Gap Analysis Facilitator's Guide: Appendix D

Anonymous Reporting Tool

The Gap Analysis process relies heavily on key informant interviews and perspectives, which often take place in a focus group setting. Many times individuals have additional, more sensitive information to share, or information/observations that are counter to the general consensus of the group in which they participated.

Recommendation: If possible, place these questions into an electronic survey system to ensure anonymity is preserved. Alternatively, attach the tool to an email and ask the recipient to print, complete, and return to the sender. As a final option, send the tool via email, but request that all responses go to a different person than who sent the message.

The following template can be used as an Anonymous Reporting Tool.

Recently you participated in a Gap Analysis Focus Group, and we would like to give you the opportunity to provide us with any additional feedback

  1. Please indicate which hospital(s) you currently practice in:
       _________________________________ [insert name]
       _________________________________ [insert name]
  2. Do you have any additional information to share with us about your experiences related to the topics covered in the Gap Analysis Focus Group?
 
  3. Do you have any advice for leadership about the best way to get staff on board with the CANDOR process?
 

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Proceed to Appendix E

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Page last reviewed April 2016
Page originally created April 2016
Internet Citation: Gap Analysis Facilitator's Guide: Appendix D. Content last reviewed April 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module3-facguide-apd.html