Exit this survey Community Involvement and Patient Satisfaction 1. Community Involvement and Patient Satisfaction Question Title * 1. Facility Name: Question Title * 2. Does your facility support, sponsor, or organize any community service projects? Yes No If Yes, Please describe Question Title * 3. Do you have a strategy for helping your community learn about your facility and the services it offers? If so, please briefly describe your strategy (brochures, newspaper advertisements, word of mouth, etc.)? Yes No If Yes, please describe Question Title * 4. How many of your patients understand a need for preventative medical imaging in the following areas? None Less than 10% 10%-33% 34%-66% 67%-99% All Breast cancer (mammography) Breast cancer (mammography) None Breast cancer (mammography) Less than 10% Breast cancer (mammography) 10%-33% Breast cancer (mammography) 34%-66% Breast cancer (mammography) 67%-99% Breast cancer (mammography) All Osteoporosis (DEXA) Osteoporosis (DEXA) None Osteoporosis (DEXA) Less than 10% Osteoporosis (DEXA) 10%-33% Osteoporosis (DEXA) 34%-66% Osteoporosis (DEXA) 67%-99% Osteoporosis (DEXA) All Pregnancy (ultrasound) Pregnancy (ultrasound) None Pregnancy (ultrasound) Less than 10% Pregnancy (ultrasound) 10%-33% Pregnancy (ultrasound) 34%-66% Pregnancy (ultrasound) 67%-99% Pregnancy (ultrasound) All Tuberculosis and other lung disease (chest radiography) Tuberculosis and other lung disease (chest radiography) None Tuberculosis and other lung disease (chest radiography) Less than 10% Tuberculosis and other lung disease (chest radiography) 10%-33% Tuberculosis and other lung disease (chest radiography) 34%-66% Tuberculosis and other lung disease (chest radiography) 67%-99% Tuberculosis and other lung disease (chest radiography) All Question Title * 5. On average, how long must a patient wait before getting the following services performed on an outpatient/ambulatory basis (Please leave the row(s) blank if your facility does not have that imaging modality or does not offer outpatient service). Within 24 hours 2-3 days Within 1 week Within 1 month More than 1 month See a physician See a physician Within 24 hours See a physician 2-3 days See a physician Within 1 week See a physician Within 1 month See a physician More than 1 month CT CT Within 24 hours CT 2-3 days CT Within 1 week CT Within 1 month CT More than 1 month Plain Film Radiography Plain Film Radiography Within 24 hours Plain Film Radiography 2-3 days Plain Film Radiography Within 1 week Plain Film Radiography Within 1 month Plain Film Radiography More than 1 month Ultrasound Ultrasound Within 24 hours Ultrasound 2-3 days Ultrasound Within 1 week Ultrasound Within 1 month Ultrasound More than 1 month MRI MRI Within 24 hours MRI 2-3 days MRI Within 1 week MRI Within 1 month MRI More than 1 month Mammography Mammography Within 24 hours Mammography 2-3 days Mammography Within 1 week Mammography Within 1 month Mammography More than 1 month Nuclear Medicine Nuclear Medicine Within 24 hours Nuclear Medicine 2-3 days Nuclear Medicine Within 1 week Nuclear Medicine Within 1 month Nuclear Medicine More than 1 month Interventional Radiology Interventional Radiology Within 24 hours Interventional Radiology 2-3 days Interventional Radiology Within 1 week Interventional Radiology Within 1 month Interventional Radiology More than 1 month GI Fluoroscopy GI Fluoroscopy Within 24 hours GI Fluoroscopy 2-3 days GI Fluoroscopy Within 1 week GI Fluoroscopy Within 1 month GI Fluoroscopy More than 1 month Question Title * 6. How long do patients typically wait to see a physician for emergent care? Less than 30 minutes 30 minutes to 1 hour 1 hour to 2 hours 2 hours to 6 hours 6 hours to 10 hours More than 10 hours Question Title * 7. What methods do you use to assess patient satisfaction? Please select all that apply. Survey or questionnaire filled by patient Phone call to patient In-person discussion with patient Other If Other, please specify Question Title * 8. What are your goals for improving patient service? Question Title * 9. Comments? Page1 / 1 100% of survey complete. Done
