Share Your Care Experience – Help Us Improve

Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.

Overall Overview

This Patient Feedback Form is thoughtfully designed to collect granular, actionable feedback across every critical touchpoint of a healthcare episode from pre-admission to discharge. The breadth of sections (ranging from staff professionalism to billing, digital tools, and overall safety) ensures that every stakeholder area is covered. The matrix rating questions are particularly effective because they let respondents quickly quantify sensitive areas without free-text fatigue, and they are immediately aggregated for dashboards. The conditional logic starting with yes/no questions breaks the form into digestable steps and keeps the perceived burden of completion low, especially when a visitor has only experienced a limited number of services. The reassuring introductory paragraph and explicit note that identifying information "is optional and used only to link any follow-up you may request" addresses the privacy concern that usually reduces willingness to participate. The inclusion of the NPS (1–10 recommendation) and emotion rating at the end give the form a clear closing anchor that will translate into a single metric that can be tracked across time and facilities.

However, the form is extremely long (14 sections and roughly 40+ questions). Even the smartest conditional logic cannot mask the cognitive overhead of seeing such a long progress bar, so it risks abandonment at the mid-point (survey at 8 minutes, abandon at 10) and may inflate response time and cost-to-serve per patient. It would benefit from a split-page design with progress indicators, and the possibility to save and continue later (pausable consent). The large number of mandatory fields inside matrix questions (all five fields are mandatory) can also increase the risk of abandonment when respondents are unsure how to score a particular item (for example, someone who did not interact with financial counselling but is asked a mandatory question about it). Additionally, the Date of your last visit field is the only mandatory field outside the matrix; it should be validated to prevent future dates or dates that are too far in the past (more than 24 months) otherwise the data quality will be mixed.

Question: Date of your last visit

Why ask Date is the anchor field that allows the facility to cluster feedback by service date and to correlate feedback with staffing roster or facility changes (for example, a spike in negative comments around a specific date).

Strength It is a discrete single number and is easy to answer. Using an open-ended date input allows for an exact date which is often more precise than a quarter or a dropdown month selector.

Data implications The raw date will be processed as experience_date and linked to operational data such as occupancy, staffing and survey date for analytics. The sensitive data is sensitive in the sense that it could be used to identify the respondent if combined with other identifiers, so the form uses a consent header at the beginning stating that responses are stored in aggregate.

Question: Please describe what happened so we can recognise them

Why ask Positive feedback is a morale driver and can be used for staff recognition and staff training. The HR side uses a story example to build role model training.

Strength Only appears when go above and beyond is selected, meaning question fatigue is kept low and the narrative is anecdotally provided at story time for staff meetings; this causes only a soft increase to response length rather than a mandatory narrative for all users.

Data implications Stories are anonymised and run through sentiment analysis and are used in internal only recognitions; stories are stored without identifiable metadata. Storage is encrypted.

Question: Please describe the incident (role, approximate time, what occurred)

Why ask The facility needs qualitative details for root cause analysis and mandatory reporting mandated by accreditation bodies and the facility policy.

Strength It is only triggered if unprofessional behaviour is ticked, and asks for specifics needed for incident analysis (role, time, what occurred).

Data Because this is a mandatory field it will trigger a flag for a quality officer to review and will be escaled into an HR or privacy review. The data will be anonymised and stored separately from the general feedback database.

Question: Describe any environmental factor that positively or negatively affected your visit

Why ask Environmental factors such as lighting or noise are subjective and can be missed by facilities audits. Collecting patient stories helps the facility to make improvements that are not captured by the usual matrix questions.

Strength This is optional and open-ended, so users can provide nuance without a ceiling on examples (for example, a parent might mention a child or a sensory issue). This broadens the narrative without the friction that would be caused by a matrix.

Data implications The data is unstructured and will need qualitative analysis (topic modelling) but is anonymised and stored in aggregate for a qualitative insights that will be used in the facility planning meetings.

Question: Have you visited any other healthcare provider for the same issue within the past months?

Why ask Understanding likelihood of dual care or provider switching helps the facility to understand the likelihood of leakage (the facility is losing value by not being the primary provider).

Strength

This question is asked at the end of the form, so the respondent is already warmed up and is able to contextualise the question in terms of their overall experience. The follow-up question is a rating (how does our facility compare) which gives actionable insight (win or switch).

Data implications This data is aggregated to retention score and informs the marketing and retention group who is a risk of churn.

Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.

Mandatory Fields Justification

Question: Date of your most recent visit
Justification: The exact date of the visit is required for the feedback to be linked to staffing rotas, occupancy and other administrative metrics. Without this date, the feedback cannot be contextualised for root cause analysis or quality review, therefore it must be collected to ensure the feedback is actionable.

Question: Please describe what happened so we can recognise them
Justification: The open-text field is mandatory because the organisation wants to capture concrete stories that can be used for staff recognition and internal training. A simple yes without narrative would not provide sufficient detail for HR to follow up; therefore the description is required to make the recognition programme meaningful.

Question: Please describe the incident (role, approximate time, what occurred)
Justification: This field is mandatory to meet internal quality and accreditation policies that require a written account of any unprofessional behaviour. The description enables the quality team to investigate, classify, and escalate the incident, and it is a prerequisite for mandatory reporting to accrediting bodies.

Question: Please describe what you observed so we can investigate
Justification: Witnessed infection-control lapses must be documented in detail so that the infection prevention team can trace the breach and take corrective action. The narrative is mandatory to ensure that the facility can conduct a thorough investigation and comply with safety standards.

Overall Mandatory Field Strategy Recommendation

The form keeps almost every field optional, which is appropriate for a patient-centric feedback form where anonymity is encouraged and completion rate is critical. However, the four mandatory free-text fields are all conditional and only spring into action when a specific issue (positive or negative) is flagged. This design minimises the burden on the majority of respondents while ensuring that the organisation receives the detail it needs for action. To further improve completion rates, consider adding a progress bar with section names so that respondents can see how far they are from the end; also, allow respondents to save and continue later to reduce abandonment due to interruption.

Finally, consider making some of the matrix rows optional by adding an Not applicable column. Currently every row inside Staff Professionalism, Wait & Access Times, and Facility Environment is implicitly mandatory because a rating must be chosen. Adding an N/A option will reduce forced answers and increase data quality. Overall, the current mandatory strategy is well-balanced for a healthcare feedback context where privacy and patient burden are paramount.