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.
Sign in to Google to save your progress. Learn more
What did you set out to change or improve?
How did you change it? What new policy, process, or practice did you put in place?
Who was involved in making the change and what was each person’s role?
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?
What was the biggest barrier to making the change? How did you overcome that barrier?
If you had one piece of advice for someone who wanted to make a similar change in their setting, what would you advise?
Did you use BirthTOOLS during the process of making the change?  If so, how?
If you have data or other evidence that your change was successful, please provide that data.
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 contact information:
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy