This questionnaire is part of the research project “Development of New Methods for Operations Management in Healthcare Systems”, approved by the research ethics committee of Hospital de Clínicas de Porto Alegre (Brazil, www.hcpa.edu.br) - ethics approval number - 79424617.0.0000.5327. The objective is to assess the use of practices that support organizational resilience in intensive care units.
 
The study is part of the PhD thesis of student Wagner Pietrobelli Bueno (wagner.bueno@ufrgs.br), carried out at the Industrial Enginering Post-Graduation Program at the Federal University of Rio Grande do Sul (UFRGS), Brazil.

The supervisors are professors Tarcisio Saurin (saurin@ufrgs.br), Priscila Wachs (wachs.priscila@gmail.com), Ricardo Kuchenbecker (rkuchenbecker@hcpa.edu.br) and Marcio Boniatti (mboniatti@hcpa.edu.br). Prof. Robyn Clay-Williams (robyn.clay-williams@mq.edu.au) from Macquarie University (Australia) is a co-investigator. 
 
If your hospital has more than one ICU, consider only the ICU where you work to answer questions. The estimated time to answer the questionnaire is 15 minutes.


By answering this questionnaire, we assume that you give your informed consent. Your name will not be mentioned in any publication/report resulting from this research. It will be fully confidential. We are asking your identification data only for the purpose of following-up with you later on for gathering additional information if necessary. Please do not hesitate to contact us should you have any questions related to ethical matters.    

Thank you for your participation!

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* 1. Identification of the respondent

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* 2. Description of the hospital and ICU

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* 3. Regarding the administration and financing of the hospital, it is mostly:

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* 4. Is the hospital a teaching or university affiliated one?

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* 5. Is there a multiprofessional palliative care team?

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* 6. Is this hospital a reference center in one or more of the specialties below?

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* 7. Type of ICU

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* 8. Are all the ICU bays configured as individual rooms?

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* 9. Decision-making model

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* 10. Are there multidisciplinary rounds?

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* 11. How many doctors are dedicated exclusively to the ICU?

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* 12. How many nurses are dedicated exclusively to the ICU?

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* 13. Are there physiotherapists exclusively dedicated to the ICU?

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* 14. Are there pharmacists exclusively dedicated to the ICU?

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* 15. Are there psychologists exclusively dedicated to the ICU?

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* 16. Are there nutritionists exclusively dedicated to the ICU?

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* 17. Are there speech therapists exclusively dedicated to the ICU?

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* 18. Are there dentists exclusively dedicated to the ICU?

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* 19. Considering the last three months, indicate the ICU occupancy rate.

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* 20. Workplaces are clean and tidy, without unnecessary items such as used syringes, empty medicine bottles, used gloves, among others.

Strongly disagree Strongly agree
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* 21. The results of performance indicators (e.g. occupancy rate, mortality rate, etc.) are widely disseminated, through means such as posters, electronic panels, whiteboards, brochures, meetings.

Strongly disagree Strongly agree
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* 22. Information about the treatment and condition of each patient (e.g., exams, vital signs, medical records, prescriptions, care plan) are easily accessed by caregivers.

Strongly disagree Strongly agree
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* 23. Real-time information on the ICU status as a whole (e.g., number of hospitalized patients, number of patients waiting for beds, professionals on duty) is easily accessed by caregivers.

Strongly disagree Strongly agree
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* 24. The allocation of people changes as needed and in an agile way, such as, for example, reallocating staff from one area of the ICU to another.

Strongly disagree Strongly agree
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* 25. The allocation of material resources changes as needed and in an agile way, such as, for example, reallocating dialysis equipment and supplies from one area of the ICU to another.

Strongly disagree Strongly agree
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* 26. There are extra or standby human resources that can be quickly deployed, and these are available in sufficient quantity to cope with unforeseen events.

Strongly disagree Strongly agree
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* 27. There are extra or standby material resources that can be quickly deployed, and these are available in sufficient quantity to cope with unforeseen events.

Strongly disagree Strongly agree
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* 28. Caregivers have adequate time availability to carry out their activities, without excessive haste or too many simultaneous tasks.

Strongly disagree Strongly agree
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* 29. There are protocols, training or technological support for the early detection of the need for changing  the care plan (e.g., early detection of the need for palliative care, of sepses, of mobilizing the patient to facilitate rehabilitation).

Strongly disagree Strongly agree
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* 30. Decision-making about the plan of care takes into account the impacts on other units of the hospital (e.g., implications of discharge for the wards, implications for the sectors that perform medical exams).

Strongly disagree Strongly agree
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* 31. Decision making about the plan of care is multidisciplinary.

Strongly disagree Strongly agree
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* 32. Opinions of patients and family members are accounted for in healthcare decision-making.

Strongly disagree Strongly agree
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* 33. Interventions to improve ICU management and patient care protocols are developed by multiprofessional teams and, if relevant, involving representatives from other units of the hospital.

Strongly disagree Strongly agree
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* 34. Professionals know when, why, and how to adapt or fill in gaps in standardized operating procedures.

Strongly disagree Strongly agree
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* 35. There are routines to check reality against what is prescribed in care plans, protocols, and policies. Examples of possible routines: quality audits, meetings to compare expected versus actual performance.

Strongly disagree Strongly agree
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* 36. There are systems for voluntary reporting of incidents, abnormalities, or other relevant situations, such as unprofessional behaviour of coworkers.

Strongly disagree Strongly agree
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* 37. There are routines to learn from what goes well or from normal everyday variability. Possible examples: short meetings at the end of the working day (i.e. after action reviews), reporting systems for the dissemination of good practices.

Strongly disagree Strongly agree
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* 38. Changes in ICU management and patient care protocols are preceded by a study of how work actually occurs in practice, knowing its variability, constraints, and difficulties.

Strongly disagree Strongly agree
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* 39. Changes in ICU management and patient care protocols are made firstly on a small scale and rapid cycles, before large-scale implementation.

Strongly disagree Strongly agree
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* 40. As part of planning changes in ICU management and patient care protocols, there is a formal analysis of barriers and risks.

Strongly disagree Strongly agree
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* 41. When there are changes in ICU management and patient care protocols, multiple performance indicators are gathered for assessing the outcomes, contributing to the identification of unintended consequences.

Strongly disagree Strongly agree
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* 42. When there are changes in ICU management and patient care protocols, the outcomes are monitored over the medium (months) and long term (years), rather than just in the immediate post-intervention period.

Strongly disagree Strongly agree
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* 43. Patients are safe at this ICU.

Strongly disagree Strongly agree
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* 44. Professionals are safe at this ICU.

Strongly disagree Strongly agree
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* 45. This ICU is a resilient system, that is, it adapts and achieves the expected results despite adverse and unanticipated conditions.

Strongly disagree Strongly agree
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* 46. Please provide at least one example of resilient performance at the ICU system level (for example, measures to cope with the coronavirus pandemic).

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* 47. Would you like to receive a summary of the main results of this survey?

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* 48. You can use this space for comments or suggestions (for example, as to the clarity and relevance of the questions, as to the completion time, etc.). 

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