| Surveys
For The Office
Medical
Home Family Index - Developed by The Center for Medical Home Improvement
(CMHI)
This survey is composed of twenty five questions to assess what
the
families
of
children
with
special
health
care
needs
have
to
say about
their care and its quality? This survey is used as
a
companion
to
the
Medical
Home
Index.
Pre-visit
survey 
- Developed by Exeter Pediatrics with support from the Center
for Medical Home Improvement
This survey is handed out to patients and families prior to their visit. They
can fill it out in the waiting area and note what brings them in today, topics
of concern and or discussion. Office staff can review the survey before the
evaluation so that they can prepare for specific needs/concerns ( i.e. length
of visit, need for care coordinator assistance, handouts needed...). Please
note that when handed out, a patient or caregiver should be asked if assistance
is needed in completing the form.
Post-visit
survey
- Developed by Exeter Pediatrics with support from the Center
for Medical Home Improvement
This survey done by families after their visit allows the
office to evaluate if they are meeting the needs of their
patients and families. It allows for quality improvements
in care coordination and office systems.
Provider
Survey -
Developed by Exeter Pediatrics with support from the Center
for Medical Home Improvement
This
survey allows the physician or health care professional
to evaluate if they are meeting the needs of their patients
and families. It allows for quality improvements in care
coordination and office systems.
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