Part One: Tell Us How We're Doing

Heartland Kidney Network (HKN) is interested in your opinions and comments regarding the operations of our office and the services we offer.  As a quality focused organization, your evaluation of us is of great importance.  Please take a few minutes to complete this questionnaire.  The information provided will be used for monitoring and improving our services.  We ask that you submit your feedback no later than Tuesday, January 31, 2017.

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* 1. (1)  Topic:  I AM A ... (select your role/disciple ... check all that apply)

* 2. Topic:  CONTACTING HEARTLAND KIDNEY NETWORK (HKN)

  Always Most of the Time Some of the Time Never Does Not Apply
(2)  When I call HKN, my call is answered promptly.
(3)  When I call the Network, the staff is courteous and polite.
(4) When I email HKN staff, their response is timely.
(5)  When I fax HKN, my fax goes through.

* 3. Topic:  CORRESPONDENCE FROM HEARTLAND KIDNEY NETWORK

  Always Most of the Time Some of the Time Never Does Not Apply
(6)  When I receive a request for information from the Network (e.g., letter or email), the instructions are clear and easy to understand.
(7)  When I see something from the Network (e.g., on HKN letterhead, an email from Network staff or a flyer with the HKN logo), I know it is important for me to review the material.

* 4. Topic:  GENERAL PERCEPTIONS

  Always Most of the Time Some of the Time Never Does Not Apply
(8)  The Network is a resource that helps my unit in matters of quality of care and QAPI issues.
(9)  The Network is a resource for ESRD data and statistics.
(10)  The Network is a resource for dealing with patient/staff communication and professionalism issues.
(11) Overall, I view the Network as a partner for me and my unit to provide quality care/services.

* 5. (12) Overall, the performance of Heartland Kidney Network is ...

* 6. Topic:  RATING HEARTLAND KIDNEY NETWORK RESOURCE MATERIALS  (rate the Network materials on content)

  Very Good OK Very Poor Never Saw It (N/A)
(13)  Heartland Happenings -- a monthly electronic newsletter for dialysis and transplant facility staff
(14)  Heartland Headlines -- a periodic hardcopy newsletter for kidney patients
(15)  MY KIDNEY KIT -- a freestanding binder of patient education
(16)  MY KIDNEY CALENDAR -- a yearly calendar distributed to patients and dialysis units
(17)  HKN Posters -- "Patients' Rights and Responsibilities", "Let Your Voice Be Heard", "Talk Transplant" and "Network Information"
(18)  Infection control education offerings, including webinars on CDC's NHSN
(19)  Feedback reports and education related to Vascular Access
(20)  2015 Annual Report -- available online (http://heartlandkidney.org/article_resources/NW12_Final_2015_Annual_Report_Nov_30_Submission.pdf)
(21)  Website (www.heartlandkidney.org)
(22)  Facebook (www.facebook.com/heartlandkidney) -- used to promote patient education and stories
(23)  CROWNWeb support
(24)  Information related to ESRD QIP, Dialysis Facility Reports and Dialysis Facility Compare
Topic:  BEST WAYS TO COMMUNICATE WITH YOU

* 7. (25)  What is the BEST way to share key information with you?  - select one per row -

  Email Regular Mail Fax Telephone Call Facebook Post Tex (SMS)
a.  General Network News (e.g., meeting announcement and core Network communications)
b.  Network Project Information (e.g., project descriptions or feedback reports)
c.  Critical News Requiring Action (e.g., emergency response and reporting)
d.  Best Practices (e.g., educational workshops or tools)
e.  Patient Education Materials (e.g., fliers or games in support of Network projects)

* 8. (26) Think about your normal day.  When is the BEST time to share key information with you (by method)?

Email (when do you prefer to receive / read emails):
:
Direct Calls (when do you prefer to receive / make telephone conversations):
:
Webinars (when do you prefer to participate in web-based teleconferences):
:
Fax (when do you prefer to receive / make facsimile transmissions):
:

* 9. (27) Which days of the week are BEST for the Network to engage with you using these methods?

  Monday Tuesday Wednesday Thursday Friday Saturday
Email
Direct Call
Webinar
Fax
Topic:  OTHER ITEMS

* 11. (29) GENERAL COMMENT:  Feel free to use this space to share a suggestion for how HKN can improve, share a successful interaction with the Network, or leave your name (phone number and email address) for us to contact you directly

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