The Patient Experience Module is an assessment of patient experience including patient enablement, access, comprehensiveness, coordination, relationship, and suggestions on how to improve the practice. 


Methods for surveying patients

A practice facilitator will visit the practice and provide each participating clinician with Patient Experience surveys.  Instructions on survey completion and collection will be briefly described to office staff. 

A minimum of 20 consecutive patients shall be handed the survey at the time of the visit and asked to complete a portion of it before the visit and a small portion post-visit, before leaving the office.  The survey should take no more than 5 minutes to complete.

The patient will place the completed survey in the envelope provided to them and return it to the front desk.  The office will have the option of using a box at the front desk, or another area designated by the front office staff to receive the completed surveys.

Survey collection should take no longer than 3 days.  At the end of data collection, a practice facilitator will pick up the completed surveys.

Results of the Patient Experience Survey will be shared with the participating clinician no later than 14 days after collection, at which time members of the Peer Support Collaborative team will sit down with participating physicians to plan an intervention based on results.  Results may vary between physicians; however the practice improvement/quality improvement coaching will be the same for all.

Deadlines will be provided in order to facilitate the completion of the Part IV project.

Patient Experience Survey (PDF)