TABLE 4.
Items Grouped by Categories | Response Options |
---|---|
Communication with parent | |
Communication between you and your child’s nurses | |
During this hospital stay, how often did your child’s nurses listen carefully to you? | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s nurses explain things to you in a way that was easy to understand? | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s nurses treat you with courtesy and respect? | Never/Sometimes/Usually/Always |
Communication between you and your child’s doctors | |
During this hospital stay, how often did your child’s doctors listen carefully to you? | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s doctors explain things to you in a way that was easy to understand? | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s doctors treat you with courtesy and respect? | Never/Sometimes/Usually/Always |
Communication about your child’s medicines | |
During the first day of this hospital stay, were you asked to list or review all of the prescription medicines your child was taking at home? a | Yes, definitely/Yes, somewhat/No |
During the first day of this hospital stay, were you asked to list or review all of the vitamins, herbal medicines, and over-the-counter medicines your child was taking at home? a | Yes, definitely/Yes, somewhat/No |
Before your child left the hospital, did a provider or hospital pharmacist explain in a way that was easy to understand how your child should take these new medicines after leaving the hospital? a | Yes, definitely/Yes, somewhat/No |
Before your child left the hospital, did a provider or hospital pharmacist explain in a way that was easy to understand about possible side effects of these new medicines? a | Yes, definitely/Yes, somewhat/No |
Keeping you informed about your child’s care | |
During this hospital stay, how often did providers keep you informed about what was being done for your child? | Never/Sometimes/Usually/Always |
How often did providers give you as much information as you wanted about the results of these tests? a | Never/Sometimes/Usually/Always |
Privacy when talking with doctors, nurses, and other providers | |
During this hospital stay, how often were you given as much privacy as you wanted when discussing your child’s care with providers? | Never/Sometimes/Usually/Always |
Preparing you and your child to leave the hospital | |
Before your child left the hospital, did a provider ask if you had any concerns about whether your child was ready to leave? | Yes, definitely/Yes, somewhat/No |
Before your child left the hospital, did a provider talk with you as much as you wanted about how to care for your child’s health after leaving the hospital? | Yes, definitely/Yes, somewhat/No |
A child’s regular activities can include things like eating, bathing, going to school, or playing sports. Before your child left the hospital, did a provider explain in a way that was easy to understand when your child could return to his or her regular activities? | Yes, definitely/Yes, somewhat/No |
Before your child left the hospital, did a provider explain in a way that was easy to understand what symptoms or health problems to look out for after your child left the hospital? | Yes, definitely/Yes, somewhat/No |
Before your child left the hospital, did you get information in writing about what symptoms or health problems to look out for after your child left the hospital? | Yes, definitely/Yes, somewhat/No |
Keeping you informed about your child’s care in the emergency department | |
While your child was in this hospital’s emergency department, were you kept informed about what was being done for your child? a | Yes, definitely/Yes, somewhat/No |
Communication with child | |
How well nurses communicate with your child | |
During this hospital stay, how often did your child’s nurses listen carefully to your child? a | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s nurses explain things in a way that was easy for your child to understand? a | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s nurses encourage your child to ask questions? a | Never/Sometimes/Usually/Always |
How well doctors communicate with your child | |
During this hospital stay, how often did your child’s doctors listen carefully to your child? a | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s doctors explain things in a way that was easy for your child to understand? a | Never/Sometimes/Usually/Always |
During this hospital stay, how often did your child’s doctors encourage your child to ask questions? a | Never/Sometimes/Usually/Always |
Involving teens in their care | |
During this hospital stay, how often did providers involve your child in discussions about his or her health care? a | Never/Sometimes/Usually/Always |
Before your child left the hospital, did a provider ask your child if he or she had any concerns about whether he or she was ready to leave? a | Yes, definitely/Yes, somewhat/No |
Before your child left the hospital, did a provider talk with your child about how to take care of his or her health after leaving the hospital? a | Yes, definitely/Yes, somewhat/No |
Attention to safety and comfort | |
Preventing mistakes and helping you report concerns | |
Before giving your child any medicine, how often did providers or other hospital staff check your child’s wristband or confirm his or her identity in some other way? a | Never/Sometimes/Usually/Always |
Mistakes in your child’s health care can include things like giving the wrong medicine or doing the wrong surgery. During this hospital stay, did providers or other hospital staff tell you how to report if you had any concerns about mistakes in your child’s health care? | Yes, definitely/Yes, somewhat/No |
Responsiveness to the call button | |
After pressing the call button, how often was help given as soon as you or your child wanted it? a | Never/Sometimes/Usually/Always |
Helping your child feel comfortable | |
Things that a family might know best about a child include how the child usually acts, what makes the child comfortable, and how to calm the child’s fears. During this hospital stay, did providers ask you about these types of things? | Yes, definitely/Yes, somewhat/No |
During this hospital stay, how often did providers talk with and act toward your child in a way that was right for your child’s age? | Yes, definitely/Yes, somewhat/No |
Hospitals can have things like toys, books, mobiles, and games for children from newborns to teenagers. During this hospital stay, did the hospital have things available for your child that were right for your child’s age? | Never/Sometimes/Usually/Always |
Paying attention to your child’s pain | |
During this hospital stay, did providers or other hospital staff ask about your child’s pain as often as your child needed? a | Yes, definitely/Yes, somewhat/No |
Hospital environment | |
Cleanliness of hospital room | |
During this hospital stay, how often were your child’s room and bathroom kept clean? | Never/Sometimes/Usually/Always |
Quietness of hospital room | |
During this hospital stay, how often was the area around your child’s room quiet at night? | Never/Sometimes/Usually/Always |
Global rating | |
Overall rating | |
Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your child’s stay? | 0 through 10 |
Recommend hospital | |
Would you recommend this hospital to your family and friends? | Definitely no/Probably no/Probably yes/Definitely yes |
Other | |
During your child’s hospital stay, how much of the time were you at the hospital? | None of the time/A little of the time/Some of the time/Most of the time/All or nearly all of the time |
How did that person help you? Mark one or more. a | Read the questions to me/Wrote down the answers I gave/Answered the questions for me/Translated the questions into my language/Helped in some other way (please print) |
Is there anything else you would like to say about the care your child received during this hospital stay? | Write-in |
Screeners | |
Was your child born during this hospital stay? | Yes/No |
For this hospital stay, was your child admitted through this hospital’s emergency department? | Yes/No |
Were you in this hospital’s emergency department with your child? | Yes/No |
Is your child able to talk with nurses and doctors about his or her health care? | Yes/No |
Tests in the hospital can include things like blood tests and x-rays. During this hospital stay, did your child have any tests? | Yes/No |
During this hospital stay, did you or your child ever press the call button? | Yes/No |
During this hospital stay was your child given any medicine? | Yes/No |
During this hospital stay, did your child have pain that needed medicine or other treatment? | Yes/No |
Before your child left the hospital, did a provider tell you that your child should take any new medicine that he or she had not been taking when this hospital stay began? | Yes/No |
During this hospital stay, was your child 13 years old or older? | Yes/No |
Did someone help you complete this survey? | Yes/No |
Demographics | |
In general, how would you rate your child’s overall health? | |
What is your child’s age? | |
Is your child male or female? | |
Is your child of Hispanic or Latino origin or descent? Mark one or more. | |
What is your child’s race? Mark one or more. | |
How are you related to the child? | |
What is your age? | |
What is the highest grade or level of school that you have completed? | |
What is your preferred language? |
Item requires a screener.