Outpatient - Patient and Family Experience Survey
1.
Who is completing this survey?
Patient
Family Member/Caregiver
2.
Your experience was at which Huron Health System Facility?
Alexandra Marine and General Hospital (AMGH - Goderich)
South Huron Hospital (SHH - Exeter)
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
Walk in Clinic
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
5.
Did the hospital change your appointment to a later date?
No
Yes, once
Yes, 2 or 3 times
Yes, 4 times or more
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
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
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
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
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
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
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
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
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)
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
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
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
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
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
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
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
22.
What else would you like to say about this outpatient experience?
(Please do not include any names, contact information, or identifying information)
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.
