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Patient Satisfaction Survey
Please mark the appropriate response. All comments, particular where you feel we could improve, are encouraged. If you have any questions, please contact us on 1300 378 747 or at DON@drtsirbas.com
1.
Were you given adequate instructions about how to prepare for your surgery before you arrived at the Day Surgery?
Yes
No
2.
Were you informed of any out-of-pocked expenses associated with your surgery prior to your admission?
Yes
No
3.
Was the 'Pick Up Instructions' and Map provided as part of your confirmation letter helpful?
Yes
No
4.
Was the time between your arrival and your surgery starting what you expected?
If not, please comment:
Yes
No
Comments:
5.
Were your goals (needs) met during your stay?
Yes
No
6.
Was your pain adequately managed? (knowing that there is some pain with all operations/procedures)
Yes
No
7.
Were you informed of how to alert nurses if assistance were required?
Yes
No
8.
Was the Day Surgery clean?
Yes
No
9.
Did the Doctors and Nurses communicate adequately and respectfully with you during your stay?
Yes
No
10.
Was the post procedure refreshment satisfactory?
Yes
No
11.
Did you observe Doctors, Nurses and Staff washing their hands and/or using hand gel?
Yes
No
12.
Were you involved in decisions about your care as much as you wanted?
Yes
No
13.
When you asked questions, did you get answers you could understand?
Yes
No
14.
Was your carer of family involved in your care as much as you wanted them to be?
Yes
No
15.
Was adequate information given to you regarding what to do and what to expect when you left the Day Surgery?
Yes
No
16.
Were you satisfied that you knew what to do if you had concerns after you got home following the procedure?
Yes
No
17.
Were you satisfied with the overall care and service received?
Yes
No
18.
Would you recommend the Day Surgery to your family and friends?
Yes
No
19.
Do you have any suggestions to improve the care and service delivery at the Day Surgery?
Yes
No
Comments:
(Optional) Would you and/or your carer be interested i participating in one of our Consumer Partnership Forums to help us maintain optimal care and service delivery?
If you do, please provide your details below so that we can contact you:
20.
Name:
21.
Telephone number:
Thank you for your participation.
