2017 - Day Surgery Patient Experience Survey AMGH Day Surgery Patient Survey Would you recommend our operating room services to your family and friends? Question Title * 1. Would you recommend our operating room services to your family and friends? Yes No OK Did you attend a pre-admit clinic with a nurse prior to your scheduled procedure? Question Title * 2. Did you attend a pre-admit clinic with a nurse prior to your scheduled procedure? Yes No - If no, skip to question 6. OK At your pre-admit clinic visit, how often were you treated with respect and courtesy? Question Title * 3. At your pre-admit clinic visit, how often were you treated with respect and courtesy? Always Usually Sometimes Never OK At your pre-admit clinic, how often were things explained to you in a way you could understand? Question Title * 4. At your pre-admit clinic, how often were things explained to you in a way you could understand? Always Usually Sometimes Never OK Did your pre-admit clinic prepare you for your experience on the day of your procedure? Question Title * 5. Did your pre-admit clinic prepare you for your experience on the day of your procedure? Yes No OK On the day of your procedure, how often did staff treat you with respect and courtesy? Question Title * 6. On the day of your procedure, how often did staff treat you with respect and courtesy? Always Usually Sometimes Never OK On the day of your procedure, how often did the staff respect your privacy? Question Title * 7. On the day of your procedure, how often did the staff respect your privacy? Always Usually Sometimes Never OK On the day of your procedure, were you seen close to your scheduled appointment time? Question Title * 8. On the day of your procedure, were you seen close to your scheduled appointment time? Yes No OK On the day of your procedure, were things explained to you in a way you could understand? Question Title * 9. On the day of your procedure, were things explained to you in a way you could understand? Yes No OK On the day of your procedure, how often was your pain well controlled? Question Title * 10. On the day of your procedure, how often was your pain well controlled? Always Usually Sometimes Never OK On the day of your procedure, when you were discharged did you know who to call if you had any questions or concerns? Question Title * 11. On the day of your procedure, when you were discharged did you know who to call if you had any questions or concerns? Yes No OK On the day of your procedure, when you were discharged were you given printed instructions regarding care and follow up? Question Title * 12. On the day of your procedure, when you were discharged were you given printed instructions regarding care and follow up? Yes No OK Were all of your questions answered before you left? Question Title * 13. Were all of your questions answered before you left? Yes No OK Is there anyone you would like to recognize for providing exceptional care? Question Title * 14. Is there anyone you would like to recognize for providing exceptional care? OK Is there anything else we could do to improve your experience at AMGH? Question Title * 15. Is there anything else we could do to improve your experience at AMGH? OK Please provide full name and contact information if you would like to discuss your experience with a member of our leadership team. Question Title * 16. Please provide full name and contact information if you would like to discuss your experience with a member of our leadership team. OK DONE