Post-Discharge Patient Survey
Ask patients after an inpatient stay about admission, medical care, nursing, the room, meals and discharge planning — modeled on the Patients' Experience Questionnaire and the HCAHPS topic areas, including likelihood to recommend.
Take the template with one click, adapt it to your project in a few minutes and start collecting answers.
Why this template?
Adapted in minutes
Change, add or remove questions — the AI assistant rephrases them on request.
Free to start
Publish the template on a free account — no trial clock, no expiry date.
Results in real time
Charts, filters and export to Excel, SPSS or CSV — with no extra work.
How to use this survey
- 1
Take the template
Create a free account and copy the template into your project with one click.
- 2
Adapt the questions
Adjust wording, scales and logic to your context — as often as you like.
- 3
Invite respondents
Share it by link, QR code, email or embedded on your website.
- 4
Analyse the answers
A live dashboard with charts, filters and export into your analysis tool.
The questions in this template
- How were you admitted to our hospital?
- How much do the following statements apply to your admission to hospital?
- How do you rate the medical care in the following respects?
- How do you rate the nursing care in the following respects?
- During your stay, did you have to wait for examinations or treatments?
- Was everything done to relieve your pain?
- Before you were given a new medication, was it explained what it was for and what side effects it could have?
- How satisfied were you with your accommodation?
- How satisfied were you with the meals?
- How much do the following statements apply to your discharge?
- How well was your discharge organized overall?
- When you were discharged, did you know whom to contact with questions?
All 18 questions are fully editable.
Frequently asked questions
Is the “Post-Discharge Patient Survey” template free?
Yes. You can use, customize and publish the template for free — a free account is all you need.
How do I use the “Post-Discharge Patient Survey” template?
One click on “Use this template” creates it as your own survey in the editor. From there you can adapt it and share it by link, QR code, email or embedded on your own website.
Can I change, delete and add questions?
Completely. Once taken, the survey sits in your editor: every question, scale and answer option can be edited, reordered or removed.
What data does the “Post-Discharge Patient Survey” template collect?
Which data you collect is decided question by question — if you don't ask for personal data, none is collected. Every question in the template can be changed or removed before you publish.
Are surveys built from the “Post-Discharge Patient Survey” template secure and anonymous on empirio.ai?
Respondents need no account and simply open the link. Whether answers stay anonymous is up to the questions you ask: as long as nothing personal is asked, no answer can be traced back to a person.