Debrief Follow Up for QI

1. Equipment and Instruments

Were there any equipment or supply issues today?

Please specify
Other

Give details

Add media

2. Staffing and Personnel

Were there any problems with staffing on the list today?

Please specify

Provide Details

3. Preparation and Planning

Were there any problems with preparation for the list today?

Please specify
4. Operating Room Environment

Were there any environment problems today?

Please select:
Take a photo

Provide details

5. Patient-related issues

Were there any DATIX incidents to report directly involving the patient ?

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.