Critical Care Family Assistance Program

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CCFAP Readiness Survey

The following survey will assist your team in the assessment of your readiness to begin the replication of the CCFAP. The core project team should exam its work and assess its progress by using the scoring guide. Any item receiving a rating of 3 or lower should be examined, and the necessary adjustments should be made before proceeding with implementation plans. Hospitals with total scores of 48 or above are ready to begin the implementation process.

Rating Scale:

1=Strongly Disagree

2=Disagree

3=Neutral

4=Agree

5=Strongly Agree

Statement of Readiness	1	2	3	4	5
Need for family assistance and support in critical care units is clearly documented and has been acknowledged by staff and administration as priority.
It is clear how the project will advance the hospital's mission.
Specific outcomes for families and patients in critical care units have been identified.
Core project team members have been identified, and a project director and project coordinator have been selected.
Core project team members and their respective departments are strongly committed to the CCFAP initiative and are willing to commit resources to planning and implementation.
The core project team has developed an action plan with a specific timeline and schedule of activities.
The core project team has an implementation plan; they know HOW the action plan is going to be implemented by the team.
The core project team has the experience and capacity to mobilize staff for planning and implementation of the CCFAP initiative.
A budget has been developed for the project.
Financial resources are available or have the strong potential of being obtained for the project.
ICU staff and administration are committed to significantly change the hospital critical care environment to meet the needs of the families.
Hospital administration is supportive of the CCFAP and has committed resources (fiscal, physical, and human) toward this initiative.

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