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G. Data and Evaluation

Tracking program utilization and outcomes is an important step in ensuring the longevity and continuous improvement
of the program. Below are recommended surveys for your institution to collect:

  • Peer Supporter Training Evaluation: This should be customized to the training offered at your institution, and should solicit feedback on the prerequisite materials, meeting format (in-person vs. virtual), breakout rooms, and the extent to which learning objectives were met.
  • Peer Support Feedback Survey: This feedback form solicits feedback from Peers who received Peer Support (see Triage and Deployment Process above for sample)
  • Peer Supporter Interventions Form: This form documents the interventions performed by a Peer Supporter, and also gives Peer Supporters an opportunity to offer feedback on the program (see Triage and Deployment Process above for sample)
  • Hospital-Wide Peer Support Program Survey: This feedback survey should be customized to your institution’s unique Peer Support program, and should solicit feedback on the Peer Support program’s utilization, effectiveness, and impact on Safety Culture
Triage and Deployment Process: To Do’s
☐ Create Peer Supporter Training Evaluation

☐ Create Peer Support Feedback Survey

☐ Create Peer Supporter Interventions Form

☐ Create Hospital-wide Peer Support Program Survey

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