TDMH IN-PATIENT Patient and Family Experience Survey

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* 1. Did Nurses treat you with courtesy and respect?

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* 2. Did Nurses listen carefully to you?

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* 3. Did Nurses explain things in a way you could understand?

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* 4. After you pressed the call button, did you get help as soon as you needed it?

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* 5. Did Doctors treat you with courtesy and respect?

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* 6. Did Doctors listen carefully to you?

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* 7. Did Doctors explain things in a way you could understand?

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* 8. Were your room/bathroom kept clean?

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* 9. Before giving you any new medication, did a Doctor or Nurse explain what the medicine was for and describe possible side effects?

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* 10. Did you get all the information you needed about your condition and treatment?

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* 11. Did you get the support you needed to help you with any anxieties, fears or worries you had during this hospital stay?

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* 12. Were your family or friends involved as much as you wanted in decisions about your care and treatment?

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* 13. Before you left the hospital, did you have a clear understanding of all of your prescribed medications, including those you were taking before your hospital stay?

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* 14. Did you receive enough information from the hospital team members about what to do if you were worried about your condition or treatment after you left the hospital?

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* 15. Canadians come from different ethnic backgrounds, religious beliefs and gender identifications. At our hospital we strive to treat everyone equally, fairly and appropriately. Have you experienced any challenges in these areas? If so, your input would be appreciated.

If yes, please explain and offer your suggestions on how we can improve:

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* 16. Did you have any difficulty getting your needs met for mobility, hearing, vision or any other challenges you may have?

If yes, what were your challenges?

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* 17. Overall, do you feel you were helped by your hospital stay?

Not at all
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2

3

4

5

6

7

8

9

Helped Completely
10

Not at all
1

2

3

4

5

6

7

8

9

Helped Completely
10

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* 18. Overall, I had a very:

Poor experience
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2

3

4

5

6

7

8

9

Good experience
10

Poor experience
1

2

3

4

5

6

7

8

9

Good experience
10

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* 19. Is there anything else you would like to say about your experience or is there a team member or group that you would like to recognize for providing exceptional care or service?