2017 Evaluation of Network Council Meeting and Overall Customer Satisfaction

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.

Question Title

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

Physician

Nurse

Social Worker

Dietitian

Technician

Patient

Medical Director

Unit Administrator

Corporate / Regional Manager

Administraive Assistant / Secretary

Other (please specify)

Question Title

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

Question Title

* 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.	(6) When I receive a request for information from the Network (e.g., letter or email), the instructions are clear and easy to understand. Always	(6) When I receive a request for information from the Network (e.g., letter or email), the instructions are clear and easy to understand. Most of the Time	(6) When I receive a request for information from the Network (e.g., letter or email), the instructions are clear and easy to understand. Some of the Time	(6) When I receive a request for information from the Network (e.g., letter or email), the instructions are clear and easy to understand. Never	(6) When I receive a request for information from the Network (e.g., letter or email), the instructions are clear and easy to understand. Does Not Apply
(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.	(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. Always	(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. Most of the Time	(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. Some of the Time	(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. Never	(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. Does Not Apply

Question Title

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

Question Title

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

Very Poor

Poor

Fair

Good

Very Good

Very Poor

Poor

Fair

Good

Very Good

Question Title

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

Topic: BEST WAYS TO COMMUNICATE WITH YOU

Question Title

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

Question Title

* 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):

Time

AM/PM

Direct Calls (when do you prefer to receive / make telephone conversations):

Time

AM/PM

Webinars (when do you prefer to participate in web-based teleconferences):

Time

AM/PM

Fax (when do you prefer to receive / make facsimile transmissions):

Time

AM/PM

Question Title

* 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	Email Monday	Email Tuesday	Email Wednesday	Email Thursday	Email Friday	Email Saturday
Direct Call	Direct Call Monday	Direct Call Tuesday	Direct Call Wednesday	Direct Call Thursday	Direct Call Friday	Direct Call Saturday
Webinar	Webinar Monday	Webinar Tuesday	Webinar Wednesday	Webinar Thursday	Webinar Friday	Webinar Saturday
Fax	Fax Monday	Fax Tuesday	Fax Wednesday	Fax Thursday	Fax Friday	Fax Saturday

Topic: OTHER ITEMS

Question Title

* 10. (28) (optional) From the topics listed below, consider what you would like to see as a Network-developed educational program / resource material, then select the form this education may take and the priority (need) you have for this material (low, medium or high priority):

	Webinar for Dialysis Staff	Webinar for Patients	My Kidney Kit Page - Education for Patients	Educational Flyer / Poster - Developed for the Dialysis Staff Audience	Educational Flyer / Poster - Developed for the Patient Audience
ESRD Quality Incentive Program (ESRD QIP)	ESRD Quality Incentive Program (ESRD QIP) Webinar for Dialysis Staff menu	ESRD Quality Incentive Program (ESRD QIP) Webinar for Patients menu	ESRD Quality Incentive Program (ESRD QIP) My Kidney Kit Page - Education for Patients menu	ESRD Quality Incentive Program (ESRD QIP) Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	ESRD Quality Incentive Program (ESRD QIP) Educational Flyer / Poster - Developed for the Patient Audience menu
CDCs NHSN Reporting Requirements	CDCs NHSN Reporting Requirements Webinar for Dialysis Staff menu	CDCs NHSN Reporting Requirements Webinar for Patients menu	CDCs NHSN Reporting Requirements My Kidney Kit Page - Education for Patients menu	CDCs NHSN Reporting Requirements Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	CDCs NHSN Reporting Requirements Educational Flyer / Poster - Developed for the Patient Audience menu
Decreasing Hospital Utilization	Decreasing Hospital Utilization Webinar for Dialysis Staff menu	Decreasing Hospital Utilization Webinar for Patients menu	Decreasing Hospital Utilization My Kidney Kit Page - Education for Patients menu	Decreasing Hospital Utilization Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	Decreasing Hospital Utilization Educational Flyer / Poster - Developed for the Patient Audience menu
Patient Modality Choice	Patient Modality Choice Webinar for Dialysis Staff menu	Patient Modality Choice Webinar for Patients menu	Patient Modality Choice My Kidney Kit Page - Education for Patients menu	Patient Modality Choice Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	Patient Modality Choice Educational Flyer / Poster - Developed for the Patient Audience menu
Vascular Access Management	Vascular Access Management Webinar for Dialysis Staff menu	Vascular Access Management Webinar for Patients menu	Vascular Access Management My Kidney Kit Page - Education for Patients menu	Vascular Access Management Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	Vascular Access Management Educational Flyer / Poster - Developed for the Patient Audience menu
Infection Control	Infection Control Webinar for Dialysis Staff menu	Infection Control Webinar for Patients menu	Infection Control My Kidney Kit Page - Education for Patients menu	Infection Control Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	Infection Control Educational Flyer / Poster - Developed for the Patient Audience menu
Vaccinations	Vaccinations Webinar for Dialysis Staff menu	Vaccinations Webinar for Patients menu	Vaccinations My Kidney Kit Page - Education for Patients menu	Vaccinations Educational Flyer / Poster - Developed for the Dialysis Staff Audience menu	Vaccinations Educational Flyer / Poster - Developed for the Patient Audience menu

Other (please provide as much detail as possible)

Question Title

* 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