Hospital Staff Communication Survey Form
Share your feedback about communication across hospital teams, shifts, and departments.
Respondent Information
Department/Team
*
Please Select
Administration
Anesthesia
Cardiology
Emergency Department
Facilities
Finance
Housekeeping
ICU
Laboratory
Medical Records
Nursing
Oncology
Pediatrics
Pharmacy
Radiology
Registration
Surgery
Other
Role/Job Title
*
Communication Survey
Overall communication rating
*
1
2
3
4
5
Clarity of shift handoff communication
*
Very unclear
1
2
3
4
Very clear
5
1 is Very unclear, 5 is Very clear
Timeliness of updates from leadership
*
Very untimely
1
2
3
4
Very timely
5
1 is Very untimely, 5 is Very timely
Effectiveness of communication tools and channels used in the hospital
*
Not effective
1
2
3
4
Highly effective
5
1 is Not effective, 5 is Highly effective
Preferred communication channels for work updates
*
Email
Phone call
Text message
Team huddle
Secure messaging app
Bulletin board
Other
Main communication challenges
Suggestions and Follow-up
Suggestions for Improving Communication
May we contact you for clarification or follow-up?
Yes
No
Submit Survey
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