1 Start 2 Complete I am a: * New Site Champion and my workplace is a new member New Site Champion and my workplace has been a member for over 1 year Not a new Site Champion. I attended the training again as a refresher Please rate the extent that you agree/disagree with the following: * Strongly DisagreeDisagreeNeither Agree nor DisagreeAgreeStrongly Agree Strongly DisagreeDisagreeNeither Agree nor DisagreeAgreeStrongly Agree The content was applicable to my work The content was applicable to my work - Strongly Disagree The content was applicable to my work - Disagree The content was applicable to my work - Neither Agree nor Disagree The content was applicable to my work - Agree The content was applicable to my work - Strongly Agree The educational design and format of this activity facilitated my learning The educational design and format of this activity facilitated my learning - Strongly Disagree The educational design and format of this activity facilitated my learning - Disagree The educational design and format of this activity facilitated my learning - Neither Agree nor Disagree The educational design and format of this activity facilitated my learning - Agree The educational design and format of this activity facilitated my learning - Strongly Agree I have a better understanding of my role as a Site Champion I have a better understanding of my role as a Site Champion - Strongly Disagree I have a better understanding of my role as a Site Champion - Disagree I have a better understanding of my role as a Site Champion - Neither Agree nor Disagree I have a better understanding of my role as a Site Champion - Agree I have a better understanding of my role as a Site Champion - Strongly Agree I understand how to complete Medication Audits, distribute Client Surveys and Annual Reports I understand how to complete Medication Audits, distribute Client Surveys and Annual Reports - Strongly Disagree I understand how to complete Medication Audits, distribute Client Surveys and Annual Reports - Disagree I understand how to complete Medication Audits, distribute Client Surveys and Annual Reports - Neither Agree nor Disagree I understand how to complete Medication Audits, distribute Client Surveys and Annual Reports - Agree I understand how to complete Medication Audits, distribute Client Surveys and Annual Reports - Strongly Agree I am comfortable in accessing Parkinson's Foundation resources and other educational materials I am comfortable in accessing Parkinson's Foundation resources and other educational materials - Strongly Disagree I am comfortable in accessing Parkinson's Foundation resources and other educational materials - Disagree I am comfortable in accessing Parkinson's Foundation resources and other educational materials - Neither Agree nor Disagree I am comfortable in accessing Parkinson's Foundation resources and other educational materials - Agree I am comfortable in accessing Parkinson's Foundation resources and other educational materials - Strongly Agree I understand how the Member Portal will support my role as a Site Champion I understand how the Member Portal will support my role as a Site Champion - Strongly Disagree I understand how the Member Portal will support my role as a Site Champion - Disagree I understand how the Member Portal will support my role as a Site Champion - Neither Agree nor Disagree I understand how the Member Portal will support my role as a Site Champion - Agree I understand how the Member Portal will support my role as a Site Champion - Strongly Agree Participation in this activity will improve care I provide to people with Parkinson's Participation in this activity will improve care I provide to people with Parkinson's - Strongly Disagree Participation in this activity will improve care I provide to people with Parkinson's - Disagree Participation in this activity will improve care I provide to people with Parkinson's - Neither Agree nor Disagree Participation in this activity will improve care I provide to people with Parkinson's - Agree Participation in this activity will improve care I provide to people with Parkinson's - Strongly Agree I feel comfortable sharing outcome measures with senior management at my workplace I feel comfortable sharing outcome measures with senior management at my workplace - Strongly Disagree I feel comfortable sharing outcome measures with senior management at my workplace - Disagree I feel comfortable sharing outcome measures with senior management at my workplace - Neither Agree nor Disagree I feel comfortable sharing outcome measures with senior management at my workplace - Agree I feel comfortable sharing outcome measures with senior management at my workplace - Strongly Agree What new care strategies will you consider employing because of the site champion training? * Involve more team members to create the care plan for residents and clients Document and share successful cueing and care strategies with other team members Improve communication with family caregivers Share relevant information for medical providers regarding observed PD changes and prior to appointments Utilize visual reminders (TULIPS images) within care plan, medication records, client rooms, etc. Share medication audit/client survey/annual report outcomes with team members Other... What new care strategies will you consider employing because of the site champion training? Other... What are the barriers you face in your setting that may impact care for your residents and clients? (Check all that apply) * Time Resources Staffing schedules and structure Organizational/Institutional support Staff Interests Personal Bias No Barriers Other... What are the barriers you face in your setting that may impact care for your residents and clients? (Check all that apply) Other... Please rate the extent that you agree/disagree with the following: Because my workplace is a member of the Parkinson's Foundation Community Partners in Parkinson's Care program, I believe it will: * Strongly DisagreeDisagreeNeither Agree nor DisagreeAgreeStrongly Agree Strongly DisagreeDisagreeNeither Agree nor DisagreeAgreeStrongly Agree Positively impact the care my staff and I provide for people with Parkinson's Positively impact the care my staff and I provide for people with Parkinson's - Strongly Disagree Positively impact the care my staff and I provide for people with Parkinson's - Disagree Positively impact the care my staff and I provide for people with Parkinson's - Neither Agree nor Disagree Positively impact the care my staff and I provide for people with Parkinson's - Agree Positively impact the care my staff and I provide for people with Parkinson's - Strongly Agree Increase the number of residents or clients at my workplace Increase the number of residents or clients at my workplace - Strongly Disagree Increase the number of residents or clients at my workplace - Disagree Increase the number of residents or clients at my workplace - Neither Agree nor Disagree Increase the number of residents or clients at my workplace - Agree Increase the number of residents or clients at my workplace - Strongly Agree Actively engage and empower staff to provide better Parkinson's care Actively engage and empower staff to provide better Parkinson's care - Strongly Disagree Actively engage and empower staff to provide better Parkinson's care - Disagree Actively engage and empower staff to provide better Parkinson's care - Neither Agree nor Disagree Actively engage and empower staff to provide better Parkinson's care - Agree Actively engage and empower staff to provide better Parkinson's care - Strongly Agree Would you recommend other senior living communities and/or homecare agencies apply to become members of the Parkinson’s Foundation Community Partners in Parkinson’s Care program? * Yes No Do you have any concerns regarding your role and responsibilities as a Site Champion? * Yes No Please comment: If you have anything else you would like to share about your experience participating in Site Champion training, please comment here: Leave this field blank
