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  1. Surveys
  2. 2014
  3. June
  4. E
  5. Evaluation of Mock Surveys
0%
Exit Survey
 
 
Dear Executive Director,

Please complete this evaluation of the mock survey process with your Leadership Team by Wednesday, July 9th. This evaluation consists of 10 questions and will only take approximately 5-10 minutes. Your input will help us make the necessary improvements to meet your needs!

Your responses will be strictly confidential and data from this evaluation will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the evaluation or the procedures, please contact Liz Kopochis at 847-692-1135.or by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the button below.
 
 
 
Were you notified of what to expect before the mock survey began?
 
Yes
 
No
 
If not, what information was not provided before the survey began?
 
 
 
 
How helpful was the chart audit report?
 
Very helpful
 
Somewhat helpful
 
Not very helpful
 
Not helpful at all
 
How can we improve the chart audit report?
 
 
 
 
How helpful was the survey report?
 
Very helpful
 
Somewhat helpful
 
Not very helpful
 
Not helpful at all
 
How can we improve the survey report?
 
 
 
 
Did the surveyor provide education during the survey?
 
Yes
 
Sometimes
 
No
 
What additional education could have been provided?
 
 
 
 
Did the surveyor offer recommendations for the Plan of Correction?
 
Yes
 
Some
 
No
 
What area would you have liked to receive additional recommendations for?
 
 
 
 
Did your site get the support it needed from the Regional Team for writing the Plan of Correction?
 
Yes
 
Some
 
No
 
What additional support would you have liked to receive from the Regional Team?
 
 
 
 
Did you have any difficulty writing the Plan of Correction?
 
Yes
 
No
 
How can we improve the Plan of Correction format?
 
 
 
 
Did the mock survey help you to prepare for a State or Joint Commission survey?
 
Yes
 
No
 
What area was your site not prepared for?
 
 
 
 
The mock surveyor was (check all that apply):
 
Knowledgeable
 
Approachable
 
Educational
 
Supportive
 
Fair
 
Responsive to our needs
 
Flexible
 
Positive
 
Not able to answer questions
 
Confrontational
 
Threatening
 
Negative
 
Too picky
 
Difficult to understand
 
Not flexible
 
Not supportive
 
Additional comments:
 
 
 
 
Overall, did your site benefit from the mock survey?
 
Yes
 
No
 
How can we improve the mock survey process?
 
 
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