We would like to hear your reactions to or thoughts about our yearly report to help us continuously improve our work. Please take a few minutes to answer the following questions. The survey should take you only 5 minutes to complete.

Would you like to hear from us in the future? By providing us with an email address (optional), you can ensure that you hear about HQO's activities and related topics. Please be assured that your e-mail address will not be sold. It will be kept confidential by HQO and will be used for the sole purpose of e-mailing HQO information.

Email:

Please tell us your thoughts about the report:

1) How easy was the report to read? Very easy Somewhat easy Somewhat difficult Very difficult

2) How would you rate the overall quality of the report? Excellent Very good Good Fair Poor

3) This report is coming from an independent, unbiased source. Strongly disagree Disagree Neither / Not sure Agree Strongly Agree

4) The information in this report is scientifically valid and reliable. Strongly disagree Disagree Neither / Not sure Agree Strongly Agree

5) The most interesting or informative parts of the report were:

6) The least interesting or informative parts of the report were:

By reading this report, I:

7) I learned more about a healthcare issue that matters to me. Strongly disagree Disagree Neither / Not sure Agree Strongly Agree

8) As a result of reading this report, will you do any of the following? (Check all that apply.) Take a more active role in my own health care or care of a family member Ask my doctor/nurse more questions Follow any other advice to patients suggested in the report Write to your Member of Provincial Parliament or the Ministry of Health and Long-term Care about a health issue in the report Express your concerns to your provider organization (e.g. hospital, long-term care facility, community care access centre, local health integration network) Use the information in the report for your research Quote the information in a media story or letter to the editor Other, please specify

9) What are the most important topics for Health Quality Ontario to cover in its report next year?

10) For future reports, would you be interested in seeing:       a) Comparisons between individual health institutions, e.g. hospitals? Very interested Somewhat interested Not interested Don't know       b) Comparisons between communities, e.g. North Bay, Windsor, Kingston? Very interested Somewhat interested Not interested Don't know

11) How did you hear about Health Quality Ontario /about the yearly report? (check all that apply) Through a newspaper ad or article From a co-worker, friend or family-member Through the internet From a brochure or flyer During an event (meeting, conference or trade show) Through radio or television Other, please specify         11a) Had you heard of HQO prior to reading this report? Yes No

12) Comments about report /suggestions to improve :

Demographic questions (for internal analysis only):

13) Gender: Male Female

14) Age: Less than 20 years 20-34 years 35-50 years 51-64 years 65 years and over

15) What is the highest level of education you have completed? Less than high school High school diploma College diploma or technical degree University degree Post-university

16) How would you describe yourself? Member of the general public Health care provider (e.g., nurse, doctor, physiotherapist, home care worker, social worker) Employee or board member of a health care organization (e.g., hospital, long-term care home, community health agency) Employee or board member of a health-related advocacy group, association or regulatory body (non-delivery organization) Employee or member of government, a government agency of a local health integration network (LHIN) Researcher or academic Student Other, please specify

17) Where do you live? (please enter the first three digits of your postal code) (please enter 999 if you live outside of Canada)