Manningham Day Procedure Centre - Doncaster
Feedback Questionnaire
Procedure Date
<
March 2010
>
Mon
Tue
Wed
Thu
Fri
Sat
Sun
22
23
24
25
26
27
28
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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22
23
24
25
26
27
28
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31
1
2
3
4
Name of Surgeon
Assoc. Prof Julian Rait
Dr Grant Snibson
Dr Maged Atalla
Dr Ben Connell
Dr Justin Friebel
Dr Trevor Gin
Dr Wilson Heriot
Dr Troy Lim Joon
Dr Peter Meagher
Dr Salmaan Qureshi
Dr David Workman
Professor Peter Danne
Mr Kevin Spencer
Mr Tom Sunderland
Mr Tim Brown
____________________
FINDING US
Did you receive a pre-admission phone call from our staff?
Yes
No
Would you have liked to received a pre admission phone call to better assist you?
Yes
Not really
Possibly
No
Was the pre-admission phone call helpful?
Yes
Sort of
Not Really
No
How could of the pre admission phone call of been better?
Were you able to locate the Maningham Day Procedure Centre easily?
Yes
Sort of
Not really
No
What difficulites did you have in locating us?
Was the signage helpful?
Yes
Sort of
No
Can't recall
How could the signage of been better?
Were you able to find a car park easily?
Yes
Sort of
Not really
No
At what time of the day did you have difficulties in getting a park?
____________________
THE ADMISSION
Were the reception staff courteous and helpful?
Yes
Sort of
Not really
No
How could the reception staff of been better?
Were you happy with the length of time spent before your operation?
Yes
Sort of
Not really
No
Approx. how long was your wait after being first admitted?
0-15min
1-1.5 hrs
15-30min
1.5 - 2 hrs
30-45min
greater than 2 hrs
45-60min
What were you feelings about having to wait?
Did not worry me at all
Concerned me a little bit
I little frustrated
Getting impatient
Very impatient
Extremely frustrated
Did you feel well cared for by the admission nurse?
Yes
Sort of
Not really
No
How could the the care of the admission nurse been better?
____________________
THE THEATRE
Did you feel well cared for by the theatre staff?
Yes
Sort of
Not really
No
How could the care of the theatre staff been better?
Did you feel well cared for by the recovery/discharge staff?
Yes
Sort of
Not really
No
How could the care of the recovery/discharge staff of been better?
Did you recover from your procedure without any nausea or vomiting?
Yes
No
What nausea or vomiting did you experience?
Were the discharge instructions clear, easily understood and helpful?
Yes
Sort of
Not really
No
Ho could the discharge instructions been better?
Were the refreshments served adequate?
Yes
Sort of
Not really
No
How were the refreshments not adequete?
Were you happy with the length of time spent after your procedure?
Yes
Sort of
Not really
No
How were you not happy with the length of time post operation?
____________________
A QUICK FINAL RATING
Staff friendliness
1
2
3
4
5
Why did you rate staff friendliness so low?
Professionalism
1
2
3
4
5
Why did you rate Professionalism so low?
Care received
1
2
3
4
5
Why did you rate Care received so low?
Ambiance
1
2
3
4
5
Why did you rate the Ambiance so low?
My overall experience
1
2
3
4
5
Why did you rate your Overall experience so low?
Would you recommend the Manningham Day Procedure Centre?
Yes
Possibly
Not really
No
Why would you consider not recommending us?
Level of Insurance
Privately insured
DVA
Self Insured
Pensioner
Other
What is your level of Insurance(if selected other)?
Any other comments to assist us?
May we contact you regarding this information?
Yes
No
As thanks for your feedback would you like to go into the draw for a weekend indulgence package staying at the Langham hotel?
Yes
No
Your Name:
Contact Number(s)
Contact email (for draw)
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