AHRQ Safety Program for Ambulatory Surgery

Coaching Clinical Teams Module

Checklist for Creating an Observation Tool

This checklist can help you in each step of creating your observation tool.

Development Drafting Testing

(Before Drafting Your Tool) (Before Testing Your Tool) (Before Using Your Tool)

Make sure your tool— Make sure your tool— Make sure
Make sure that
your your
tool— tool:
 Has clear objectives  Is brief  Is tested by those who
 Is used at a clearly  Is readable  Is tested
will use itby those who will us
identified point in  Does not include  Takes less than 15
 Takes less than 15 minutes fo
time of patient care personal identifiers minutes
the for the
observer to fill out
 Builds on tools you  Uses simple sentence observer to fill out
already have structure and basic  Incorporates
AHRQ Pub. No. 16(17)-0019-02-EF
any feedback fro
February 2017
 Can be used to observe language feedback
the testingfrom the
teamwork,  Lists the items in the testing
communication, and order in which the team Make sure that:
Make sure that—
tone in addition to will perform them
 Every time you change your t
process you testyour
it before
change tool using
you it
 Focuses on things that
test it before using it
are visible to the  All observers are trained on
 All how observers aretool and give
to use the
observer
trained on how to use
teams constructive feedback
the tool and teams are
given
(Before constructive
Using Your Tool)
feedback

AHRQ Pub. No. 16(17)-0019-2-EF

May 2017