HHL24. During this hospital stay, did you have to sign any forms? After HHL23 1 Yes Note: Before items HHL24 – 2 No If No, go to HHL26 HHL31, add a new subheading: About “Communication Forms” HHL25. During this hospital stay, how often did hospital staff After HHL24 explain the purpose of a form before you signed it? Note: Use with HHL24 1 Never 2 Sometimes 3 Usually 4 Always During this hospital stay, did you have to fill out any forms? After HHL25 HHL26. 1 Yes 2 No If No, go to HHL32 HHL27. During this hospital stay, how often did hospital staff offer After HHL26 you help to fill out a form? Note: Use with HHL26 1 Never 2 Sometimes 3 Usually 4 Always During this hospital stay, how often were the forms easy to After HHL27 HHL28. fill out? Note: Use with HHL26 1 Never 2 Sometimes 3 Usually 4 Always HHL29. During this hospital stay, how often were you given enough After HHL28 time to fill out forms? Note: Use with HHL26 1 Never 2 Sometimes 3 Usually 4 Always
HHL24. During this hospital stay, did you have to sign any forms? 1 Yes 2 No If No, go to HHL26 After HHL23 Note: Before items HHL24 – HHL31, add a new subheading: “Communication About Forms” HHL25. During this hospital stay, how often did hospital staff explain the purpose of a form before you signed it? 1 Never 2 Sometimes 3 Usually 4 Always After HHL24 Note: Use with HHL24 HHL26. During this hospital stay, did you have to fill out any forms? 1 Yes 2 No If No, go to HHL32 After HHL25 HHL27. During this hospital stay, how often did hospital staff offer you help to fill out a form? 1 Never 2 Sometimes 3 Usually 4 Always After HHL26 Note: Use with HHL26 HHL28. During this hospital stay, how often were the forms easy to fill out? 1 Never 2 Sometimes 3 Usually 4 Always After HHL27 Note: Use with HHL26 HHL29. During this hospital stay, how often were you given enough time to fill out forms? 1 Never 2 Sometimes 3 Usually 4 Always After HHL28 Note: Use with HHL26
suppl_health_lit_items_hcahps-adult_957-3a.docx