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Patient Assessment Needs and measuring their Satisfaction

level using MRI:

Name:

Age: Sex:

Address:

Contact No: Region of Scan:

(Grading scale: 1 – Poor 2 – Average 3 – Good)

Experience prior to MRI appointment or during arrival:

1. Where were you referred from?


a. Inpatient stay at Hospital b. From GP/Surgeon c. Self

2. How was your appointment?


a. Walk in basis b. Prior appointment

3. Have you undergone MRI scan before?


a. Yes b. No

4. Waiting time for the appointment?


a. Same day b. 1 – 2 days c. 2 – 3 days d. More than 3 days

5. Time taken for registration?


a. Less than 5 min b. 5 – 15 minc. More than 15 min

6. Waiting time taken after registration and before the scanning procedure?
a. 15 – 30 min b. 30 – 60 min c. more than 1 hour

7. Was your appointment changed or cancelled on the allotted time?


a. Yes b. No

8. Were the receptionists trained and courteous?


a. 1 b. 2 c. 3

9. How were other facilities like Water and Restroom?


a. 1 b. 2 c. 3

10.Cleanliness at waiting lounge?


a. 1 b. 2 c. 3

Experience during the Procedure:

11.Was a brief history taken before the scan?


a. Yes b. No

12.Any other physical examination was done before the procedure?


a. Yes b. No
13.How was the safety protocols and the procedure explained to you regarding MRI
scan?
a. 1 b. 2 c. 3

14.How was the changing room?


a. 1 b. 2 c. 3

15.Was a safe locker available for depositing your valuable like Jewellery/mobile?
a. Yes b. No

16.How comfortable were you made during the scan?


a. 1 b. 2 c. 3

17.How long did your procedure last?


a. Less than 15 min b. 15 – 30 min c. More than 30 min

18.Any problem/Inconvenience faced during the scan?


a. Yes b. No if Yes, then what.....................................................

Experience after the MRI Scan:

19.Were any post-operative instructions advised?


a. Yes b. No

20.How long were you made to wait for the final printed report along with films?
a. 2 hrs to 6 hrs b. 6 hrs to 12 hrs c. 12 hrs to 24 hrs

21.Any expert guidance or opinion was available after the scan guiding what next to do?
a. Yes b. No

22.How well are you satisfied with the overall MRI service?
a. 1 b. 2 c. 3

23.Do you feel that the service offered here is costlier than the market rate?
a. Yes b. No

24.Do you feel that there was a need for this diagnostic scan?
a. Yes b. No

25.Did your report had any findings or was it a normal study?


a. Findings b. Normal Study

26.Did the provisional diagnosis match the findings of the scan?


a. Yes b. No

27.Is this service covered under Insurance?


a. Yes b. No

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