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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
 
Don't know
 
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
 
 

Please select your department:
 
Sales
 
System Engineers Sales
 
Professional Services
 
Marketing
 
Customer Service
 
General Administration
 
Other
 
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
How long have you worked for (Company)?
 
Less than 3 months
 
3 months - 1 year
 
1 - 3+ years
 
4 - 6+ years
 
7 - 10+ years
 
10+ years
 
 
 
What category BEST describes your job?
 
Officer/Director/Manager/Supervisor
 
Professional (salaried non-mgt. business & technical)
 
Technical (hourly)
 
Sales Reps
 
Administrative Support
 
Group Leader
 
Customer Service
 
 
 
Please indicate your level of agreement with each of the following statements
 
 
Very   
satisfied   
Somewhat   
satisfied   
Neutral     Somewhat  
dissatisfied    
Very    
dissatisfied    
N/A
Salary
Benefits
Frequency and amount of bonuses
Connection between pay and performance
Security and administration of your 401(k)/stock options/pension plans
Workload
Flexibility of work hours
Physical working environment
Opportunity for advancement
Job security
Very   
satisfied   
Somewhat   
satisfied   
Neutral     Somewhat  
dissatisfied    
Very    
dissatisfied    
N/A
Ability to influence decisions that affect you
Ability to influence day-to-day company success
Opportunity to use new technologies
Opportunity to work on interesting projects
Access to company-sponsored training and seminars
Communication with your supervisor
Recognition received from your supervisor
Your supervisor's management capabilities
Your supervisor's active involvement in your career development
Your overall relationship with your supervisor
Your relationship with your peers
Your relationship with customers/clients/end users
Your understanding of the business mission
Your overall satisfaction with your company
Overall satisfaction with your job
 
 

Your Manager:
Strongly   
agree   
Agree    Neutral    Disagree    Strongly   
disagree   
N/A
Effectively leads the department
Communicates well with subordinates
Recognizes good work
Has good leadership qualities
 
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