General Information
1. Your Name*:
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2. Your Title*:
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3. EMail Address*:
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4. Hospital Name*:
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5. Burn Center Name*:
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Report Audience
6. What departments did you share your report with?*
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7. Do you share your report with your burn center staff?*
Check for yes:
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8. If yes to #7, please list the job titles of the individuals who were granted access to the report?
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9.Do you share your report with other burn centers?*
Check for yes:
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Current Report Content
Submission and Data Quality Section
10. How relevant was the information provided in this section?
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11. Did the information provided match your expectations?*
Check for yes:
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12. If no to #11, what did your expect?*
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13. Was the information on data quality used to stimulate data quality improvement initiatives?*
Check for yes:
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14. If yes to #13, please describe data quality improvement initiatives that were organized.
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Demographic and Injury Information Section
15. How relevant was the information provided in this section?
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16. Did the information provided match your expectations?
Check for yes:
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17. If no to #16, what did you expect?
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Outcomes Section
18. How relevant was the information provided in this section?
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19. Did the information provided match your expectations?
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20. If no to #19, what did you expect?
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21. Did you find the graphical presentation comparing individual facilities for mortality, charges, and length of stay to be valuable?
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22. Do these analyses increase your motivation to collect and submit more complete data?
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23. Were you satisfied with the stratifications of % TBSA used? [.1-9.9% TBSA, 10-19.9% TBSA, 20-100% TBSA]
Check for yes:
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24. If no to #23 ,what stratifications of % TBSA would you have preferred?
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25. Did these analyses stimulate any quality improvement initiatives or investigations?
Check for yes:
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26. If yes to #25, please briefly describe what was done?
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Future Content
Record Submission and Data Quality
27. What additional analysis would you recommend that would elucidate data quality at your center?
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Demographics and Injury Information
28. What additional demographic or injury variables would you like to see included in this report? [ Current variables: Gender, Age, Race, Etiology, Place of Occurence, Circumstance of Injury, Inhalation Injury, E-Codes, Procedures, Payor, and % TBSA]
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29. Would your prefer the presentation of demographic variable combinations, like age and gender or injury circumstance and injury site, over single variables?
Check for yes:
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30: If yes to #29, please list up to five additional analyses that would be of value to you.
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Outcomes
31. Beyond length of stay, hospital charges, complication rate, and mortality rate: what outcome measures or analysis would you like to see provided?
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32. Please list up to five other variables by which you like us to stratificate outcomes (Etiology of injury, Age, etc)?
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33. If you have submitted data for multiple years, how important would it be for us to provide you with trends over time?
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Thank you for taking the time to complete this survey. We will use this information to better tailor the benchmark reports to meet your needs.
General Comments
34. Compared to other benchmark reports you receive, would you consider the value delivered in this report to be?
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35. Please provide any general comments or recommendations you have regarding the current content, future content, or any other aspect of the benchmark reports.
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