Outpatient - Patient and Family Experience Survey Question Title * 1. Who is completing this survey? Patient Family Member/Caregiver Question Title * 2. Your experience was at which Huron Health System Facility? Alexandra Marine and General Hospital (AMGH - Goderich) South Huron Hospital (SHH - Exeter) Question Title * 3. Your clinic visit was to which department? Diabetes Education Clinic Physiotherapy Diagnostic Imaging (Xray, Ultrasound, Bone Mineral Density, CT, Mammography) Community Lab (SHH Only) CardioRespiratory (ECG, Echo, Stress Test, Pulmonary Function Test, Holter, Blood Pressure Monitoring) Specialty Outpatient Clinics including (Family Practice, General Surgery, Gynecology, Internal Medicine, Cardiology, Obstetrics-Prenatal, Paediatrics, Skin Clinic, Small Talk) Dialysis Question Title * 4. In the last 12 months, how many times (including this one) have you visited this outpatient clinic for any condition? This was the only time 2 or 3 times 4 to 8 times More than 8 times Question Title * 5. Did the hospital change your appointment to a later date? No Yes, once Yes, 2 or 3 times Yes, 4 times or more Question Title * 6. Were you given directions to the location of the clinic inside the hospital? Yes, good directions were given Yes, I was given directions but needed additional help Yes, directions were given but I already knew where to go No directions were given. I had to ask for directions once inside No directions were given but I already knew where to go Question Title * 7. Before your appointment, did you know what would happen to you during the appointment? Definitely For the most part Somewhat Not at all Don't know/Can't remember Question Title * 8. If your appointment did not start on time, how many minutes did you have to wait in the waiting room? I was seen on time, or early I waited up to 15 minutes I waited up to 60 minutes I waited more than 60 minutes Don't know/Can't remember Question Title * 9. If you had to 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 to wait Question Title * 10. Did a member of the staff tell you how you would find out the results of your test(s)? Definitely For the most part Somewhat Not at all Not sure/Can't remember I did not need an explanation Did not have a test Question Title * 11. Before the treatment began, did a health professional explain any risks and/or benefits in a way you could understand? Definitely For the most part Somewhat Not at all Don't know/Can't remember I did not want or need an explanation I did not have treatment Question Title * 12. Did the health professionals treating and examining you introduce themselves? Yes, all of the staff introduced themselves Some of the staff introduced themselves Very few or none of the staff introduced themselves Don't know/Can't remember Question Title * 13. How much information about your condition or treatment was given to your family, caregiver or someone close to you? Not enough Right amount Too much No family, caregiver or friends were involved They didn't want or need information I didn't want them to have any information Don't know/Can't say Question Title * 14. Were you given enough privacy when discussing your condition or treatment? Definitely For the most part Somewhat Not at all (please tell us more in the open text box at the end of this survey) Question Title * 15. Sometimes during an appointment, a health professional may say one thing and another may say something quite different. How often, during your most recent visit, did this happen to you? Never Sometimes Usually Always Question Title * 16. How often, during your most recent visit, were you involved as much as you wanted to be in decisions about your care and treatment? Always Usually Sometimes Never Question Title * 17. Before you left the outpatient area were you told what would happen next (for example, did you need another appointment, did you need to see you family doctor)? Definitely For the most part Somewhat Not at all Don't know/can't remember Question Title * 18. 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 * 19. Overall, did you feel you were treated with respect and dignity while you were at the clinic? Definitely For the most part Somewhat Not at all Question Title * 20. Overall...(Please pick a number) 0 I had a very poor experience 1 2 3 4 5 6 7 8 9 10 I had a very good experience Question Title * 21. Thinking about your experience related to this visit, to what extent did you experience smooth transitions between the outpatient area and other locations or health professionals? Always Usually Sometimes Never Not applicable Question Title * 22. What else would you like to say about this outpatient experience? (Please do not include any names, contact information, or identifying information) Question Title * 23. Is there a staff member or group that you would like to recognize for providing exceptional care or service? If you have any immediate questions or concerns regarding your experience with us, please contact our Patient Relations Office using the contact information below. Done