16T17:43:09+00:00

Harms to Patients Survey

"*" indicates required fields

This survey intends to assess perceptions of handoff-related harms to patients. If you are a rotating clinician, please indicate your current location, department or service and unit where indicated. This survey does not replace an Incident Report. If a safety event has occurred, please exit this survey and get in contact with Kyle Dunn and Ashley Redmond.
Provider Type of Survey Respondent*
Over the past month, how often did you receive a problematic handoff? (e.g., information that was clinically important was not given to you, or you received inaccurate information)*
Please keep these definitions in mind when answering the next set of questions.

Minor Harm: Limited clinical consequence—such as a need for more frequent monitoring or transient discomfort, without prolongation of hospitalization, significant organ dysfunction or worsening of clinical condition.

Major Harm: Significant clinical consequences such as deterioration in clinical status, organ dysfunction, prolonged hospitalization, disability beyond discharge, or death.
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Over the past month, please estimate the number of your patients who experienced a MINOR harm as a result of a problematic handoff.
Over the past month, please estimate the number of your patients who experienced a MAJOR harm as a result of a problematic handoff.
Please enter a number from 0 to 31.
Please enter the number of days (or shifts) that you worked over the past month.
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