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Exit Survey
 
 
What is the medical specialty of your unit?
 
forensic emergency medicine
 
dental servicies
 
Pediatric servicies
 
oncotology
 
 
 
How many staff members does your organization have working in the emergency room?
 
2
 
3
 
4
 
5 or above
 
 
 
What is the nature of the medical practice in your emergency room?
 
individual practice
 
small group practice (5 or fewer physicians)
 
large group practice (6 or more physicians)
 
other type
 
 
 
Which of the following has the highest composition of your patients load as regards spornsorship?
 
Medicade ____ %
 
Medicare _____ %
 
Self Pay _____%
 
Private _____%
 
Insurance _____ %
 
HMO _____%
 
Other ____ %
 
 
 
For how long has your department been in existence?
 
less than a year
 
more than a year but less than two
 
more than 2 but less than three
 
three years and above
 
 
 
How satisfied are you with the skill and competence of other staff members?
 
not satisfied
 
fairly satisfied
 
satisfied
 
very satisfied
 
 
 
How satisfied are you with the friendliness and competence of the staff members?
 
not satisfied
 
fairly satisfied
 
satisfied
 
very satisfied
 
 
 
How often does your organization track the performance of your department?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
What aspect of service in your department do you believe requires improvement?
 
Diagnosis
 
Medication
 
Patient care
 
None of the above
 
 
 
What was the most compelling reason that neccessitated the establisment of your department