Title of Programmanaging Disruptive Behaviors to Improve Patient Care

CME Evaluation

Title of programManaging Disruptive Behaviors to Improve Patient Care

DateApril 8, 2015

Did the program achieve its primary objectives to change competence, performance, and/or patient outcomes?

Yes / No
Objective 1: Gain a better understanding of the nature and significance of disruptive behaviors and its negative downstream impact on staff relationships, process flow, patient safety, and quality of care / ☐ / ☐ /
Objective 2: Discuss the benefits of implementing appropriate education, training and behavioral modification programs to better understand and modify behavioral traits to enhance communication and team collaboration / ☐ / ☐ /
Objective 3: Discuss the importance of providing an effective early intervention program that provides appropriate administrative and behavioral support to help providers better adjust to the pressures of today's health care environment with the goal of improving individual well- being, satisfaction, care responsibilities and relationships and overall quality of care / ☐ / ☐ /

Use the following scale to rate the speaker(s) on content and presentation skills.

SA=Stronglyagree; A=Agree; D=Disagree; SD=Strongly disagree

Speaker: Alan Rosenstein, MD, MBA / SA / A / D / SD
Was well prepared and organized / ☐ / ☐ / ☐ / ☐ /
Made effective use of available time / ☐ / ☐ / ☐ / ☐ /
Presented the material in a clear, interesting and understandable manner / ☐ / ☐ / ☐ / ☐ /
The Program:
Content was consistent with the description provided on the registrationpage / ☐ / ☐ / ☐ / ☐ /
Will help me increase my knowledge / ☐ / ☐ / ☐ / ☐ /
Will help me increase my competence / ☐ / ☐ / ☐ / ☐ /
Will help me improve my performance / ☐ / ☐ / ☐ / ☐ /
Will help me improve patient outcomes / ☐ / ☐ / ☐ / ☐ /

As a result of participating in this activity, the primary thing I will do differently in my practice is?

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What might impede you from making this change?

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Was the activity free of commercial bias? Yes ☐ No☐

If no, please specify why not Click here to enter text.

What practice areas could you use additional training in to practice more effectively?

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In order to receive a CME Certificate for viewing the recorded version of this webinar, the following questions must be completed:

1.Which of these is not one of the spectrum of disruptive behaviors:

☐a.Fully engaged: collaborative

☐b.Non-compliant

☐c.Passive aggressive

☐d.Disruptive

2.“Disruptive behavior” is defined as:

☐a.Any inappropriate behavior, confrontation or conflict

☐b.Verbal abuse, physical or sexual harassment

☐c.Potentially negatively impact patient care

☐d.All of the above

3.In the recent Physician Stress and Burnout Survey, stress and burnout is:

☐a.Decreasing

☐b.Causing almost half of physicians (46%) to be severely stressed

☐c.Is caused only by controllable work-related factors

☐d.Only affects physicians, not other providers or patients

Physician Attendance Verification: I attended the entire presentation.

Signature with Credentials Click here to enter text.

Email Click here to enter text.Date Click here to enter text.

To receive CME credit for the recorded version of this webinar, type your name, email address and date above and check the box below to send it electronically to . It may also be faxed to Joleen Doty at 952-838-6808. Your CME certificate will then be emailed to you.

☐ By checking this box, I attest that the completed information is accurate. Please accept this as my signature.