Skip to main content
205-638-9100
Close
In this section
Back
Main Menu
Locations
Emergency Department
Pediatric Practices
Surgery Centers
Outpatient Centers
Programs & Services
Patients & Visitors
Clinics
Visitation
Planning Your Visit
Online Pre-Registration
Patient Billing Information
Patient Name Change Request Form
Financial Assistance
Request Medical Records
Request Medical Records (PDF)- English
Request Medical Records (PDF)-Spanish
Immunization Schedule
Immunization Catch-up Schedule
Find a Provider
Ways to Help
Support Children's
Volunteer Services
Donate Now
About Children's
For Healthcare Professionals
Careers
Newsroom
Español
View All
Dismiss Modal
Close
205-638-9100
About Children's
For Healthcare Professionals
Careers
Newsroom
Español
Locations
View All
Emergency Department
Pediatric Practices
Surgery Centers
Outpatient Centers
Patients & Visitors
Clinics
Visitation
Planning Your Visit
Online Pre-Registration
Patient Billing Information
Patient Name Change Request Form
Financial Assistance
Request Medical Records
Request Medical Records (PDF)- English
Request Medical Records (PDF)-Spanish
Immunization Schedule
Immunization Catch-up Schedule
Ways to Help
Support Children's
Volunteer Services
Locations
Programs & Services
Patients & Visitors
Find a Provider
Ways to Help
Donate Now
search
show off canvas menu
You must have JavaScript enabled to use this form.
SAFETY AND QUALITY DAY 2021
OBJECTIVES:
Upon completion of this live activity the participants will be able to
Develop skills to improve the quality and safety of care provided at your institution.
Identify potential quality and safety improvement projects in your everyday work environment.
Review the resources available at our institution to take action.
Examine quality improvement methodology.
Reflect on safety efforts by a diverse set of disciplines across the institution.
First Name
Last Name
Credentials:
M.D.
D.O.
CRNP
RN
Other
If Other, please specify:
Email
Address
City
State
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please evaluate the speaker and their lecture: “Health Equity and Quality Improvement” Allyson Hall, PhD
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “Reducing Length of Stay in Preterm Infants” Sam Gentle, M.D.
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “Grand Rounds: At the Intersection of Equity, Science and Social Justice: An Inflection Point for Organized Medicine” Joseph Wright, M.D.
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “How to Build Dashboards” Eric Brown
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “Food Insecurity” Samantha Hanna M.D. and Adolfo Molina, M.D.
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “Unplanned Extubations” Felicia Sifers, M.D.
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “Measurement for Quality Improvement” Sam Gentle, M.D.
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
Please evaluate the speaker and their lecture: “Screening for Social Risk Factors in Patient Care: Real-time Use of the Area Deprivation Index (ADI)” Gabriela Oates, PhD
Communication Skills & Clarity of Talk:
Outstanding
Good
Fair
Poor
How likely are you to make a change as a result of this lecture?
Very Likely
Considering Making a Change
Already Practice It
Not Relevant to My Practice
Not Likely
What change will you make?
What one idea did you think was the most beneficial to you?
SAFETY AND QUALITY DAY 2021 CONFERENCE EVALUATION
Was this conference free of commercial bias?
Yes
No
If no, please explain.
Commercial bias is defined as a personal judgment in favor of a specific product or service of a commercial interest.
A commercial interest is any entity producing, marketing, selling, re-selling, or distributing healthcare goods or services consumed by, or used on, patients.
Stated objectives were met during this activity?
Completely
Partially
Not at all
Suggestions for future topics, and why:
Comments on the overall activity:
ATTENDEE INFORMATION (IMPORTANT)
Background:
Faculty
Pediatrician
Other
If Other, please specify:
Credentials
PhD
Fellow
Resident
Nurse
M.D. or D.O.
Other
If Other, please specify:
Check here if you would like to be included on a cause analysis team.
Yes, please include me
No, do not include me
I agree to the
Terms and Conditions
.
Terms and Conditions
Terms and Conditions
Users are advised that the information submitted through this form may be transmitted over unsecured email and releases Children's of Alabama and its employees, agents, and subcontractors from all responsibility or liability for any claims or damages arising from the content of the Email Form or the transmission thereof. By selecting the "I agree to Terms and Conditions" checkbox user acknowledges these terms and conditions and consents to transmission of the form.
Leave this field blank
Translate this page