Ambulance staff questionnaire


1. What is your current role/job title? .....................................................................................................................................................
2. How long have you held this role? ......................................................................................................................................................
3. Have you received any formal training in the handover of patients to emergency department staff? (please circle most appropriate answer)
Yes		No
Was that training:
Very poor
Poor
Average
Good
Very good
How could it be improved? ................................................................................................................................................................
4. From the last handover what do you feel were the most important pieces of information? ......................................................................
5. Was the quality of this handover
Very good
Good
Average
Poor
Very poor
Please give reasons for your answer .....................................................................................................................................................
6. What additional information are you often asked for? ...........................................................................................................................
7. What common problems do you encounter during handover? ................................................................................................................

Medical staff questionnaire

1. What is your current role/job title? .......................................................................................................................................................
2. How long have you held this role? ........................................................................................................................................................
3. Have you received any formal training in receiving the handover of patients from ambulance staff? (please circle most appropriate answer)
Yes	No
Was that training
Very poor
Poor
Average
Good
Very good
4. For the last patient handover please can you recall as much information as possible in the space below, without formally identifying the patient concerned: ..............................................................................................................................................................................................................
5. What additional information do you often ask for? ...............................................................................................................................
6. What common problems do you encounter during handover? ................................................................................................................