AHI EMERGENCY DEPARTMENT (ED) Patient and Family Experience Survey
1.
What was the main reason you came to the Emergency Department (ED)?
An accident or injury
A new health problem
An ongoing health condition or concern
2.
When you first arrived at the ED, how long was it before someone talked to you about the reason you were here?
Less than 5 minutes
5 to 15 minutes
More than 15 minutes
3.
Did Nurses treat you with courtesy and respect?
Always
Usually
Sometimes
Never
4.
Did Nurses listen carefully to you?
Always
Usually
Sometimes
Never
5.
Did Nurses explain things in a way you could understand?
Always
Usually
Sometimes
Never
6.
Did Doctors treat you with courtesy and respect?
Always
Usually
Sometimes
Never
7.
Did Doctors listen carefully to you?
Always
Usually
Sometimes
Never
8.
Did Doctors explain things in a way you could understand?
Always
Usually
Sometimes
Never
9.
Do you feel there was good communication about your care between doctors, nurses and other hospital staff?
Always
Usually
Sometimes
Never
Don't know/Not sure
10.
Did care providers help to ease your discomfort, pain or symptoms?
Yes
Yes, mostly
Yes, somewhat
No
Not applicable
11.
Did you get the emotional support you needed to help you with any anxieties, fears or worries you had during this ED visit?
Always
Usually
Sometimes
Never
Not Applicable
12.
Before you left the ED, if given any new medications, did a Doctor or Nurse explain what the medicine was for?
Yes, definitely
Yes, somewhat
No
Not applicable
*
13.
Did you receive enough information from the 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
14.
Overall, how long did your visit to the ED last
Less than 1 hour
1-3 hours
3-6 hours
6-12 hours
12-24 hours
Greater than 24 hours
15.
Did team members provide communication and updates about your wait time?
Always
Usually
Sometimes
Never
16.
If you had a long wait, were you told why?
Yes
No, but I would have liked a reason
No, but I did not mind
Don't know/Can't remember
I did not have a long wait
17.
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
N/A
If Yes, please explain and offer your suggestions on how we can improve.
18.
Did you have any difficulty getting your needs met for mobility, hearing, vision or any other challenges you may have?
No
Yes
N/A
If yes, what were your challenges?
19.
Overall, do you feel you were helped by your hospital visit?
Not at all
0
1
2
3
4
5
6
7
8
9
Helped Completely
10
Not at all
0
1
2
3
4
5
6
7
8
9
Helped Completely
10
20.
Overall, at this ED visit, I had a very:
Poor experience
0
1
2
3
4
5
6
7
8
9
Good experience
10
Poor experience
0
1
2
3
4
5
6
7
8
9
Good experience
10
21.
What else would you like to say about this emergency department experience? (Please do not include any names, contact information or identifying information.)
Yes, I have more to say about this ED experience.
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