Form questions

Hospital discharge survey questions sent ten days after

Ask 12 to 16, about ten days after discharge. Never skip whether medicines were explained, whether follow up was arranged, and whether the patient has needed to go back to hospital. Those three track the handover home, which is where many avoidable readmissions start.

Hospital discharge survey questions check whether patients left knowing their medicines, warning signs and next appointments, and how the stay went. Sent about ten days after discharge, these twenty two questions catch problems at home that a survey on the day of leaving would miss.

The questions

About the stay

  1. Which ward or unit were you mainly in?DropdownRequired

    A list of wards so results can go to the right manager.

  2. How long was your stay?Single choice

    One night, two to three nights, four to seven nights, more than a week.

  3. Was the admission planned or an emergency?Single choice

Care on the ward

  1. How much do you agree with each statement about the ward staff?Rating grid

    Rows: nurses listened, doctors explained, staff came when called, I was treated with dignity. Columns strongly disagree to strongly agree.

  2. How well was your pain managed?Single choice

    A five point scale.

  3. Were you involved in decisions about your care?Single choice

  4. How clean was your room and bathroom?Single choice

  5. How was the food?Single choice

Leaving hospital

  1. Before you left, were your medicines explained, including side effects?Single choiceRequired

    Yes completely, yes partly, no, I had no new medicines.

  2. Were you told what warning signs to watch for at home?Single choice

  3. Was a follow up appointment booked or explained?Single choiceRequired

  4. Did you get written information to take home?Single choice

  5. Was your discharge delayed on the day?Single choice

  6. Did your GP receive information about your stay?Single choice

    Many patients do not know; include a not sure option.

Since you got home

  1. Since leaving, have you had to go back to hospital or emergency?Single choiceRequired

  2. Have you had any problems with your medicines at home?Single choice

  3. Did you have the support you needed at home?Single choice

  4. How confident do you feel managing your recovery?Single choice

Overall

  1. Overall, how would you rate your hospital stay?Single choice

    0 to 10 as eleven options.

  2. What could the hospital have done better?Long text

  3. Would you like someone to contact you?Single choice

  4. Anything else?Long text

Which questions to make required

Four are required: the ward, whether medicines were explained, whether follow up was arranged, and whether the patient has gone back to hospital. These are the measures most tied to safe discharge, and a response without them cannot be counted for the handover report. The rating grid and open questions are optional, since some patients recovering at home want to answer only the essentials.

The form built from these questions

A static copy of the finished form, from its own example page.

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Please do not type your name, Medicare number or details about your health anywhere in this survey. Answers are stored without any link to your patient record.

What kind of appointment was it? *

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Three ways to change this bank

For a day surgery unit, drop the food and room questions and ask about fasting instructions, waking from anaesthetic and whether someone was there to take the patient home. For a maternity ward, add questions about feeding support and the first home visit. For a mental health unit, replace the pain question with whether the person had a safety plan on leaving and knew who to call. Whatever the unit, send the survey at the same interval after discharge for every patient, so results from different weeks can be compared, and offer a phone or paper option for patients who do not use email or text links.

Questions people ask

Why send a discharge survey days after leaving?

Because some of the most important questions, such as whether medicines worked at home and whether the patient had to come back, cannot be answered on the day of discharge. About a week or two later the stay is still fresh and early problems at home are known. Very late surveys lose detail.

What is a good discharge survey response rate?

It varies widely by method and population. Text and email links reach many patients, but older patients and some groups may prefer paper or a phone call. Offering more than one method and keeping the survey short helps. Track response rates by ward so low ones can be followed up.

Should the survey ask about readmission?

Yes. Whether the patient returned to hospital or emergency is a strong signal about the discharge. It is not the same as an official readmission rate, which hospitals measure from their own records, but it often surfaces problems such as missed follow up or medicine confusion.

Who should receive discharge survey results?

Ward managers for their own ward, the patient experience team for the whole hospital, and clinical leads for themes such as medicines and follow up. Comments that suggest a safety issue need a fast path to a senior clinician, not just a monthly report.

Can family members complete the survey?

Yes, especially for patients who are unwell, elderly or have limited English. Add a question asking who is completing it, the patient or someone on their behalf, so the answers can be interpreted correctly. Make it clear the survey is optional and does not affect care.

How does this relate to standard hospital surveys?

Many hospitals take part in established surveys, such as the HCAHPS survey in the United States or state run patient experience surveys in Australia. A hospital's own discharge survey can fill gaps and give faster feedback to wards, but should not change the wording of questions used for official comparisons.

Should a discharge survey be anonymous?

Ward level results are more honest when individual answers cannot be linked to a patient. If the survey is linked to records for follow up, say so clearly. Offer a separate contact question for patients who want a call, and handle those details apart from the analysis.

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On writing the questions themselves, read How to write survey questions. For everything the builder can do, see the form maker. Step by step: Create a conversational form with AI, then View, export and manage your responses.

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