MediNetOS Quality

Report Safety Incident

Operational Data Entry

Date & Time

Ward / Unit

Incident Type

Severity (WHO Scale)

Description

SERVQUAL Survey

Service Quality Gap Analysis (Expectation vs Perception)

Service Area *

Survey Date *

Rate each dimension twice: Expectation (what you expected) and Perception (what you experienced). Scale: 1-7

Tangibles

Physical facilities, equipment, staff appearance

Expectation 4

Perception 4

Reliability

Dependable and accurate service delivery

Expectation 4

Perception 4

Responsiveness

Willingness to help and provide prompt service

Expectation 4

Perception 4

Assurance

Knowledge, courtesy, trust and confidence

Expectation 4

Perception 4

Empathy

Individualized care and understanding of patient needs

Expectation 4

Perception 4

Additional Comments (Optional)

HeFRA Compliance Checklist

Facility Licensing Requirements

Inspector Name *

Area/Department *

Compliance Items

Fire extinguishers present and serviced Emergency exit signs illuminated Medical waste properly segregated Staff credentials displayed/accessible Equipment maintenance logs up to date

Notes / Findings

JCI Patient Safety Goals (IPSG)

International Patient Safety Goals Audit

Auditor Name *

Chapter/Area *

IPSG Compliance Items

IPSG.1: Patient Identification

Two identifiers used before procedures/medications

IPSG.2: Effective Communication

Read-back for verbal/phone orders

IPSG.3: High-Alert Medications

Proper storage and labeling of high-risk meds

IPSG.4: Correct Site/Procedure/Patient

Surgical site marking and time-out performed

IPSG.5: Infection Risk Reduction

Hand hygiene guidelines followed

IPSG.6: Fall Risk Reduction

Fall risk assessment and interventions in place

Observations / Required Actions

Infection Prevention Checklist

Ward/Unit Observation Audit

Observer Name *

Ward/Unit *

Infection Control Items

Hand Hygiene Compliance

5 moments of hand hygiene observed

PPE Usage Correct

Gloves, gowns, masks worn appropriately

Sharps Disposal

Sharps containers not overfilled, properly sealed

Surface Cleaning

High-touch surfaces cleaned per schedule

Isolation Precautions

Isolation signs posted, precautions followed

Observations / Notes

Log Patient Complaint

Patient Relations

Department *

Category *

Complaint Details *

Patient Contact (Optional)

New CAPA

Corrective & Preventive Action

CAPA Type *

Priority *

Issue Description *

Assigned Owner *

Due Date *

New Clinical Audit

Create a quality audit record

Audit Name *

Department *

Frequency *

Compliance Score (%) *

Findings / Notes

Schedule Audit

Plan a future audit

Audit Name *

Department *

Frequency *

Scheduled Date *

Assigned Auditor *

Notes

UGMC Healthcare Quality Management

Demo accounts:

Admin: siabi@ugmc.edu.gh / admin123

Staff: boateng@ugmc.edu.gh / staff123

Manage User Access

Select modules this user can access:

Add New User

Create a new system user

Full Name *

Email Address *

Department *

Role *

Initial Password *

Report Safety Incident

Staff Satisfaction Survey

Job Satisfaction (1-5 scale)

Patient Experience Survey

Service Experience (1-5 scale)

SERVQUAL Survey

Tangibles

Reliability

Responsiveness

Assurance

Empathy

HeFRA Compliance Checklist

Compliance Items

JCI Patient Safety Goals (IPSG)

IPSG Compliance Items

Infection Prevention Checklist

Infection Control Items

Log Patient Complaint

New CAPA

New Clinical Audit

Schedule Audit