Minor Operation Satisfaction Audit

Test

1. Feedback form

Please take a few moments to fill in this questionnaire 2 weeks after the procedure, it will help us maintain our high standards.

1. Pleas enter the unique ID number provided by the practice. *

2. Please would you grade the following: *

	5 = Excellent	4 = Good	3 = Adequate/OK	2 = Insufficent	1 = Poor
Explanation given	Explanation given 5 = Excellent	Explanation given 4 = Good	Explanation given 3 = Adequate/OK	Explanation given 2 = Insufficent	Explanation given 1 = Poor
Consent form	Consent form 5 = Excellent	Consent form 4 = Good	Consent form 3 = Adequate/OK	Consent form 2 = Insufficent	Consent form 1 = Poor
Anaesthetic (if applicable)	Anaesthetic (if applicable) 5 = Excellent	Anaesthetic (if applicable) 4 = Good	Anaesthetic (if applicable) 3 = Adequate/OK	Anaesthetic (if applicable) 2 = Insufficent	Anaesthetic (if applicable) 1 = Poor

3. Our complication rate is very low, but we would like to know if: - *

	Yes	No
You have been prescribed antibiotics after getting a post-operative infection	You have been prescribed antibiotics after getting a post-operative infection Yes	You have been prescribed antibiotics after getting a post-operative infection No
You have been prescribed painkillers for unexpected post-operative pain	You have been prescribed painkillers for unexpected post-operative pain Yes	You have been prescribed painkillers for unexpected post-operative pain No
You have needed to make an appointment because of post-operative bleeding	You have needed to make an appointment because of post-operative bleeding Yes	You have needed to make an appointment because of post-operative bleeding No
Your wound has opened after suturing	Your wound has opened after suturing Yes	Your wound has opened after suturing No
You needed to make an appointment with any other concerns regarding this procedure	You needed to make an appointment with any other concerns regarding this procedure Yes	You needed to make an appointment with any other concerns regarding this procedure No

Are there any other comments you would like to make?