Dear Valued NOSH Patient;

Re:  Your Experience with Wilson Memorial General Hospital site

Our records show that you recently visited our emergency department.  Because you had a recent visit to our emergency department, we are asking for your help.

The survey is part of an ongoing national effort to understand how patients view their hospital experience.  These results will help patients make important choices about their hospital care, and will help our hospital measure and improve the care we provide.

We hope that you will take the time to complete the survey.  Your participation is greatly appreciated.  After you have completed the survey, please return it in the pre-paid envelope.

Your participation is voluntary and completely anonymous, and will not affect your health benefits.  Your responses will be included with other responses received and will be used by the hospital for quality improvement.

Thank you for helping us to improve the health care for our patients. 

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* 1. Please identify from which NOSH site you accessed emergency services

Going to the emergency department

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* 2. When you first arrived at the emergency department, how long was it before someone talked to you about the reason why you were there?

During you emergency department visit

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* 3. During this emergency department visit, did you get care within 1 hour of getting to the emergency department?

People who took care of you

Please answer the following questions about the people who took care of you during your emergency department visit.

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* 4. During this emergency department visit, how often did nurses treat you with courtesy and respect?

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* 5. During this emergency department visit, how often did nurses listen carefully to you?

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* 6. During this emergency department visit, how often did nurses explain things in a way you could understand?

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* 7. During this emergency department visit, how often did doctors treat you with courtesy and respect?

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* 8. During this emergency department visit, how often did the doctors listen carefully to you?

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* 9. During this emergency department visit, how often did doctors explain things in a way you could understand?

Leaving the emergency department

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* 10. Before you left the emergency department, did you understand what symptoms or health problems to look out for when you left the emergency department?

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* 11. Before you left the emergency department, did a doctor or nurse tell you that you should take any new medicines that you had not taken before?

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* 12. Before you left the emergency department, did a doctor or nurse tell you what the new medicines were for?

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* 13. Before you left the emergency department, did someone discuss with you whether you needed to follow-up care?

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* 14. 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?

Overall Experience

Please answer the following questions about your visit to the emergency department named on the front of the survey. Do not include any other emergency department visits in your answers.

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* 15. How would you rate your care during this emergency department visit?

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* 16. Would you recommend this emergency department to your friends and family?

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* 17. Overall, how long did your visit to the emergency department last?

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* 18. During this visit to the emergency department, were you respected and your preferences considered regarding your treatment and care plan?

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* 19. During this hospital stay, did you have enough say about your treatment?

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* 20. Overall, how was your experience during your hospital stay? Please answer on a scale where 0 is “I had a poor experience” and 10 is “I had a very good experience”.

0 5 10
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i We adjusted the number you entered based on the slider’s scale.

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* 21. More information on my rating:

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* 22. Is there anything else you would like to share about your Emergency Department visit?

Thank you.

T