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Consumer and Commuinity Feedback

All questions are mandatory
Facility
Ward

General Q1

Overall, how would you rate the care you received while in hospital?
 1 - Very poor
 2 - Poor
3 - Neither good nor poor
4 - Good
5 - Very good

Q1

Did you feel you were treated with respect and dignity while you were in hospital?
Yes,always
Yes, sometimes
No

Q2

Did the health professionals explain things in a way you could understand?
Yes, always
Yes, sometimes
No

Q3

Were you involved, as much as you wanted to be, in decisions about your care and treatment?
Yes, definitely
Yes, to some extent
No, I was not well enough to be involved

Q4

If your family or someone else close to you wanted to talk to a doctor, did they get the opportunity to do so?
Yes,definitely
Yes, to some extent
No, they did not get the opportunity
Not applicable to my situation

Q5a (If no, continue to Q6)

Did you have worries or fears about your condition or treatment while in hospital?
Yes
No

Q5b

Did a healthcare professional discuss your worries or fears?
Yes, completely
Yes, to some extent
No

Q6

How much information about your condition or treatment was given to your family, carer or someone close to you?
Not enough
Right amount
Too much
It was not necessary to provide information to any family or friends
Don't know / can't say

Q7a (If no, please continue to Q8)

Were you ever in any pain while in hospital?
Yes
No

Q7b

Do you think the hospital staff did everything they could to help manage your pain?
Yes, definitely
Yes, to some extent
No

Q8

If you needed assistance, were you able to get a member of staff to help you within a reasonable time frame?
All of the time
Most of the time
Some of the time
Rarely
Never
You did not need assistance

Q9

How clean were the toilets and bathrooms that you used while in hospital?
Very clean
Fairly clean
Not very clean
Not clean at all

Q10

Thinking about when you left hospital, were you given enough information about how to manage your care at home?
Yes, completely
Yes, to some extent
No, I was not given enough
I did not need this type of information

Q11

Thinking about when you left hospital, were adequate arrangements made by the hospital for any services you needed?
Yes, completely
Yes, to some extent
No, arrangements were not adequate
I did not need any services

Q12

How would you rate how well the doctors and nurses worked together?
1 - Very good
 2 - Good
 3 - Neither good nor poor
 4 - Poor
 5 - Very poor
 I don't know

STD-1

What year were you born?

STD-2

Which language do you mainly speak at home?
English
A language other than English, please specify:

STD-3

In general, would you say your health is?
Excellent
Very good
Good
Fair
Poor

STD-4

Are you of Aboriginal origin, Torres Strait Islander origin or both?
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, both Aboriginal and Torres Strait Islander
No

Disaggregation by socio-economic indexes for areas (SEIFA) is generated from the patient’s residential address. Patient address is collected on admission and typically generated with the survey samples before contacting the patient. The medium-term intention is for SEIFA to be derived from the patient’s residential address based on statistical area level 2 (SA2). The SEIFA Index of Relative Socio-Economic Disadvantage (IRSD), which is used for National Health Agreement reporting, is recommended.

 

 


Last updated: 20 December 2016