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My Hospital Experience
MICs Group of Health Services
1.
Discharge Date
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2.
I am being discharged from
Anson General Hospital
Bingham Memorial Hospital
Lady Minto Hospital
3.
My nurses listened carefully to me
Never
Sometimes
Usually
Always
Not Applicable
No Answer
4.
My nurses treated me with courtesy and respect
Never
Sometimes
Usually
Always
Not Applicable
No Answer
5.
My nurses explained things in a way I could understand
Never
Sometimes
Usually
Always
Not Applicable
No Answer
6.
When I pressed the call button, I got help when I needed it
Never
Sometimes
Usually
Always
Not Applicable
No Answer
7.
My doctors listened carefully to me
Never
Sometimes
Usually
Always
Not Applicable
No Answer
8.
My doctors treated me with courtesy and respect
Never
Sometimes
Usually
Always
Not Applicable
No Answer
9.
My doctors explained things in a way I could understand
Never
Sometimes
Usually
Always
Not Applicable
No Answer
10.
My room was kept clean
Never
Sometimes
Usually
Always
Not Applicable
No Answer
11.
My bathroom was kept clean
Never
Sometimes
Usually
Always
Not Applicable
No Answer
12.
My room and area were quiet at night
Never
Sometimes
Usually
Always
Not Applicable
No Answer
13.
My food and beverage serviced at an acceptable temperature
Never
Sometimes
Usually
Always
Not Applicable
14.
I received the service/assistance required in order to meet my needs at meal time.
Never
sometimes
Usually
Always
Not Applicable
15.
I received an X-ray and/or Ultrasound (Diagnostic Imaging) during my stay in hospital and it was a good experience.
Yes
No
Not Applicable
16.
My pain was well controlled
Never
Sometimes
Usually
Always
Not Applicable
No Answer
17.
Staff did everything they could to keep me comfortable
Never
Sometimes
Usually
Always
Not Applicable
No Answer
18.
I was told about new medication prescribed for me
Never
Sometimes
Usually
Always
Not Applicable
No Answer
19.
I was told what side effects to expect after starting new medication
Never
Sometimes
Usually
Always
Not Applicable
No Answer
20.
I was given a clear and complete explanation by the staff prior to any procedure or exam
Never
Sometimes
Usually
Always
Not Applicable
No Answer
21.
The hospital staff consulted me or my family or caregiver in making decisions about my care
Never
Sometimes
Usually
Always
Not Applicable
No Answer
22.
The quality of care or services provided by the staff was
Poor
Fair
Good
Very Good
Excellent
No Answer
23.
When I leave the hospital, I am going to
My own home
Someone else's home
Another healthcare facility
No Answer
24.
The help that I need to care for myself at home has been arranged
Yes
No
Not Applicable
No Answer
25.
Written information, about what to look out for after I leave the hospital, was provided to me
Yes
No
Not Applicable
No Answer
26.
I understand what I am responsible for to manage my health
Yes
No
Not Applicable
No Answer
27.
Overall, my experience was
Poor
Fair
Good
Very Good
Excellent
No Answer
28.
I would recommend this hospital to friends and family
Yes
No
No Answer
29.
I was offered services, during my care, in my preferred language. (Check preferred language)
English
French
Other (please specify)
30.
My experience would have been better if
31.
I would you like to recognize someone special on your staff who helped make my experience excellent
Current Progress,
0 of 31 answered
