I was transferred to a nursing home 2 Go to 44 Do you think the hospital staff did everything they could to help control your pain? I went home Go to 37 3 I went to stay with a friend or relative Yes, definitely 4 1 Go to 37 Yes, to some extent 2 I went to stay somewhere else Go to 37 No 5 3 / know Can’t say don’t 4 Medications (e.g. medicines, tablets, AND ointments) Before you left the emergency department, were any medications prescribed for you? new In your opinion, how clean was the emergency department? Yes Go to 38 1 Very clean 1 No Go to 40 2 Fairly clean 2 Did a member of staff explain the purpose of the Not very clean 3 medications you were to take at home in a way Not at all clean 4 you could understand?  Can’t say Yes, completely 5 1 Yes, to some extent While you were in the emergency department, 2 did you feel threatened by other patients or No 3 visitors? I did not need an explanation 4 Yes, definitely 1 Did a member of staff tell you about medication Yes, to some extent 2 side effects to watch for? No 3 Yes, completely 1 Were you able to get suitable food or drinks Yes, to some extent 2 when you were in the emergency department? No 3 Yes 1 I did not need this type of information 4 No 2 I was told not to eat or drink 3 I did not know if I was allowed to eat or drink 4 I did not want anything to eat or drink 5 Information Did a member of staff tell you when you could resume your usual activities, such as when to go back to work or drive a car? Yes, definitely 1 Yes, to some extent 2 No 3 I did not need this type of information 4 What happened at the end of your visit to the Did hospital staff take your family or home emergency department? situation into account when you were leaving I was admitted to hospital Go to 44 the emergency department? 1
Do you think the hospital staff did everything they could to help control your pain? 1 Yes, definitely 2 Yes, to some extent 3 No 4 Can’t say / don’t know AND In your opinion, how clean was the emergency department? 1 Very clean 2 Fairly clean 3 Not very clean 4 Not at all clean 5  Can’t say While you were in the emergency department, did you feel threatened by other patients or visitors? 1 Yes, definitely 2 Yes, to some extent 3 No Were you able to get suitable food or drinks when you were in the emergency department? 1 Yes 2 No 3 I was told not to eat or drink 4 I did not know if I was allowed to eat or drink 5 I did not want anything to eat or drink What happened at the end of your visit to the emergency department? 1 I was admitted to hospital Go to 44 2 I was transferred to a nursing home Go to 44 3 I went home Go to 37 4 I went to stay with a friend or relative Go to 37 5 I went to stay somewhere else Go to 37 Medications (e.g. medicines, tablets, ointments) Before you left the emergency department, were any new medications prescribed for you? 1 Yes Go to 38 2 No Go to 40 Did a member of staff explain the purpose of the medications you were to take at home in a way you could understand? 1 Yes, completely 2 Yes, to some extent 3 No 4 I did not need an explanation Did a member of staff tell you about medication side effects to watch for? 1 Yes, completely 2 Yes, to some extent 3 No 4 I did not need this type of information Information Did a member of staff tell you when you could resume your usual activities, such as when to go back to work or drive a car? 1 Yes, definitely 2 Yes, to some extent 3 No 4 I did not need this type of information Did hospital staff take your family or home situation into account when you were leaving the emergency department?
AE16_Questionnaire_with_CQC_copyright.docx