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PIPER transfer feedback survey - how did it go?

Please complete the survey below.

Hi Team,

Thank you for clicking on the link and taking the time to feedback from your recent paediatric resusctiation and transfer.

Prior to commencing this, remember there is no pressure to complete this feedback tool, it is 100% optional. But we would love to hear how the resus went and look for ways that we can impove as a team for future acutely unwell children and also celebrate our teams fantastic performance.

Thanks again for taking part and thanks for all you do,

Heather

UR number of patient transferred

DOB

Date of presentation

Please provide a 1-2 sentence brief medical summary of the case ( ie. 3 year old status epilepticus requiring intubation).

What was your role in the patient's care during their time at SHED?

Team lead

Team lead support

Airway doctor

Airway nurse

Ciculation doctor

Ciculation nurse

Scribe

Scout

Procedure doctor

Runner

Other

Was role allocation clear?

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Did the team leader provide clear leadership?

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Did the team demonstrate good use of closed loop communication?

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Were there any challenges with communication between team members during the patient's care? If issues identified please provide some detail?

I was aware of what was happening with this patient?

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The team leader provided frequent summaries to the team?

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I felt empowered to speak up and provide input

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Was there a requirement to call anaesthetics?

Yes No

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If intubation was required who performed the intubation?

PEM Consultant PEM registrar PEM resident FACEM Consultant ACEM reg Resident Anaesthetics Other

Were there any difficulties with equipment?

No issues Ventilator CPAP High flow Intubation equipment IO drill Ultrasound Resus trolley Supply in resus trolley Other

Please elaborate on the equipment issues in this box?

Were you responsible for communicating with PIPER?

Yes No

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If you were responsible for discussing with PIPER. Were there any difficulties with the phone call? Please provide details

Did you feel supported by the PIPER team?

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Was the plan clear from the PIPER team?

Did your initial plan from your first PIPER phone call result in one of the following? Please tick one that applies

If there was an interim plan could you please describe this briefly? ( ie trial IV therapy for asthma then review need for transfer).

Please describe the handover to the PIPER team and transition of care to the PIPER team lead? If you observed this please also comment on what you observed

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Do you have specific feedback (constructive or positive) for the PIPER team or any additional issues to feedback? ( This will be facilitated in a general and annonymous fashion).

Was the resuscitation followed by a de-brief?

Yes No

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If yes was this de-brief helpful?

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If a de-brief was not facilitated do you think there was a role for a de-brief in this situation?

Yes No

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Were there barriers to facilitating a de-brief? (time, departmental load etc)

Do you have any final feedback, thoughts or comments after your involvment with this case? All thoughts and opinions well come :)

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.