Post Discharge Inpatient Satisfaction Survey Template

Get feedback from inpatients about their entire experience and satisfaction during stay at the hospital using this Post-Discharge Inpatient Satisfaction (IPD) Survey Template.

Try 7 days for Free
Lightening fast setup

Measuring the Post Discharge Feedback of Inpatient

During the stay and post-discharge of your patients, it is important for you to closely monitor their experience regarding the treatment and care. Collecting patient feedback post-discharge can help you to understand the level of the care and treatment including staff efficiency and friendliness, experience with the doctor, availability of medicines at the pharmacy, and much more. This helps you to improve the quality of your healthcare services and keeps you abreast of our patients' needs and expectations.

A Post Discharge Patient Feedback Form sent via Email & SMSes can effortlessly measure the core satisfaction level of the in-patient at a transactional level. This survey can be filled by the patient or by their relative or spouse as well. You can set up a Post-Discharge Inpatient Satisfaction Survey Template on Email, SMS, or you can also handover the Tablet either to the patients or their relatives. You can ask for their feedback regarding various things like hospital facilities, how cooperative the nursing staff was, how cleanliness was, and so on.

You can connect your Hospital and Patient Management Tools to the Patient Feedback Software to automate the trigger of the Post-Discharge Inpatient Survey during the post-discharge. You can also crucial data like Patient Name, Patient ID, the Doctor or Physician they met, discharge summary, and so on.

To create a survey using the Post-Discharge Inpatient Satisfaction Survey Template, just sign up or sign in to Zonka Feedback. You’ll be able to choose this Survey Template when you begin creating your feedback form or survey and customize it to your preference.

21 Questions

17Screens

45 secs to complete

List of Inpatient Feedback Form Questions

The following questions are included in this Inpatient Feedback Form Template.

Your continued support and suggestions help make our hospital a better organization and help us give better care and services to all. Please spare a few minutes to share your valuable feedback.
I came as...
Full Name
Email
Mobile Number
Patient ID
Gender
If you're a friend, visitor or relative, please try and answer all the questions from the perspective of the patient only.
How was your stay at the hospital?
How was the ambience at the hospital?
How would you rate the ward facilities?
How was the food and diet served to you during your stay?
How would you rate the toilets and changing rooms in the hospital?
How would you rate the attitude and service of the attending doctor?
How would you rate the billing process at the hospital during discharge?
How was the reception and enquiry service?
How would you rate the admission process?
How would you rate the discharge process?
How was your overall experience at the hospital?
Based on your stay at the hospital, how likely are you to recommend this hospital to your friends and family?
Please do share your comments, suggestions and inputs here.

Ideally, Patients' details like Name, Email Address, and Mobile Number can be passed from your tools when (and if) you integrate Zonka Feedback into your tools.

Sign Up on Zonka Feedback for free and implement this Post-Discharge Inpatient Satisfaction Survey Template in your account to measure Patient Loyalty based on their experience with you.

Create and send this Inpatient Feedback Form with Zonka Feedback