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Health Care Facility ED survey
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Health Care Facility ED survey
Health Care Facility ED survey
Katie Von Derau
2017-07-19T03:22:39+00:00
As our state’s provider of immediate, free and expert treatment advice in the case of exposure to poisonous, hazardous, or toxic substances, we would appreciate your time in completing our Emergency Department Survey and returning it to us. The Washington Poison Center serves as your partner in improving patient outcomes, reducing unnecessary hospital stays and treatments, and as the expert voice on poisoning and drug overdose.
Today's Date
*
Facility Name
*
If you are replying for more than one facility, PLEASE fill out a separate survey for each one.
Who is the best ADMINISTRATIVE contact person for general inquiries? This is NOT FOR INCOMING PATIENT NOTIFICATIONS OR WHEN DOING FOLLOW UP CALLS.
*
First
Last
Contact Title or Job Responsibility
*
Contact Email
*
We would like to add this email to our electronic news for updates on Toxic Trends, important public health alerts, and other PC news. (If you wish to OPT OUT please check the box below)
Opt Out of the electronic news
Please do not include me
Facility Details
*
Check all that apply.
Inpatient Beds available
ICU beds available
PICU beds available
Psych beds available
ED open 24/7
ED open limited hours
Other
Other details
Does your staff have access to Poisindex and other Micromedex resources in the ED?
*
Yes
No
Unknown
Do you have a general email address for your Emergency Department that can be used if faxing is not working?
*
For example- we could email treatment guidelines or Alerts.
Yes
No
General Email
We would like to add this email to our electronic news for updates on Toxic Trends, important public health alerts, and other PC news. (If you wish to opt out please check the box below)
Opt Out of the electronic news
Please do not include me
Do you have suggestions for how the poison center can help your staff improve patient care?
Would you like a follow up call to discuss the WAPC and how we can better serve you?
*
Yes
No
