Are you? | Male/female | |
How old are you? | <35, years | |
35–44 | |
45–54 | |
55–64 | |
≥65 | |
Where is your practice located? | City | Urban |
Suburb | Rural |
Small town | |
Rural area | |
|
General organisation and workload indicators | | |
How many full-time equivalent (FTE) doctors, including yourself, are in your practice? n | Continuous | <3/3–5/>5 |
On average, how much time are you able to spend with a patient during a routine consultation? | Continuous | <10 minutes/10–20 minutes/>20 minutes |
Thinking about your medical practice, estimate how many hours a week you typically work | Continuous | ≤40 hours per week/41–50 hours per week/>50 hours week |
In a typical week, about what percentage of time do you spend on the following: administrative issues | Continuous | ≤10%/11–20%/>20% |
What proportion of your patients who request a same- or next-day appointment can get one? | Almost all (>80%) | >50% |
Most (60–80%) | |
About half (about 50%) | About 50% |
Some (20–40%) | 20–40% |
Few (<20%) | <20% |
Do you and/or other personnel that work with you in your practice provide care in any of the following ways? — Make home visits | Yes, frequently | Yes, frequently |
Yes, occasionally | Yes, occasionally |
No | No |
|
Coordination indicators | | |
Do you and/or other personnel that work with you in your practice provide care in any of the following ways? | Yes, frequently | Yes/no |
Yes, occasionally | Yes/no |
No | |
•Coordinate follow-up care with hospitals for patients being discharged | | |
• Contact patients between visits to monitor their condition | | |
Do you or other personnel in your practice communicate with your patient’s home care provider about your patient’s needs and the services to be provided? | Routinely | Yes/no |
Occasionally | |
Never | |
Does your practice use personnel, such as nurses or case managers, to monitor and manage care for patients with chronic conditions that need regular follow-up care? | Yes, within practice | Yes, within practice |
Yes, outside of practice | Yes, outside |
Yes, within and outside | No |
No | |
After your patient has been discharged from the hospital, on average how long does it take before you receive the information you need to continue managing the patient, including recommended follow-up care? | <24 hours | ≤2 days |
24–48 hours | |
2–4 days | 2 days–2 weeks |
5–14 days | 3–4 weeks |
15–30 days | >1 month or never |
>30 days | |
Rarely or never | |
|
Quality-of-care indicators | | |
Does the place where you practice routinely receive and review data on the following aspects of your patients’ care? | Yes/no | |
• Clinical outcomes | | |
• Surveys of patient satisfaction and experiences with care | | |
• Patients’ hospital admissions or emergency department use | | |
• Percentage of patients who have received recommended preventive care | | |
Are any areas of your own clinical performances reviewed against targets at least annually? | Yes/no | |
Do you receive information on how the clinical performance of your practice compares with other practices? | Yes, routinely | Yes/no |
Yes, occasionally | |
No | |
|
Use of electronic tools | | |
Do you use electronic patient medical records in | Yes/no | |
your practice | | |
Do you use any of the following technologies in your | Yes, routinely | Yes, routinely |
practice? Electronic alerts or prompts about a | Yes, occasionally | Yes, occasionally |
potential problem with drug dose or drug interaction | No | No |