Policies And Procedures

Practice Guidelines

Postpartum Evaluation Form

Disclosure and Resolution

QI/RM Statements




Cord Blood



QMA Risk Management LLC
Victoria Grace 1/24/2012

"Feedback is the breakfast of champions!"  …Ken Blanchard
Contains a combination of open-ended questions, multiple-choice questions and a rating system.  Be specific and restrict your questions to the most value added.

Include the following areas:

  • practitioner
  • service
  • medical care
  • client’s experience
  • cost/value
  • request for additional input – be specific

Add other areas you are concerned with or want feedback on.  Don’t wait until postpartum to ask for feedback – can ask ‘how am I doing?’ verbally at any time – take notes.
Consider giving the evaluation and explaining the purpose at the home visit and asking for its return at the postpartum visit.  Be inventive with ideas to make getting them back easier and more rewarding for your clients and yourself.
Evaluate usefulness: modify the evaluation form to meet your current needs for feedback
Review the feedback obtained and make changes to your practice accordingly