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Careers at PSI

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Home
Our Care Team
Procedures
For Patients
- Patient Survey
For Providers
Careers at PSI

Patient Survey

The providers, staff, and management of Premier Surgical Institute are dedicated to providing the best care to all of our patients.

The purpose of this questionnaire is to provide our team with information about our work through the eyes of our patients, with the intention of furthering our development through these responses.

Your participation in this survey is completely voluntary.

I. BEFORE YOUR PROCEDURE
The first few questions are about getting ready for your procedure.

1. Before your procedure, did your doctor or anyone from the facility give you all the information you needed about your procedure?

Yes, definitely Yes, somewhat No

2. Before your procedure, did your doctor or anyone from the facility give you easy to understand instructions about getting ready for your procedure?

Yes, definitely Yes, somewhat No

II. ABOUT THE FACILITY AND STAFF
The next questions ask about the day of your procedure.

3. Did the check-in process run smoothly?

Yes, definitely Yes, somewhat No

4. Was the facility clean?

Yes, definitely Yes, somewhat No

5. Were the clerks and receptionists at the facility as helpful as you thought they should be?

Yes, definitely Yes, somewhat No

6. Did the clerks and receptionists at the facility treat you with courtesy and respect?

Yes, definitely Yes, somewhat No

7. Did the doctors and nurses treat you with courtesy and respect?

Yes, definitely Yes, somewhat No

8. Did the doctors and nurses make sure you were as comfortable as possible?

Yes, definitely Yes, somewhat No

III. COMMUNICATIONS ABOUT YOUR PROCEDURE
As a reminder, please include any information you received before and on the day of the procedure.

9. Did the doctors and nurses explain your procedure in a way that was easy to understand?

Yes, definitely Yes, somewhat No

10. Anesthesia is something that would make you feel sleepy or go to sleep during your procedure. Were you given anesthesia?

Yes, definitely Yes, somewhat No (Skip to question #13)

11. Did your doctor or anyone from the facility expain the process of giving anesthesia in a way that was easy to understand?

Yes, definitely Yes, somewhat No

12. Did your doctor or anyone from the facility explain the possible side effects of the anesthesia in a way that was easy to understand?

Yes, definitely Yes, somewhat No

13. Discharge instructions include things like symptoms you should watch for after your procedure, instructions about medicines, and home care. Before you left the facility, did you get written discharge instructions?

Yes No

IV. YOUR RECOVERY

14. Did your doctor or anyone from the facility prepare you for what to expect during your recovery?

Yes, definitely Yes, somewhat No

The next questions are about possible outcomes you could have during recovery. Some procedures do not require that you get this information. Please answer based on what you remember.

15. Some ways to control pain include prescription medicine, over-the-counter pain relievers or ice packs. Did your doctor or anyone from the facility give you information about what to do if you had pain as a result of your procedure?

Yes No

16. At any time after leaving the facility, did you have pain as a result of your procedure?

Yes No

17. Before you left the facility, did your doctor or anyone from the facility give you information about what to do if you had nausea or vomiting?

Yes No

18. At any time after leaving the facility, did you have nausea or vomiting as a result of either your procedure or the anesthesia?

Yes No

19. Before you left the facility, did your doctor or anyone from the facility give you information about what to do if you had bleeding as a result of your procedure?

Yes No

20. At any time after leaving the facility, did you have bleeding as a result of your procedure?

Yes No

21. Possible signs of infection include fever, swelling, heat, drainage or redness. Before you left the facility, did your doctor or anyone from the facility give you information about what to do if you had possible signs of infection?

Yes No

22. At any time after leaving the facility, did you have any signs of infection?

Yes No

V. YOUR OVERALL EXPERIENCE

23. Using any number from 0 to 10, where 0 is the worst facility possible and 10 is the best facility possible, what number would you use to rate this facility?

0 Worst facility possible 1 2 3 4 5 6 7 8 9 10 Best facility possible

24. Would you recommend this facility to your friends and family?

Definitely no Probably no Probably yes Definitely yes

VI. ABOUT YOU

25. In general, how would you rate your overall health?

Excellent Very good Good Fair Poor

26. In general, how would you rate your overall mental or emotional health?

Excellent Very good Good Fair Poor

27. What is the highest grade or level of school that you have completed?

8th grade or less Some high school, but did not graduate High school graduate or GED Some college or 2-year degree 4-year college graduate More than 4-year college degree

28. Are you of Hispanic, Latino, or Spanish origin?

Yes, Hispanic, Latino, or Spanish No, not Hispanic, Latino, or Spanish (Skip to question #30)

29. What group best describes you?

Mexican, Mexican American, Chicano Puerto Rican Cuban Another Hispanic, Latino, or Spanish origin

30. What is your race?

White Black or African American American Indian or Alaska Native Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander

31. How well do you speak English?

Very well Well Not well Not at all

32. What language do you mainly speak at home?

English Spanish Chinese Russian Vietnamese Portuguese German Some other language

33. Did someone help you complete this survey?

Yes No (Skip to end)

34. How did that person help you? Check all that apply.

Read the questions to me Wrote down the answers I gave Answered the questions for me Translated the questions into my language Helped in some other way

1303 Mattec Dr, Loveland, OH 45140
513-982-4774

Monday & Thursday ONLY: 7AM-5PM - Rest Of Week By Appointment Only

info@psisurgery.com

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