University of Wisconsin–Madison

Tools

Computerized Provider Order Entry in ICUs

3 Month Post-Implementation Questionnaire
12 Month Post-Implementation Questionnaire – Physicians
12 Month Post-Implementation Questionnaire – Nurses
Usability Evaluation Planning Document
Heuristic Evaluation Definitions and Worksheet
Heuristic Evaluation Script
Specifications, Script, Data, Collection Tool for eMAR Usability Testing Evaluation
Slide Presentation – Usability Principles and Methods
Slide Presentation – Scenario-Based Usability Evaluations

Health IT and Practice Redesign
Interview Guide for Clinicians and Office Staff
Clinician and Office Staff Survey
Pre-Visit Questionnaire
Patient Interview Guide

Keystone Beacon Community
Baseline Health Information Exchange Questionnaire – Clinicians
Beacon Care Manager Survey
Beacon Clinician Questionnaire
Care Manager Questionnaire
Care Manager and Clinician Questionnaire
KBC Process Evaluation Questionnaire
Patient Satisfaction with Hospital Care Questionnaire
Case Manager Observation Guide
KBC MMA’s Interview/Observation Guide
Care Coordination Interview Guide – Case Managers
Care Coordination Interview Guide – Others
Case Manager Interview Guide
Case Manager Final Interview Guide
KBC Management Team Interview Guide
Patient Satisfaction with KBC Care Management Interview Guide
KBC Care Manager Focus Groups Process
Patient Focus Group

Mychart Bedside
Parent Survey
MCB Pre-Implementation Survey
MCB Post-Implementation Survey

Nursing Work Obstacles
Performance Obstacles of ICU Nurses Questionnaire

Pediatric Family Centered Rounds
Children’s Hospital Safety Climate Questionnaire
Family-Centered Rounds Toolkit

SAFE – C
Instructions for Nurses and MAs
Patient Scenarios to be used during training sessions
Physician Overview of the Patient Overview Process
Teamwork-Huddle Training
Training Evaluation
Patient Overview Document
Patient Overview Document with Sample Questions and Cues

Smart IV Pump Implementation
BCMA Observation Form
Pre-Implementation Pump Observation Guide
Post-Implementation Pump Observation Guide
Post-Pump Observation Interview Guide
Usability Testing Script & Data Collection Guide
Usability Testing Questionnaire – Anesthesiology
Usability Testing Questionnaire – Nursing
Pre-Implementation Questionnaire
3 Months Post-Implementation Questionnaire
One Year Post-Implementation Questionnaire
Team Evaluation Interview Guide

Virtual ICU
Tele – ICU Characteristics Survey
Tele – ICU Observation & Interview Guide
Tele – ICU Manager Interview Guide
Tele – ICU Nurse Interview Guide
Tele – ICU Questionnaire

VTE and Health IT
VTE Prophylaxis Risk Assessment Tool Survey: Physicians
VTE Prophylaxis Risk Assessment Tool Survey: Nurses
VTE Prophylaxis Risk Assessment Tool Survey: Pharmacists
Multidisciplinary Rounds Observation Tool
VTE prophylaxis – VTE Interview Guide

Human Factors in Computer & Information Security
Pilot Study Questionnaire
Explanation of Topics in Questionnaire

Paths to Retention & Turnover in the IT Workforce
Full Length Version of Questionnaire
Shortened Version of Questionnaire
Comparison of Initial & Revised Questionnaire

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