Organizational Concern Survey Template

Health Care survey of organizational concern for patient satisfaction.

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
How important is patient satisfaction within 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?
Don't know
How often does your organization conduct surveys to evaluate
patient satisfaction?
Daily basis for each patient
Monthly or more often
Yearly or less often
Which one of the following means is used to evaluate patient satisfaction?
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
Has your organization initiated programs to improve patient satisfaction within the past year?
Don't know
In your opinion, what sector of the healthcare industry needs the most improvement in patient satisfaction?
Managed-care plans
Nursing homes
Outpatient providers
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
In your opinion, has patient satisfaction been shown to have a direct effect on your organization's bottom line?
Don't know

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