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We have tried to make your visit to Dayton Children's Almost Home Unit as pleasant and efficient as possible. Your complete satisfaction is our goal. To help us evaluate and improve our services, we need your feedback. Even if you have given us your opinions before, please take a few minutes to fill out this survey regarding your most recent visit.

Please rate the following services you or your child received by indicating the response that best represents your feeling. Also, please comment on any good or bad experiences you may have had during this visit. Thank you!

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* 1. Ease of admission process on the Almost Home Unit?

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* 2. Cleanliness of your child's room?

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* 3. Accommodations for family members?

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* 4. Noise level in and around room?

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* 5. Availability of books/toys/video games/other activities for your child?

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* 6. Availability of food your child likes to eat?

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* Comments (please describe good or bad experiences)

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* 7. How well the doctor listened to you and explained your child’s condition and treatment?

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* 8. How well the nurses listened to you and explained your child's tests, treatments, and equipment?

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* 9. How well the nurses checked your child's ID band before giving medications?

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* Comments (please describe good or bad experiences)

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* 10. Staff responsiveness to call lights?

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* 11. Staff sensitivity toward any pain or discomfort your child experienced?

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* 12. Staff concern for your child's privacy?

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* 13. Staff responsiveness to any concerns or complaints?

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* 14. Overall coordination of your child's care and treatment?

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* 15. Your understanding of the follow-up care required after your visit?

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* 16. Assistance provided to you at discharge?

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* 17. Overall quality of care received in the Almost Home Unit?

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* 18. Likelihood of recommending the Almost Home Unit to others?

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* Comments/suggestions for improvement (please be specific)

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