Safety Culture in Surgery Survey

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0

Surgeon
0

Surgery
0

Rate the following aspects of the surgical procedure:

Poor

Excellent

Staff training

Poor

Excellent

1 Poor

2

3

4

5 Excellent

Work procedures

Poor

Excellent

1 Poor

2

3

4

5 Excellent

Safety protocols

Poor

Excellent

1 Poor

2

3

4

5 Excellent

Safety issues

Poor

Excellent

1 Poor

2

3

4

5 Excellent

Risk assessments

Poor

Excellent

1 Poor

2

3

4

5 Excellent
0

How safe did you feel during the process?
Not at all

Slightly

Moderately

Very

Extremely
0

How much did you trust the surgeons and staff?
Not at all

Slightly

Moderately

Very

Extremely
0

Was the surgery properly explained to you beforehand?
Yes

No
0

Please elaborate

0 / 5000
0

Who explained the surgery procedure to you?

0 / 5000
0

How is the surgical environment lacking in safety?

0 / 5000
0

Were you injured during surgery?
Yes

No
0

Please elaborate

0 / 5000
0

Overall, how satisfied are you with safety of the surgery?
Very dissatisfied

Dissatisfied

Neutral

Satisfied

Very satisfied
0

What could have been improved? List your suggestions below.

0 / 5000