Emergency Department Patient Experience Survey

Thank you for taking the time to complete our Emergency Department Patient Satisfaction Survey. We value your input. Please answer the questions about your recent visit to the emergency department. Do not include any other experiences in your answers.

During this emergency department visit.......

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* 1. If you had a long wait, were you told why?

No, but I would have liked to know the reason

No, but I did not mind

Don't know / Can't remember

I did not have a long wait

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* 2. How often did care providers treat you with courtesy and respect?

Never

Sometimes

Usually

Always

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* 3. How often did care providers explain things in a way you could understand?

Never

Sometimes

Usually

Always

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* 4. Did you feel there was good communication within your care between doctors, nurses, and other hospital staff?

Never

Sometimes

Usually

Always

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* 5. Did you get the emotional support you needed to help with your anxieties, fears, or worries you had during this hospital visit?

Never

Sometimes

Usually

Always

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* 6. Did care providers do everything they could to ease your discomfort or symptoms?

Yes, Somewhat

Yes, mostly

Yes

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* 7. Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital?

Not at all

Partly

Quite a bit

Completely

Question Title

* 8. Overall, how would you rate your experience in the emergency department?

10 (best)

Clear

i We adjusted the number you entered based on the slider’s scale.

Emergency Department Patient Experience Survey

Question Title

* 1. If you had a long wait, were you told why?

Question Title

* 2. How often did care providers treat you with courtesy and respect?

Question Title

* 3. How often did care providers explain things in a way you could understand?

Question Title

* 4. Did you feel there was good communication within your care between doctors, nurses, and other hospital staff?

Question Title

* 5. Did you get the emotional support you needed to help with your anxieties, fears, or worries you had during this hospital visit?

Question Title

* 6. Did care providers do everything they could to ease your discomfort or symptoms?

Question Title

* 7. Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital?

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* 8. Overall, how would you rate your experience in the emergency department?

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* 9. What else would you like to say about this emergency department experience?