A hospital satisfaction questionnaire is primarily structured to evaluate the needs of the patient and his family members as well as to record their satisfaction level with the facilities and services offered at the hospital. A hospital satisfaction questionnaire is essential as it encompasses the patient’s view of the systems in place.
Sample Hospital Satisfaction Questionnaire
Date of admission: _______________________________________________
Date of discharge: _______________________________________________
Doctor in charge: ________________________________________________
Q1: On a scale of ten, how would you rate the hygiene and cleanliness of the hospital, keeping in mind the outdoor space as well as the cabins and inner chambers?
Q2: Which place of the hospital did you find needs better cleaning and hygiene?
Q3: How would you assess your monetary charges for treatment? Would you consider some of the tests as extraneous?
Q4: How would you evaluate the quality of food served to you during the duration of your stay as a patient here?
d. Any other comments: ____________________________________________________________________________________________________________________________________
Q5: Are you satisfied with the level of care offered by our staff members? Do you have any specific complaints?
Q6: Would you recommend this hospital to your acquaintances? What would you consider our area of expertise?
Q7: Are you satisfied with your doctor in charge?
a. Yes most definitely
Q8: If you have chosen “no” as your answer to the last question, please state the reason.
Q9: Would you like to make any other suggestions for the improvement in the services offered at the hospital? ________________________________________________________________________________________________________________________________________________
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