AHRQ Safety Program for Perinatal Care
Purpose of the tool: This tool helps assess unit strengths and opportunities for improving unit processes and upgrading unit safety culture.
Who should use this tool? Health care teams
Directions: Your team should collectively complete one Team Checkup Tool every month.
State:
Hospital Name:
Date:
| # | Knowledge / Skills | Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree |
|---|---|---|---|---|---|---|
| 1 | Five randomly selected staff members (e.g., nurses, nurse-midwives, physicians) from our unit can list at least two interventions that are part of the Safety Program for Perinatal Care. | |||||
| 2 | Unit staff members are confused about how to proceed with project activities to improve safety. | |||||
| 3 | All staff members can communicate the project’s goals. | |||||
| 4 | All team members can list the number of days between incidents on the unit. | |||||
| 5 | There are good systems in our unit to ensure we meet the goal of <Insert a safety measure here>. | |||||
| 6 | There is a lack of quality improvement skills on our team. | |||||
| 7 | We perform a unit analysis for each incident using the Learning from Defects Tool. |
| # | Attitudes / Beliefs | Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree |
|---|---|---|---|---|---|---|
| 1 | We have had ownership from staff members on this unit. | |||||
| 2 | We have had good ownership from physician staff on this unit. | |||||
| 3 | We have had good ownership from nursing staff on this unit. | |||||
| 4 | Staff members on this unit do not believe that perinatal safety is an issue for this unit. | |||||
| 5 | A junior staff member feels comfortable questioning a more senior staff member who is not using a unit-developed safety tool or following a unit-developed safety process or procedure | |||||
| 6 | Our senior executive can state three safety concerns the staff have identified. |
| # | Resources | Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree |
|---|---|---|---|---|---|---|
| 1 | Our team meets at least once a month. | |||||
| 2 | There is not enough time to get our team’s work done. | |||||
| 3 | Unit leadership (managers, physicians, opinion leaders) is stable (i.e., low turnover). | |||||
| 4 | Data collection has not been a burden. | |||||
| 5 | Staff members do not have time to collect maintenance data. |
