Size of practice |
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How many general practitioners, including those working part time, currently work at your clinic?
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Presence of nurses |
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How many nurses currently work at your clinic?
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Information technologies used in the practice |
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In your clinic, do you use… |
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access to the health and social services telecommunications network?
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a Web-based appointment system for patients?
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computerized tools for continuing professional education?
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electronic medical records?
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electronic interface to diagnostic imaging laboratory services?
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computerized tools to aid medical decision-making?
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Blood taking service available in the same building |
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Are the following services available in the building where your clinic is located… |
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Blood samples taking?
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Radiology available in the same building |
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Are the following services available in the building where your clinic is located… |
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Radiology?
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Collaboration with other PHC practices |
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Does your clinic have formal or informal arrangements with other PHC clinics… |
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to schedule services offered?
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to access to technical services?
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to exchange resources?
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Collaboration with hospitals |
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Does your clinic have formal or informal arrangements with hospitals… |
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to schedule services offered?
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to access to technical services?
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to exchange resources?
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Predominant type of visits in the practice |
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What percentage of walk-in visits to all visits do you provide at your clinic? |
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0% to 25% = By-appointment visits |
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26 to 75% = Mixed |
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51% or more = Walk-in visits |
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Quantity of diagnostic or therapeutic services available in the practice |
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At your clinic, are the following services available… |
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Strep-test?
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Skin biopsy?
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IUD insertion?
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Musculo-skeletal injection/aspiration?
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Suture/minor surgery?
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Cervical smear (Pap test)?
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Childhood vaccination?
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Influenza vaccination?
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3 or less among these = Few |
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4 or 5 among these = A fair number |
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6 or more among these = Several |
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