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Rangely District Hospital

Hospital survey : How are we doing?

Your opinion is valuable to us, Please give us your feedback about your experience while at the hospital.
Please take a few minutes to fill out this survey on the timeliness and quality of the service you received today. Rangely District Hospital welcomes your feedback and your answers will be kept confidential. Thank you for your participation.
GENERAL PATIENT INFORMATION
* In general, what is the quality of your health? Outstanding     Good     Some Chronic Issues     Poor    
* How would you rate our concern for your privacy?
Outstanding     Good     Adequate     Needs Improvement     Poor     N/A    
* How often have you visited RDH within the past year? First Visit     2-5 Visits     More Than 6    
* If you were seeking a referral to a specialist, was your request handled in a timely manner? Yes     No     N/A    
* Which department did you visit? Lab     Radiology     Cardio/Pulmonary     ER     P/T     Clinic     N/A    
THE NURSING STAFF
* How would you rate the competence of the nurse who helped you? Outstanding     Good     Adequate     Needs Improvement     Poor     N/A    
* How would you characterize the concern shown to you by the nurse? Outstanding     Good     Adequate     Needs Improvement     Poor    
* Did the nurse respond to you within a reasonable period of time? Yes     No    
THE DOCTORS
* Were you able to see the doctor of your choice? Yes     No     N/A    
* Did you feel that your doctor spent an adequate amount of time with you? Yes     No     N/A    
* Mark the boxes that characterize the demeanor of your doctor Attentive     Concerned     Friendly     Distracted     Rushed     Inconsiderate    
* How would you rate the competence of your doctor? Outstanding     Good     Adequate     Needs Improvement     Poor     N/A    
* Did you feel that your doctor's exam was thorough? Yes     No     N/A    
* Please rate the clarity of your doctor's explanation of your condition and treatment options? Outstanding     Good     Adequate     Needs Improvement     Poor     N/A    
* How well did your doctor include you in your healthcare decisions? Outstanding     Good     Adequate     Needs Improvement     Poor     N/A    
* Were your questions answered to your satisfaction? Yes     No     N/A    
CLINIC
* If you needed an appointment, did you have to wait longer than expected? Yes     No    
* How easy was it to make an appointment by telephone? Very Easy     Moderately Easy     Very Difficult    
* How long did you wait to speak to a scheduling staff member? 0 to 2minutes     3 to 5minutes     5 to 7minutes     Longer    
* Was the person who scheduled your appointment courteous and helpful? Very Courteous     Moderately Courteous     Rude    
* How would you rate the courtesy of the staff at the reseption desk? Very Courteous     Moderately Courteous     Rude    
* How long did you wait in the reception area beyond your appointment time? 0 to 5minutes     5 to 20minutes     20 to 40minutes     Longer    
* How long did you wait in the exam room before you saw your physician? 0 to 5minutes     5 to 20minutes     20 to 40mintues     Longer    
THE LAB STAFF
* How would you rate the professionalism and competence of the lab tech who took your blood? Outstanding     Good     Adequate     Needs Improvement     Poor    
* How long did you have to wait to speak to a lab tech? 0-2minutes     3-5minutes     5-7minutes     Longer    
BUSINESS OFFICE
* How would you rate your level of satisfaction with our business office staff? Very Satisfied     Satisfied     Dissatisfied     Very Dissatisfied    
* How would you rate the helpfulness of the business office staff? Very Helpful     Helpful     Not Helpful     Indifferent    
* If you had an issue with your bill, did you feel that you received the necessary help to resolve your issue? Yes     No    
* How would you rate your overall experience in dealing with the hospital staff and services? Very satisfied     Satisfied     Adequate     Needs Improvement     Poor    
ADDITIONAL FEEDBACK
* Please list any areas in which our services could be improved.
* Please share any additional comments you may have.
PERSONAL INFORMATION
Providing the following information is optional.
  First Name
  Last Name
  Address
  City
  Telephone
  Would you like some one to contact you? Yes     No