Survey Simulation & Walking-Tour Template (Interactive)

Purpose

This interactive template helps facilitators run a realistic unit-level accreditation simulation: a scripted walking tour, staff interviews, an evidence checklist, and a remediation tracker. Use it during preparation windows and monthly for high-risk units. Complete the checklist and interview fields during the tour, then record remediation items and follow-up owners.

Quick walking-tour script (prompts)

• Introduce purpose: "This is a preparedness simulation to learn and improve — not punitive."
• Observe posted policies, standard work, and competency records near the point of care.
• Ask staff to show policies and documentation for common prompts (e.g., isolation, medication safety, competency).
• Request to view three documentary items tied to survey standards (policy, competency proof, audit record).
• Note observable practices: hand hygiene, PPE, medication storage, equipment checks, documentation accuracy.

Staff interview prompts (use as cue cards)

• "Walk me through how you verify a medication order."
• "Where is the policy for isolation precautions? Can you show me?"
• "How are competencies for this task documented and refreshed?"
• "If a patient safety event occurs, what steps do you take and who do you notify?"

How to use this form

Complete the checklist while touring, capture interview notes, score overall readiness, and record remediation items. Save results to create a traceable record for follow-up. For units with many remediation items, repeat the simulation after actions are completed or export remediation lists for tracking.