Skip survey header
Perinatal Quality Collaborative of North Carolina

Page One

Patient and Families as Partners 2 – Post Meeting Feedback

3. Initiative: *This question is required.
4. Which of the following best describes your primary role on the improvement team: *This question is required.
5. Did your PQIT have a team meeting this month?  *This question is required.
6. Did you attend your PQIT’s meeting this month? *This question is required.
6. Did any patients/family members participate in the meeting? *This question is required.
This question requires a valid number format.
Each of the below questions should be answered on a 7-point Likert scale:

1 – Strongly disagree
2 – Disagree
3 – Somewhat disagree
4 – Neither agree or disagree
5 – Somewhat agree
6 – Agree
7 – Strongly agree

6. During the meeting: *This question is required.
Space Cell 1234567
The patient/family perspective was respected.
Patients/family members appeared properly prepared to participate.
Patients/family members appeared comfortable asking questions.
Patient/family engagement was supported and encouraged by the team.
A plan was developed including next steps and action items to be completed by team members.
A plan was developed that was, in part, a product of patient/family feedback.
A plan was developed that included tasks to be completed by patients/family members.