VHA Inpatient Customer Satisfaction Survey 2018v1.0
American Customer Satisfaction Index Veterans Affairs: Veterans Health Administration
VHA Inpatient 2018
PROG. NOTE: Move in CONTACT NAME from sample
[CONTACT NAME]: FNAME LNAME FROM SAMPLE
________________________________________________________________________
May I speak with (RESTORE CONTACT NAME)?
Hello, I'm (NAME) calling on behalf of the CFI Group. Today I want to ask you about services you may have received as an inpatient from the VA Medical Center. The purpose of the research is to help the Veterans Health Administration improve its services to veterans. Your name will be confidential, and you may stop at any time or skip any question you do not wish to answer.
This interview is authorized by Office of Management and Budget Control No. 1090-0007 which expires on September 30, 2021. This interview will take approximately 8-10 minutes.
IF YES, proceed to Q1
IF NO, proceed to TERMINATE SCREEN
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PROG. NOTE: TERMINATE SCREEN
Those are all of the questions I have for you. Thank you for your interest in this project.
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Now, I am going to ask you some questions about the VA Medical Center with which you have had experience as an inpatient.
Q1. Before you entered the VA Medical Center for inpatient care, you probably knew something about that VA Medical Center. Now think back and remember your expectations of the overall quality of the VA Medical Center. Please give me a rating on a 10-point scale on which "1" means your expectations were "not very high" and "10" means your expectations were "very high."
How would you rate your expectations of the overall quality of the VA Medical Center?
[RECORD NUMBER 1-10]
DK
REF
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Now, let's think about the information you received from caregivers at the VA Medical Center…
Q2. If you had concerns you needed answered, how clearly did your caregiver provide information to you in a way you could understand? Using a 10-point scale again on which “1” means “not at all clearly” and “10” means “very clearly,” how clearly did the VA Medical Center caregivers provide information to you in a way you could understand?
[RECORD NUMBER 1-10]
11 Had no concerns
DK
REF
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Q3. How clearly did doctors or nurses explain test results to you in a way you could understand? Using a 10-point scale again on which “1” means “not at all clearly” and “10” means “very clearly,” how clearly did the VA Medical Center doctors or nurses explain test results to you in a way you could understand?
[RECORD NUMBER 1-10]
DK
REF
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Now let’s talk about your physical comfort during your inpatient experience at the VA Medical Center…
Q4. How responsive was hospital staff when you used the call button? On a 10-point scale on which “1” means “not at all responsive” and “10” means “very responsive,” how responsive was hospital staff when you used the call button?
[RECORD NUMBER 1-10]
11 Never used call button
DK
REF
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Q5. To what degree did you feel you were treated with respect and dignity while in the hospital? On a 10-point scale on which “1” means “not at all treated with dignity and respect” and “10” means “very much treated with dignity and respect,” to what degree did you feel you were treated with respect and dignity while in the hospital?
[RECORD NUMBER 1-10]
DK
REF
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Q6. How courteous were your doctors? On a 10-point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous were your doctors?
[RECORD NUMBER 1-10]
DK
REF
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Q7. And how courteous were your nurses? On a 10-point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous were your nurses?
[RECORD NUMBER 1-10]
DK
REF
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Q10. Please consider all your experiences in the past two years with inpatient care at the VA Medical Center. Using a 10-point scale, on which “1" means "not very high" and "10" means "very high," how would you rate the overall quality of inpatient care at the VA Medical Center?
[RECORD NUMBER 1-10]
DK
REF
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Satisfaction includes many things. Let's move on and talk about your overall satisfaction with the inpatient care at the VA Medical Center.
Q11. First, please consider all your experiences to date as an inpatient at the VA Medical Center. Using a 10-point scale on which “1” means “very dissatisfied” and “10” means “very satisfied,” how satisfied are you with that VA Medical Center?
[RECORD NUMBER 1-10]
DK
REF
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Q12. Considering all of your expectations, to what extent has the inpatient care at the VA Medical Center fallen short of or exceeded your expectations? Using a 10-point scale on which "1" now means "falls short of your expectations" and "10" means "exceeds your expectations," to what extent has that VA Medical Center fallen short of or exceeded your expectations?
[RECORD NUMBER 1-10]
DK
REF
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Q13. Forget the VA Medical Center for a moment. Now, I want you to imagine an ideal medical center providing inpatient care. (PAUSE) How well do you think the VA Medical Center compares with that ideal medical center? Please use a 10-point scale on which "1" means "not very close to the ideal," and "10" means "very close to the ideal."
[RECORD NUMBER 1-10]
DK
REF
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Next, I want you to think about any communication you may have had with the VA Medical Center regarding complaints about your inpatient care experience.
Q14. Have you complained to the VA Medical Center within the past year?
1 Yes
No
DK
REF
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{IF Q14 = 1, ASK Q14A – 14B; OTHERWISE GO TO Q15}
Q14A. How well, or poorly, was your most recent complaint handled? Using a 10-point scale on which “1” means “handled very poorly” and “10” means “handled very well,” how would you rate the handling of your complaint?
[RECORD NUMBER 1-10]
DK
REF
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Q14B. How difficult or easy was it to make your most recent complaint? Using a 10-point scale on which “1” means “very difficult” and “10” means “very easy,” how difficult or easy was it to make a complaint?
[RECORD NUMBER 1-10]
DK
REF
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Q15. How likely is it that you will use the VA Medical Center again in the future when you need inpatient medical care? On a 10-point scale on which “1” means “very unlikely” and “10” means “very likely,” how likely is it that you will use the VA Medical Center again?
[RECORD NUMBER 1-10]
DK
REF
________________________________________________________________________
Q16. If asked, how willing would you be to say positive things about inpatient care at the VA Medical Center to other veterans? On a 10-point scale on which “1” means “not at all willing” and “10” means “very willing,” how willing would you be to say positive things about that VA Medical Center?
[RECORD NUMBER 1-10]
DK
REF
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Q17. What is the primary means you used to obtain services from the VA Medical Center where you were recently an inpatient? (READ CODES 1-6 IF NECESSARY; ACCEPT ONE MENTION)
Internet/World Wide Web
Telephone call
Visit to medical center
Written communication
Some other means
Not applicable/do not obtain services from this center
DK
REF
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Q18. Was your recent hospital stay an emergency or planned in advance?
Emergency
Planned in advance
DK
REF
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Q20. Consider all your recent experiences with VA (which may have included healthcare, benefits programs, or memorial services), please tell us how you feel about the following statements:
“I got the service I needed.”
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
“It was easy to get the service I needed.”
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
“I felt like a valued customer.”
“I trust VA to fulfill our country’s commitment to veterans.”
Strongly agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Strongly disagree
Now, we need to ask a few demographic questions …
QD1. What is your age, please?
[RECORD NUMBER OF YEARS 1-150]
DK
REF
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QD2. What is the highest level of formal education you completed? (READ CODES 1-5)
Less than high school
High school graduate
Some college or associate degree
College graduate
Post-Graduate
DK
REF
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QD3. Are you of Hispanic, Latino or Spanish origin?
Yes
No
DK
REF
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QD4. Do you consider your race(s) as: (READ CODES 1-5, ACCEPT UP TO 5 MENTIONS)
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or other Pacific Islander
Other race
DK
REF
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QD5. What was your total annual family income in 2016? (READ CODES 1-7 AS NECESSARY) (READ IF NECESSARY: Before taxes)
Under $20,000
$20,000 but less than $30,000
$30,000 but less than $40,000
40,000 but less than $60,000
$60,000 but less than $80,000
$80,000 but less than $100,000
$100,000 or more
DK
REF
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QD6. Gender (By Observation)
Male
Female
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PROG. NOTE: TERMINATE SCREEN
Those are all of the questions I have for you. Thank you for your interest in this project.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | ACSI Logo |
| Author | Business School |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |