Carolinas HealthCare System
TeachWell Confirmation & Commitment Form
The TeachWell Confirmation & Commitment Form provides CHS nursing and other staff a means to confirm training on the use of Teach Back and Ask Me 3, two evidenced-based best practices, and make a commitment to using both health literacy practices.
First Name: |
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Last Name: |
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Facility/Network/Other: |
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Practice/Unit/Dept/Other: |
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Inpatient/Outpatient: |
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Clinical/Non-clinical: |
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Role: |
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On average, what percentage of your work day is spent in direct communication with patients and/or caregivers? |
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On average, how often do you think you will incorporate TeachWell techniques during your patient and/or caregiver communications? |
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All fields must be completed