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ACE (croup) health professional survey
We would like your feedback on a recent referral you made to the ACE (croup) service. This will help us evaluate and improve it. The estimated time to complete it is 5 - 10 mins. Thank you for taking the time to do this.
OK
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1.
Please tell us your role.
(Required.)
GP
GP ANP
ED doctor
ED ANP
Paediatric doctor
Paediatric ANP
2.
How did you hear about the ACE service?
word of mouth
directly from the ACE team
email
oither - please specify below
Other (please specify)
3.
Did you get through to the ACE team on your first call?
Yes
No
4.
Was the referral crib sheet easy to use?
Yes
Partly / somewhat
No
Please tell us the reasons for your answer
5.
Was the referral process easy?
Yes
Not completely
No
Please tell us the reasons for your answer
6.
Were you happy with the level of contact you had with the team?
Yes
Partly
No
Please tell us the reasons for your answer
7.
Was the information we provided on discharging the child adequate, timely and clear?
Yes
Partly
No
Please tell us the reasons for your answer
8.
What could we do better? How could we improve this service or process?
9.
Please use this space to give us any other feedback, or to make suggestions of other pathways you think this model could be applied to.
10.
How happy were you with the level of contact you had with the ACE team after referral’
Very happy
Quite happy
Not very happy
Not at all happy
Please briefly tell us the main reasons for your rating.
11.
Would you use the service again?
Yes
No
Maybe
Please tell us the reasons for your answer
