Questionnaire for Submitting a Physiologic Birth Improvement Story
The following questions will help the members of the BirthTOOLS subcommittee incorporate structured case studies of successful quality improvement activities. You have indicated that you have made a change in your care setting that relates to physiologic birth. Please provide answers to the following questions about your change project. We welcome as much detail as you are willing to provide. If we use your success study in the toolkit, we will contact you to approve the final content and obtain necessary institutional permissions.
What did you set out to change or improve?
Your answer
How did you change it? What new policy, process, or practice did you put in place?
Your answer
Who was involved in making the change and what was each person’s role?
Your answer
How did you determine if the change worked? What data did you collect? How did you define “success”? How did you ensure your change didn’t have any unintended negative consequences?
Your answer
What was the biggest barrier to making the change? How did you overcome that barrier?
Your answer
If you had one piece of advice for someone who wanted to make a similar change in their setting, what would you advise?
Your answer
Did you use BirthTOOLS during the process of making the change? If so, how?
Your answer
If you have data or other evidence that your change was successful, please provide that data.
Your answer
If you have a tool or policy that was developed during the process of making your change and are willing to share this with the site, please do so.
Your answer
Your contact information:
Your answer
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