Tarlow

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Doerr

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Janicek

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Name/Room

Did the staff keep you informed about medications and their side effects.

Did you feel that your physician was engaged in your care?

Was your pain well controlled?

Who do you live with? Will you have help at home after discharge?

Comments:

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.