Emergency Department Experience: Post-ED Visit Survey

Complete this survey each time you visit an Emergency Department for treatment of a sickle cell pain crisis. Answer the following questions about your most recent Emergency Department visit.

Please note that Emergency Department is referred to as “ED” throughout the survey.

SCDAA Post-ED Visit Survey
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Name
Had you been seen at this ED prior to this visit?
Did anyone accompany you to the ED?
Selected Value: 1
With 1 = mild pain and 10 = your most severe pain
After seeing the doctor, how long did you wait before you received your first pain medication?
Did you tell the ED staff the name of your regular doctor and/or hematologist?
How responsive was ED staff to the provider information you gave them?
Did you feel “heard” by the ED staff?
Do you feel you were treated with respect?
Were your pain/concerns adequately addressed?
Were you offered the opportunity to speak with a patient advocate?
Did you ask for a patient advocate?
Were you admitted to the hospital for further treatment??
Was a pain plan discussed during your visit?
How would you rate your overall ED experience during this visit?
Did you present your MedicAlert Smart Card to the ED staff?
Do you have a doctor prescribed SCD Pain Plan on file with MedicAlert?
From your observation, did the MedicAlert Smart ID card and access to your pain plan make a difference in the care you received?
In your opinion, did presenting your MedicAlert Smart ID Card improve or worsen your ED experience compared to past visits without the MedicAlert ID?
Do you see value in continuing to carry the MedicAlert Smart Card with you?
Would you recommend a MedicAlert Smart Medical ID Card to family members or other people living with SCD?

Thank you for providing this important information to help establish the efficacy of this program. 

If you have any questions about the pilot, please contact the program administrator at sicklecellpilot@medicalert.org.