Evaluation: Medical

Evaluation: MedicalMichael2019-01-30T10:44:29-06:00

Evaluation: Medical Care

Employee Name*
First Last
Patient Name*
First Last
TRIAGE EVALUATION

Triage*

	YES	NO	N/A
Was the room checked for cleanliness?
Did the medical professional introduce themselves to the patient?
Was the exam room door completely closed?
Did the medical professional start a movie for the patient?
Did the medical professional explain the volume control and movie selection process?
Did the medical professional use hand sanitizer upon entering the room before touching patient and when leaving?
Were the patient’s vitals entered into the EMR using an electronic device while in the exam room?
Was the medical history reviewed?
Was the social history reviewed?
Was the family history reviewed?
Was the surgical history reviewed?
Was the medication history reviewed?
Were allergies reviewed?
Were point of care test results entered into the EMR within an acceptable time?
Was the medical professional logged into Google email and chat?
Upon discharge, were care plan and RX given and reviewed?

How long did it take for the medical professional to complete vitals and enter the data into the EMR?*
How long did it take for the medical professional to complete OVERALL triage?*
Comments / Observations / Improvements
Evaluated By*
First Last