TDMH DAY SURGERY Patient and Family Experience Survey
1.
Before your procedure, did a health professional explain what would happen to you in a way you could understand?
Definitely
For the most part
Not at all
Don't know/can't remember
2.
Did your doctor or anyone from the hospital give you easy to understand instructions about getting ready for your procedure?
Definitely
For the most part
Not at all
Don't know/can't remember
3.
Did a health professional explain any risks and/or benefits of the procedure in a way you could understand?
Definitely
For the most part
Not at all
Don't know/can't remember
4.
Before your procedure, did you know who to contact if your symptoms or condition got worse?
Yes
No
5.
Did you have enough time to talk about your health condition, worries or fears with the surgeon?
Definitely
For the most part
Not at all
Don't know/can't remember
6.
Did the surgeon listen carefully to what you had to say?
Definitely
For the most part
Not at all
Don't know/can't remember
7.
If you had questions to ask the surgeon, did you get answers that you could understand?
Definitely
For the most part
Not at all
I did not need to ask
8.
If you had questions to ask the anesthesiologist, did you get answers that you could understand?
Definitely
For the most part
Not at all
I did not need to ask
9.
Did team members treating and examining you introduce themselves?
Yes, all introduced themselves
Some introduced themselves
Few introduced themselves
Don't know/can't remember
10.
If your procedure did not start on time, how long did you have to wait?
I was seen on time or early
Up to 15 minutes
Up to 1 hour
More than 1 hour
Don't know/can't remember
11.
If you had to wait, were you told why?
Yes
No, but I would have liked a reason
No, but I didn't mind
Don't know/can't remember
Not applicable
12.
Were you involved as much as you wanted to be in decisions about your care and treatment?
Always
Usually
Sometimes
Never
13.
How much information about your condition or procedure was given to your family, caregiver or someone close to you?
Right amount
Not enough
Too much
No family, caregiver or other was involved
I didn't want any of them to have any information
14.
Before you left the hospital, did you have a clear understanding about all of your prescribed medications, including those you were taking before your procedure?
Definitely
For the most part
Not at all
Not applicable
15.
Do you think the hospital team did everything they could to prepare you to manage your pain after you left the hospital?
Definitely
For the most part
Not at all
Don't know/can't say
I did not need this information
16.
Before you left the hospital, were you told what would happen next (for example, did you need a follow-up appointment)?
Definitely
For the most part
Not at all
Not applicable
17.
Did you receive information about what symptoms or health problems regarding your procedure to watch for at home?
Definitely
For the most part
Not at all
I did not need this information
*
18.
Did you receive enough information from hospital team members about what to do if you were worried about your condition or treatment after you left the hospital?
(Required.)
Completely
Quite a bit
Partly
Not at all
19.
Did doctors, nurses or other health professionals talk to you about whether you would have the help you needed at home after you left the hospital?
Definitely
For the most part
Not at all
I did not need this information
20.
Overall, did you feel you were treated with respect and dignity while you were at the hospital?
Not at all
1
2
3
4
5
6
7
8
9
Helped Completely
10
Not at all
1
2
3
4
5
6
7
8
9
Helped Completely
10
21.
Canadians come from different ethnic backgrounds, religious beliefs and gender identifications. At our hospital we strive to treat everyone equally, fairly and appropriately. Have you experienced any challenges in these areas? If so, your input would be appreciated.
No
Yes
If Yes, please explain and provide your suggestions on how we can improve.
22.
Did you have any difficulty getting your needs met for mobility, hearing, vision or any other challenges you may have?
Yes
No
N/A
If yes, what were your challenges?
23.
Overall, at this visit, I had a very:
Poor experience
1
2
3
4
5
6
7
8
9
Good experience
10
Poor experience
1
2
3
4
5
6
7
8
9
Good experience
10
24.
Is there anything else you would like to say about your experience or is there a team member or group that you would like to recognize for providing exceptional care or service? Please specify below.
