|
1
|
I understood the purpose of the Safety Survey
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
2
|
I understood what was meant by ‘your recent transfer’
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
3
|
I understood each of the questions
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
4
|
The questions asked accurately captured what made me feel safe or unsafe
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
5
|
There was nothing missing from the Safety Survey
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
6
|
I did not experience difficulties completing the Safety Survey
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
7
|
I felt that the colour scheme was useful
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
8
|
The size of the text was appropriate
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
9
|
The Safety Survey allows me to provide useful feedback about the healthcare I have received
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
10
|
By receiving this form I feel I am more educated about patient safety
|
Likert scale, 1–5 (1 = Agree, 3 = Neither Agree or Disagree, 5 = Disagree)
|
|
11
|
Please use the space to expand on your answers or say anything about the survey that you think is relevant
|
Free-text
|
