Attachment B -- Direct Observations Field Notes Form

Attachment A: Direct Observations Field Notes Form 0

Attachment B: Direct Observations Field Notes Form

This document should be used to record observations of workflow and care coordination within the clinic. Please record the time and other relevant factors contributing to care coordination workflows. If you have any questions about recording your observations, please contact your site leader.

Name of Observer:

Name of Clinic:

Date of Observation:

Time	Notes Free text observations of CC work	Comments Optional: circle relevant domain or add analytical memo
		people tools/technology tasks organization environment temporality aggregation context
		people tools/technology tasks organization environment temporality aggregation context
		people tools/technology tasks organization environment temporality aggregation context