HeySurvey survey

HCAHPS-Based Patient Experience Survey 🏥

During this hospital stay, how often did nurses treat you with courtesy and respect?*

Think about all nurse interactions during your stay.

1

2

3

4

5

Never to Always

Was your room and bathroom kept clean?*

Please answer based on your overall experience.

Yes, always
Yes, usually
Sometimes
No

Before giving you any new medicine, how often did staff explain what the medicine was for?*

This helps us understand how clearly care was explained.

1

2

3

4

5

Never to Always

What could we have done to make communication with doctors better?

Share any specific examples or suggestions.

During this hospital stay, how often did doctors listen carefully to you?*

Consider whether you felt heard and understood.

1

2

3

4

5

Never to Always

Which parts of your discharge process were clearly explained?

Select all that apply.

Care instructions at home
Medicines to take after leaving
Warning signs to watch for
Follow-up appointments
I did not receive clear discharge information

After you left the hospital, did you have the information you needed to recover at home?*

Choose the option that best matches your experience.

Definitely yes
Somewhat
Not really
No

How would you rate the hospital overall?*

Please give your overall rating based on this stay.

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1

2

3

4

5

6

7

8

9

10

From Least to Most

Is there anything else you would like to share about your stay?

Your feedback helps improve the patient experience.

Thank you for taking a part in this survey.

This is a HeySurvey survey template.