Safety Issues Worksheet for Senior Executive Partnership

CUSP Toolkit

Safety Tool

Who should use this tool? Health care providers and the senior leader.

Date of safety rounds:___________
Unit:______________________
Attendees:
1.
2.
3.
4.
5.
6.
7.
8.
9.

Identified IssuesPotential/Recommended
Solutions		Resources Needed
1.  
2.  
3.  
4.  
5.  
6.  
7.  
8.  
9.  
Current as of December 2012
Internet Citation: Safety Issues Worksheet for Senior Executive Partnership: CUSP Toolkit. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/toolkit/safetysnrchklst.html