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2025 Chronic Disease Education Program (CDEP)

Client Experience Questionnaire

Tell us about your experience! Your feedback helps us to improve the way we provide care. This questionnaire was built upon our Patient Values (Dignity, Respect and Trust, Information Sharing, Participation, Accessibility and Responsiveness and Quality).

If the question does not apply, please leave blank.
Dignity, Respect and Trust:
(If question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
a. I was treated with respect.
b. My privacy was respected as best it could be.
c. My cultural needs were considered. (e.g. individuals’ own beliefs, customs, social standards, traditions or religious beliefs)
d. Before providing care, staff members introduced themselves to me, where appropriate.
e. In general, staff were compassionate.
Information Sharing:
(If question does not apply, leave blank)
Always
Usually
Sometimes
Never
a. Staff talked to me about what medications I am taking at home. (e.g. prescription, supplements, herbal, etc.)
b. Staff talked to me about my health care options. (e.g. procedures/tests)
c. My healthcare provider used words I could understand.
d. I had the necessary information needed to make good decisions about my health.
e. The staff kept my information confidential and secure.
Participation:
(If question does not apply, leave blank)
Always
Usually
Sometimes
Never
a. Staff involved me or my family/support in making decisions about my care.
b. I was encouraged to take part in my care as much as I was able.
c. My choices were respected.
d. I was comfortable expressing concerns about my care.
Accessibility and Responsiveness:
(If question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
a. My care was well coordinated.
b. I was cared for in a timely manner.
c. I had access to the care I needed.
d. My concerns were taken seriously.
e. I am aware of the Prairie Mountain Health (PMH) services and programs available to get the support I need for my health care journey.
Quality:
(If question does not apply, leave blank)
Always
Usually
Sometimes
Never
a. I saw the health care provider(s) clean their hands before providing my care.
b. My identity was confirmed before receiving care. (e.g. asked my name, asked my date of birth)
Quality:
(If question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
c. My healthcare provider discussed risks or hazards that could cause falls/slips/trips (e.g. wet floors, icy sidewalks, uneven surfaces, electrical cords, etc.).
d. I felt staff were up to date on the skills needed to provide my care.
e. Overall, I was satisfied with the quality of care I received.
Chronic Disease Education Program Specific Questions:
(If question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
a. I was satisfied with the amount of time it took to get my first appointment after being referred (either by myself or my health care provider).
b. My educator gave me individualized information that met my specific needs.
c. The type of appointment (in-person, phone, Microsoft Teams or group session) worked well for my learning.
d. During my appointment my health care needs were met.
e. After my appointment or class, I better understood how to improve my health.
f. With support from this program, I feel more confident making decisions about my health and lifestyle.
Chronic Disease Education Program Specific Questions:
(If question does not apply, leave blank)
Yes
No
g. I was satisfied with the length of my appointment(s) (not too long, not too short).
Chronic Disease Education Program Specific Questions:
(If question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
N/A
h. The location for my in-person appointment was convenient.
i. I found the virtual classes helpful.
Chronic Disease Education Program Specific Questions:
(If question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
N/A
j. The length of time between follow up visits was suitable for my needs.
Comments:
Demographics: (of the patient)
Collected for statistical purposes only to target improvements.
Gender:
Ethnicity
Age:
Forward additional concerns or compliments regarding your care to Patient Relations.
Patient Relations: email patientrelations@pmh-mb.ca or
call 1-800-735-6596

Chronic Disease Education Program (CDEP) Patient Partner Volunteers Needed!! Someone just like you helped to design this survey!
We want to partner with existing CDEP patients or family members who might be interested in helping us review, design or
provide feedback to our services.

If you would like more information or if you think you might be interested in becoming a Patient Partner, please click on the link below or contact Patient Relations by calling 1-800-735-6596.

https://prairiemountainhealth.ca/forms/patient-partner/
Questions or concerns related to this survey can be sent to ceq@pmh-mb.ca

Thank you for your participation!