*SAUSHEC - San Antonio Uniformed Services Health Education Consortium For a word copy of the CLEW questionnaire please email the primary author; woodson.s.jones.civ@mail.mil

SAUSHEC* CLINICAL LEARNING ENVIRONMENT WALK (CLEW)

Interviewer: ______________________________ Team: _________________________Unit: ______________________ Date/Time: _______________________

Interviewees: Resident (R) Fellow (F) Faculty (Fa) Nurse Other

1. Supervisiona. Are there concerns about R/F supervision? Yes No NA/DK†

b. Are there concerns about reaching a supervising attending? Yes No NA/DKc. Are staff able to verify R/F procedural competencies? Yes No NA/DK

2. Communication/Transitions a. Are there concerns with R/F/Fa transitions of care on unit? Yes No NA/DKb. Are there concerns with communication between teams? Yes No NA/DKc. Are there concerns with patients/families having adequate contact

with residents and attending (patient can patient identify primary provider) Yes No NA/DKd. Do physician rounds involve nursing and others? Yes No NA/DKe. Is a standardized process and/or template used for hand-offs? Yes No NA/DK

3. Duty Hours/Fatigue Mitigationa. Are there concerns regarding R/F duty hour? Yes No NA/DKb. Are there concerns of R/F impairment due to fatigue? Yes No NA/DK

4. Professionalism a. Are there concerns regarding R/F and professionalism? Yes No NA/DKb. Are there concerns about R/F abuse/mistreatment? Yes No NA/DKc. Are there concerns about documentation in med records? Yes No NA/DK

(cut and paste?)d. Are there concerns R/F have been pressured to compromise

their integrity to satisfy an authority figure? Yes No NA/DKe. Is there a culture of respect between teams on units? Yes No NA/DK

5. Patient Safety a. R/F know hospital’s patient safety priorities? Yes No NA/DKb. R/F (and attendings) file Patient Safety Reports (PSR)? Yes No NA/DKc. R/F receive feedback on PSR? Yes No NA/DKd. Patient Safety concerns are openly discussed (Safety Huddles)? Yes No NA/DKe. R/F conduct timeouts when performing bedside procedures? Yes No NA/DK

6. Quality Improvement a. Are R/F involved with QI on this unit? Yes No NA/DKb. Are there QI projects that would benefit from R/F involvement? Yes No NA/DKc. R/F know the core measures relevant to their unit/program? Yes No NA/DK

7. What is the most likely way a patient will be hurt on this unit?

8. How would you improve patient safety on your unit?

9. What is your greatest concern regarding residents?

Comments:

Follow Up Date:

All proceedings and records of the Graduate Medical Education Committee are confidential and all professional review actions and communications made to the Graduate Medical Education Committee are privileged under Texas and federal law. TEX .OCC .CODE ANN .CHPS.151 & 160; TEX

HEALTH AND SAFETY CODE ∋161.032; and 42 U.S.C. 11101 ∋et seq.

CLEWs Clinical Learning Environment Walks

Interviewer: Type of Team:

Unit: Date/Time:

Interviewees: Resident (R) Fellow (F) Faculty (Fa) Nurse Other

1. Supervisiona. Are there concerns about R/F supervision? Yes No NA/DKb. Are there concerns about reaching a supervising attending? Yes No NA/DK

2. Communication/Transitionsa. Are there concerns with R/F/Fa transitions of care on unit? Yes No NA/DKb. Are there concerns with communication between teams? Yes No NA/DKc. Are there concerns with Patients/families having adequate contact with providers (can patient identify primary provider) Yes No NA/DK

3. Duty Hours/Fatigue Mitigationa. Are there concerns regarding R/F duty hours? Yes No NA/DKb. Are you aware at any time of any R/F/Fa impairment due to fatigue? Yes No NA/DK

4. Professionalisma. Are there concerns regarding R/F/Fa and professionalism? Yes No NA/DKb. Are there concerns about resident abuse/mistreatment? Yes No NA/DKc. Are there concerns about documentation in med records? Yes No NA/DK

(cut and paste?)d. Are you aware of any R/F that has been pressured to compromise

their integrity to satisfy an authority figure? Yes No NA/DK

5. Patient Safetya. R/F/F know hospital’s patient safety priorities? Yes No NA/DKb. R/F file occurrence (eraf) reports? Yes No NA/DKc. R/F receive feedback on occurrence reports (eraf)? Yes No NA/DKd. Patient Safety concerns are openly discussed on unit (Safety Huddles)? Yes No NA/DKe. R/F conduct timeouts when performing bedside procedures? Yes No NA/DK

6. Quality Improvement –a. Are R/F involved with QI on this unit? Yes No NA/DKb. Are there QI projects that would benefit from R/F involvement? Yes No NA/DKc. R/F know the core measures relevant to their unit/program? Yes No NA/DK

7. Do Physician rounds involve nursing and others? Yes No NA/DK

8. Are you aware of the process to call for a taxi voucher used by R/F when fatigued? Yes No NA/DK

9. Is a standardized process and/or template used for hand-offs? Yes No NA/DK

10. Are you able to verify R/F procedural competencies (NI)? Yes No NA/DK

11. Is there a culture of respect between teams on units? Yes No NA/DK

12. How would you improve patient safety on your unit?

13. What is your greatest concern regarding residents?