QNIC Routine Outcome Measurement (ROM) Service CAMHS Satisfaction Survey (Short Version) - Parent Rated

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1 QNIC Routine Outcome Measurement (ROM) Service CAMHS Satisfaction Survey (Short Version) - Parent Rated QNIC ROM Service: Thank you for agreeing to participate in the QNIC ROM Service. The purpose of the CAMHS Satisfaction Survey is to enable young people and their parents or carers to give their feedback on the service they have received from the unit. Feedback from young people and parents is an important part of the regular review and development of the service. All the information you give will be dealt with in the strictest confidence - the data collected is anonymous and does not contain any personal identifiers. We very much welcome any comments you may have about how we can improve this service to meet the needs of your unit, so please feel free to contact the QNIC team any time: Peter Thompson (QNIC Programme Manager) on or Carly Butler (Project Worker) on IMPORTANT NOTE: For the CAMHS Satisfaction Survey (CAMHSSS), it is not necessary to enter the young person's code. This maintains the young person's/parent's anonymity when giving feedback on the service. However, some services may wish to use the CAMHSSS to feed back the evaluation to individual clinicians. If the young person or parent is happy to be identified, then please complete the young person's ID code. Instructions: Before you complete this questionnaire it is important that you read through all the sections and make sure you have access to the information you need to complete the items. You can only complete one questionnaire at a time-if you need to break half way through completion you can click on the SAVE button at the end of each page. This will save the questionnaire to the PC you were working on, which you will need to return to in order to complete and submit the questionnaire. If you use the SAVE command you will need to make sure your PC's pop-up blocker is disabled. Note that only one questionnaire can be saved at a time. Before you click SUBMIT to return the data to QNIC, click PRINT at the end of the questionnaire and add the completed questionnaire to the young person's case file. To ensure that the questions fit within an A4 layout, when you select PRINT you will need to go to 'Printing Preferences' and then 'Image Option' and reduce the image to about 50. How can we keep our own record of the data we enter? The data can be exported to an SPSS or an EXCEL format which we can back to you on a regular basis. For more information or to enquire about the results for your unit, please contact the QNIC project team on or Carly Butler at cbutler@cru.rcpsych.ac.uk or refer to the QNIC ROM web page page. TO BEGIN THE SURVEY, PLEASE CLICK THE NEXT BUTTON BELOW SECTION 1: UNIT AND YOUNG PERSON'S CODE Q1 Name of unit: IMPORTANT NOTE: For the CAMHS Satisfaction Survey (CAMHSSS), it is NOT necessary to enter the young person's code. This maintains the young person's/parent's anonymity when giving feedback on the service. However, some services may wish to use the CAMHSSS to feed back the evaluation to individual clinicians. If the young person or parent is happy to be identified, then please complete the young person's ID code below.

2 Q2 Unit and young person's code (please refer to your record sheet for the young person's code) Note: This is OPTIONAL Q3 Position or profession of person entering the data (please state if parent/carer entered data directly online: SECTION 2: CAMHS SATISFACTION SURVEY (CAMHSSS) - Parent / Carer Version The purpose of the CAMHS Satisfaction Survey is to enable young people and their parents or carers to give their feedback on the service they have received from the unit. Feedback from young people and parents is an important part of the regular review and development of the service. All the information you give will be dealt with in the strictest confidence - the data collected is anonymous and does not contain any personal identifiers. Q4 Has this young person's parent completed and returned the CAMHSSS parent-rating form or about to complete online? Yes If no, why? _ Q5 Date the CAMHSSS parent-rating was completed (DD/MM/YYYY): What is your overall feeling about: Q6a Q6b Q6c The effect of services in helping your child deal with his/her problems How the professionals (doctors, psychologists, nurses, therapists) listened to your child and understood the problems The personal manner of professionals Mixed Mixed Mixed

3 Q6d Q6e Q6f Q6g Q6h Q6i Q6j Q6k The professionals keeping time of appointments The confidentiality and respect for your child s rights The explanation given about the treatment The effect of services in helping your child to feel better The kinds of service offered to your child The service you have received, in a general sense The advice given to you about how you could help your child helping your child improve his/ her knowledge and understanding of the problems Mixed Mixed Mixed Mixed Mixed Mixed Mixed Mixed

4 Q6l Q6m Q6n Q6o Q6p Q6q Q6r Q6s helping the relationship between your child and you helping you to understand your child s problems How information was given to your child about the nature of their problems and what to expect in the future The ability of professionals to listen to and understand the worries you may have about your child How information was given to you about your child s problem and what to expect in the future The advice your child was given about what to do when on leave helping you deal better with your child s problem The length of time before a first appointment was arranged Mixed Mixed Mixed Mixed Mixed Mixed Mixed Mixed

5 Q6t The length of time between discharge and follow-up appointments Mixed Please write in your own words what you liked and disliked most about your experience of the unit, and what you would like to change Q7 Q8 Q9 The things I liked most about my experience of the unit: The things disliked most about my experience of the unit: The things I would like to change: Q10 Have you printed a copy of the completed questionnaire and placed them in the young person's file? Yes No Q11 Date all the items were completed (DD/MM/YYYY): Q12 Please add any other information you feel is relevant **Thank you for taking the time to complete and return this questionnaire** PLEASE UPDATE YOUR RECORD SHEET

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