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Questionnaires
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Author: Hospital
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Publishing date: 17 June 2002 12:11pm
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The South Coast District Hospital aims to provide high quality health care and services to the community. The purpose of this survey is to find out what you think about the South Coast District Hospital as a place to receive health care.
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Please circle your response
ACCESSIBILITY
1. How easy was it for you and your visitors to find your way to the Hospital?
Very easy /Some problems /Quite difficult
If you encountered any problems - please write the details, or suggest ways we can improve the signs.
2. Are the signs in the Hospital adequate - that is, how easy was it for you and your visitors to find the right department?
Very easy /Some problems/ Quite difficult
If you encountered any problems - please write the details, or suggest ways we can improve the signs
3. Do you have a problem with your mobility (ie. you use a wheelchair, walking stick, frame etc)
Yes/No - please go to Question 4
If you answered 'yes' - did you find the physical access to and within the hospital adequate for your needs - that is - sufficient ramps, automatic doors etc.
Adequate/ Some Problems/ Great Difficulty
4. Do you have any suggestions on how we can improve access to the Hospital? (eg. more ramps, wheelchairs etc)
5. Are the visiting hours appropriate?
Yes/No (suggestions welcome)
6. Are the Reception hours appropriate?
Yes/No (suggestions welcome)
ADMISSION PROCESS
7. When you were admitted to the Hospital, how would you rate the following
a) Waiting time from presenting to Hospital and being taken to your room
Good - very efficient/ Satisfactory/Delay unacceptable
b) Manner and courtesy of ward staff when taken to your room
Above expectation/ Satisfactory/ Below expectation
c) Efficiency of the admission process - that is, staff gaining the necessary information from you and giving you any information you required.
Above expectation/ Satisfactory/Below expectation
8. YOUR RIGHTS AS A PATIENT
a) Did you have access to a copy of "Your rights and responsibilities"
Yes/No
b) Did you feel your rights were respected while in hospital
Yes/No
CARE AND TREATMENT
9. In relation to your care and treatment, how would you rate the following?
a) Attitude of the nursing staff?
Above expectation/ Satisfactory/Below expectation
b) Attitude of cleaning/catering staff?
Above expectation/ Satisfactory/Below expectation
c) Information given regarding your care and treatment, including possible alternatives?
Above expectation/ Satisfactory/ Below expectation
d) Recognition of your opinions regarding your care and involving you in planning your care?
Above expectation/ Satisfactory/ Below expectation
e) Involving your family/carer about your care and treatment?
Above expectation/ Satisfactory/ Below expectation
f) Respect for your privacy?
Above expectation/ Satisfactory/ Below expectation
10. In relation to your condition, how would you rate the following
a) Information given to you and/ or your carer about your diagnosis (illness) and prognosis (outcome)?
A lot of information given/ Satisfactory/ Little information given
b) Information regarding all tests to be carried out?
A lot of information given/ Satisfactory/ Little information given
c) Information about treatments, including medication?
A lot of information given/ Satisfactory/ Little information given
PHYSICAL FACILITIES
11. In relation to the physical facilities - how would you rate the following?
a) General condition and appearance of your room
Above expectation/ Satisfactory/ Below expectation
b) Overall cleanliness of your room
Above expectation/ Satisfactory/ Below expectation
c) Cleanliness of the toilet and shower
Above expectation/ Satisfactory/ Below expectation
d) Did you feel you (and your belongings) were safe while you were in hospital?
No problem with security/ Satisfactory/ Below expectation
MEALS
12. In relation to your meals, how would you rate the following
a) Quality of the food
Above expectation/ Satisfactory/ Below expectation
DISCHARGE ARRANGEMENTS
13. Were you given enough notice regarding your expected discharge date?
Yes/No
14. How would you rate the way your discharge arrangements were handled
Above expectation/ Satisfactory/ Below expectation
15. How appropriate was your date of discharge?
You felt ready to go home/ You feel you needed a few more days in hospital/ You feel you could have gone home earlier
16. Would you recommend this hospital to your family or friends if they neede hospital care?
Definitely would/ Probably would/ Probably would not/ Definitely would not
If you would not recommend this hospital - is there a reason?
17. Was there anything about your experience at the South Coast District Hospital that was better than expected?
18. Was there anything about your stay at the South Coast District Hospital that was not as good as you expected?
19. We would welcome any other comments or suggestion you may like to offer
Thank you for your time and effort in completing this questionnaire.
Please forward your response to the hospital.
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