Unit 1, 38B Albert Avenue, Chatswood NSW 2067
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Patient Satisfaction Survey
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Patient Satisfaction Survey
Patient Satisfaction Survey
1
About You
2
Your Most Recent Visit
Name
*
First
Last
Your Age Is:
*
Post Code
*
Gender:
*
Male
Female
Which language do you mainly speak at home?
*
English
Arabic
Greek
Italian
Spanish
Cantonese
Hindi
Mandarin
Vietnamese
Other
Please mark one box only. If more than one language, please indicate the one that you speak most often
Other Language
*
Are you of Aboriginal or Torres Strait Islander Origin?
*
Aboriginal origin
Torres Strait Islander origin
Both
None
In general, how would you rate your health?
*
Excellent
Very Good
Fair
Poor
Are you insured?
*
Yes
No
Which health fund do you belong to?
*
Who referred you to this Day Procedure Centre?
*
My General Practitioner
My Surgeon
Other
Who referred you?
*
About the most recent time you were admitted to our day procedure centre.
The following questions are about the most recent time you were admitted to our day procedure centre. Please think about your entire experience with our day procedure centre, including all staff you came in contact with and all areas visited.
1. Appointment / Waiting Times
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
1a) The information made available to me to prepare for my appointment.
1b) The way I was treated on the phone.
1c) The overall waiting times I experienced.
Comments / Suggestions for improvement
2. Location And Physical Access
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
2a) Availability of drop off areas.
2b) Availability of car parking.
2c) Providing me with information on the location and public transport available to get to the day procedure centre (e.g. location maps, brochures, instruction from the staff).
2d) Inside and outside signs at the day procedure centre.
2e) Disability access.
Comments / Suggestions for improvement
3. Care, Services And Treatment
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
3a) Treating me with respect and dignity during my stay.
3b) How often the doctors, nurses and other health professionals caring for me, explained things in a way I could understand.
3c) Having a healthcare professional discuss my worries or fears about my condition or treatment.
3d) How much information about my condition or treatment was given to my family or carer.
3e) If I experienced pain, the staff doing everything they could do to help manage my pain.
3f) If I needed assistance, staff helping me within a reasonable timeframe.
3g) The overall cleanliness of the day procedure centre.
3h) The communication between the doctors and staff about my treatment.
3i) The overall care I received while in the day procedure centre.
Comments / Suggestions for improvement
4. Information
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
4a) Providing information about my rights and responsibilities in a way that was easy to understand and helpful.
4b) Providing information about my condition, procedure or treatment in a way that was easy to understand and helpful.
4c) Providing information about my consent to have treatment in a way that was easy to understand and helpful.
Comments / Suggestions for improvement
5. The Billing Process
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
5a) Providing advice and information on the cost of my procedure or treatment before admission.
5b) Providing information about my financial consent to have treatment easy to understand and helpful.
Comments / Suggestions for improvement
6. Decision Making And Involvement
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
6a) Being involved, as much as I wanted to be, in decisions about my care and treatment.
6b) Having enough opportunities for my carer or family to talk to the staff, if they wanted to.
6c) Allowing my carer or family to be involved in my care as much as I wanted them to be.
Comments / Suggestions for improvement
7. Discharge Process
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
7a) Making adequate arrangements for any services I needed following my discharge.
7b) Providing enough information about how to manage my care at home.
7c) Providing enough information about how to manage my medicines at home.
7d) Providing instructions for any follow-up appointments after my procedure or treatment.
7e) Providing an emergency telephone contact number and place or treating doctor for emergency medical care.
Comments / Suggestions for improvement
8. Transfer
How would you rate our day procedure centre as far as:
*
Very Poor
Poor
Fair
Very Good
Excellent
Don't know or Not Applicable
8a) Being provided with enough information about the reason for my transfer.
8b) Notifying my carer or relative about my transfer.
8c) Involving me and my carer in all parts of my transfer as much as possible.
8d) Making my transfer as easy and comfortable as possible.
Comments / Suggestions for improvement
In this section
Our Day Hospitals
Our Services
Patient Satisfaction
Medical Records and Privacy
Clinical Outcomes
ACHS Results
QPS Benchmarking Results
Internal Audits
