INDICATOR DEVELOPMENT FORM

Department: Anesthesia & ICU Measure Category:

Owner: Dr. Ezzat Salem Clinical Non clinical
Indicator name: Compliance to effective communication among care givers.
Objective: To monitor and ensure proper endorsement practice during shift change.
Monitoring Period: Monthly Quarterly Half-Yearly Annually
Type of indicator: Structure Process Outcome
Rationale for this indicator? (Why has this indicator been selected)
Meets SKH Objectives Accreditation Financial High Risk
Benchmarking Safety Issues Other (please specify):
Data source:
Medical Record Special log/tool Retrospective Incident Report
Patient Satisfaction Report Survey Concurrent
Department Logs Other (please specify):

Definition: Ensure 100% compliance to endorsement practice.

Numerator Statement: Denominator Statement:

Compliance to endorsement practice
Total number staff
Inclusions: Anesthesia doctors and technicians Exclusion: Other staff

Calculation Numerator/Denominator ×100

Actual: Q1 60%, Q2 90%, Q3 98% Target: 100%
Which of the following dimensions of quality/excellence does this indictor measure?
Appropriateness Access Effectiveness Efficiency Safety Acceptability
Are there external benchmarks, guidelines or internal targets for this indicator? Please specify.
No
Does Data collection base on sampling? Yes No
If yes, describe the sampling plan
Data reporting plan:
Bulletin Board
Who will receive the results?
Quality Department
Prepared by: Dr. Ezzat Salem Reviewed by: Ms. Ambika Approved by: Ms. Sheela Kurian

Reference: None

R-QUA-006 Rev (2) Jan 2023