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Healthcare & Clinical

Patient Experience Survey: Access, Communication & Care Quality

Measures patient satisfaction across appointment access, provider communication, follow-up timeliness, and digital touchpoints for healthcare organizations seeking actionable improvement insights and NPS benchmarking.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全23問・約10分
Q01
メッセージ

Welcome, and thank you for taking the time to share your experience. This brief survey asks about your most recent healthcare visit within the past 6 months and should take about 11 minutes to complete. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers—we are interested in your honest opinions. All responses are confidential and will be reported only in aggregate to help us improve the care we provide.

Q02
プルダウン

When was your most recent visit or interaction with us?

  • Within the last 7 days
  • 2–4 weeks ago
  • 1–3 months ago
  • 3–6 months ago
Q03
選択式

How did you schedule or start that visit?

  • Website
  • Mobile app
  • Phone call
  • Walk-in
  • Referral link or email
  • Third-party marketplace
  • Other
Q04
メッセージ

We'd like to understand your communication experience with your provider. Please indicate how much you agree or disagree with each statement.

Q05
選択式

After your visit, did you receive follow-up information or results?

  • Yes, within 24 hours
  • Yes, within 2–3 days
  • Yes, but later than 3 days
  • No follow-up was needed
  • No, I expected follow-up but did not receive it
Q06
選択式

Which of the following digital features, if any, did you use for this visit? Select all that apply.

  • Online booking
  • Secure messaging
  • View lab results
  • Prescription refill
  • Payment/checkout
  • Order tracking for meds/devices
  • None of the above
Q07
自由回答（長文）

Based on your experience, what is one thing we could improve for patients like you?

Q08
選択式

What is your age group?

  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q09
メッセージ

Thank you for your feedback—your responses will help us improve care for patients like you.

Q10
選択式

What type of care did you receive most recently?

  • Primary care
  • Specialist visit
  • Urgent care
  • Telehealth/video visit
  • Message-only consult
  • Lab or imaging
  • Pharmacy/medication delivery
  • Other
Q11
オピニオンスケール

Overall, how easy was it to get the care you needed?

スケール: 1 – 7
最小:Very difficult最大:Very easy
Q12
オピニオンスケール

My provider listened carefully to me.

スケール: 1 – 7
最小:Strongly disagree最大:Strongly agree
Q13
評価スケール

Overall, how would you rate your experience with the clinician you saw?

範囲: 1 – 5
最小:Poor最大:Excellent
Q14
オピニオンスケール

How easy was the website or app to use for your needs?

スケール: 1 – 5
最小:Very difficult最大:Very easy
Q15
AIインタビュー

We'd like to learn a bit more about your visit. An AI moderator will ask you a couple of brief follow-up questions based on your responses.

Q16
選択式

What is your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q17
プルダウン

Approximately how long did you wait past your scheduled appointment time?

  • Seen on time or early
  • 1–10 minutes
  • 11–20 minutes
  • 21–30 minutes
  • 31–45 minutes
  • More than 45 minutes
  • Not applicable (e.g., telehealth, walk-in)
Q18
オピニオンスケール

My provider explained things in a way I could understand.

スケール: 1 – 7
最小:Strongly disagree最大:Strongly agree
Q19
オピニオンスケール

My main health concern was addressed or resolved during this visit.

スケール: 1 – 7
最小:Strongly disagree最大:Strongly agree
Q20
プルダウン

In which country do you currently reside?

  • United States
  • United Kingdom
  • Canada
  • Australia
  • European Union
  • Other country
  • Prefer not to say
Q21
オピニオンスケール

My provider showed respect for what I had to say.

スケール: 1 – 7
最小:Strongly disagree最大:Strongly agree
Q22
オピニオンスケール

How likely are you to recommend our care to a friend or family member?

スケール: 0 – 10
最小:Not at all likely最大:Extremely likely
Q23
オピニオンスケール

I felt involved in decisions about my care.

スケール: 1 – 7
最小:Strongly disagree最大:Strongly agree

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Includes a dedicated AI follow-up interview segment that lets patients elaborate on their visit in their own words, beyond fixed-choice questions
  • Covers the full experience arc in one instrument: appointment access and wait time, provider communication (listening, clarity, respect, involvement), follow-up timeliness, and digital touchpoint usage
  • Pairs a clinician rating and an explicit recommend-likelihood question with an open-text improvement prompt, giving both quantifiable NPS-style benchmarking and qualitative signal
  • Uses transparent, reviewable question and interview prompts plus automated scoring, so healthcare teams can audit exactly what was asked and how responses were evaluated

SurveySparrow

Free Patient Satisfaction Survey Template | For Healthcare Industry

A ready-to-use static patient satisfaction template covering standard experience dimensions like care quality and staff interaction. It's built for quick deployment across chat-style or classic survey formats but relies on fixed questions rather than adaptive probing. Good for teams wanting a fast baseline NPS-type survey without deeper qualitative follow-up.

優れている点

  • Free, ready-to-field template aimed specifically at healthcare patient satisfaction
  • Supports SurveySparrow's conversational-style survey format for better completion rates
  • Likely includes standard satisfaction and NPS-style questions out of the box

物足りない点

  • No adaptive AI follow-up interview to probe individual patient answers in real time
  • No indication of automated per-response quality scoring or transparent prompt methodology
  • Static question set means all patients see the same questions regardless of their answers

QuestionPro

Health Insurance Satisfaction Survey Template

This template is focused on health insurance satisfaction rather than direct patient care experience (access, provider communication, follow-up), so it targets a narrower and somewhat different use case than a clinical patient experience survey. It's a standard fielding-ready form template within QuestionPro's broader survey platform. Useful if the goal is plan/insurer feedback rather than care-quality benchmarking.

優れている点

  • Ready-to-use template within an established enterprise survey platform
  • Likely includes robust reporting and cross-tab analysis tools typical of QuestionPro
  • Can be customized within a mature survey-logic builder

物足りない点

  • Template topic (insurance) is not a direct match for care-quality/provider-communication measurement
  • No adaptive AI-driven follow-up interviews or voice AI interview option
  • No transparent, auditable prompt-level methodology for how responses are scored

SurveyMonkey

Patient Satisfaction Survey Template

A post-visit patient satisfaction template covering common experience touchpoints, positioned as a straightforward fielding-ready survey. It's built on SurveyMonkey's traditional question-and-logic survey engine rather than any conversational or AI-driven interview format. Solid for basic post-visit pulse checks but limited for deeper qualitative insight.

優れている点

  • Ready-to-field template from a well-known, widely trusted survey platform
  • Likely supports skip logic and benchmarking against SurveyMonkey's question bank
  • Simple setup for post-visit satisfaction pulse surveys

物足りない点

  • No adaptive AI or voice AI interview component for deeper follow-up on patient answers
  • No automated per-response quality scoring described
  • Fixed-form structure only, without guided screen-share tasks or conversational probing

よくあるご質問

「Patient Experience Survey: Access, Communication & Care Quality」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が23問含まれており、最初の設問は次のとおりです：「Welcome, and thank you for taking the time to share your experience. This brief survey asks about your most recent healt…」・「When was your most recent visit or interaction with us?」・「How did you schedule or start that visit?」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、23問を約10分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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