CHAS Standards Field Test Tool

For clinical staff and QIS committee field testing.

Instructions for Surveyors

Rating scale: 1 = Inadequate, 2 = Needs Improvement, 3 = Adequate, 4 = Excellent, N/A = Not Applicable.

Six evaluation dimensions: A. Clarity of Wording, B. Feasibility, C. Relevance, D. Measurability, E. Evidence Availability, F. Level Appropriateness.

Complete Facility Information before evaluating standards. Write specific comments. If a standard cannot be evaluated, mark N/A and explain why.

Section 1: Facility Information

Section 2: Standards & Measurable Elements for Evaluation

Select one standard, score it, and submit. Each submission saves one record to Google Sheets.

Evaluation Rating

Detailed Feedback

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