Patient Satisfaction Survey Template

Patient Satisfaction Survey Template offers questions about the healthcare provider's concern for patient satisfaction, staff tracking, and areas for improvement. This sample can be edited by the survey maker according to the required details about the patient satisfaction. Some of the question examples of this questionnaire are "In your opinion, how have patient satisfaction ratings changed at your organization in the past year?", "How often does your organization track patient satisfaction?", "How is patient satisfaction primarily tracked?", et al.



   
 
In your opinion, how have patient satisfaction ratings changed at your organization in the past year?
 
Improved considerably
 
Improved somewhat
 
Has remained about the same
 
Has declined somewhat
 
Has declined considerably
 
Don't know
 
   
 
In your opinion, how important is patient satisfaction at your organization?
 
It's a high priority
 
It's a mid-level priority
 
It's a low priority
 
Don't know
 
   
 
Does your organization have managers/staff dedicated to patient-satisfaction matters?
 
Yes
 
No
 
Don't know
 
   
 
How often does your organization track patient satisfaction?
 
Daily basis for each patient
 
Monthly or more often
 
Quarterly
 
Semiannually
 
Yearly or less often
 
We don't
 
   
 
How is patient satisfaction primarily tracked?
 
Questionnaires sent through the mail (in-house efforts)
 
Follow-up telephone calls (in-house efforts)
 
An outside firm has been hired to track patient satisfaction
 
Suggestion boxes placed in facilities
 
Other
 
 
   
 
Has your organization initiated programs to improve patient satisfaction within the past year?
 
Yes
 
No
 
Don't know
 
   
 
What sector of the health care industry do you believe needs the most improvement in patient satisfaction?
 
Hospitals
 
Physicians
 
Managed-care plans
 
Insurers
 
Nursing homes
 
Outpatient providers
 
Other
 
 
   
 
What is the most compelling reason for your organization to improve customer satisfaction?
 
Fear of losing patients to competitors
 
Fear of losing employer contracts
 
Fear of increase regulation
 
Fear of damage to organization's reputation
 
Other
 
   
 
In your opinion, has patient satisfaction been shown to have a direct effect on your organization's bottom line?
 
Yes
 
No
 
Don't know
 

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