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Evidence-Based Services - PICS Client Feedback

1. How did you come to be aware of the PICS program?
Referral by a VUMC Physician
Referral from another patient/family (please go to question 4)
Web site (please go to question 4)
Walked in to Library (please go to question 4)
Other (please go to question 4)
    
2. Please name the physician or referring department.
    
3. Did the referring physician/department fill out a Patient Prescription for Information pad for you to bring to the library?
Yes
No
    
4. What PICS services did you use? Please select as many as apply.
Web site
Patient Information Book Collection
PICS Research Service (information/articles provided by PICS staff)
    
5. I found the information I received from PICS to be:
Too medical/technical to understand
Too general, not enough details about my specific condition
Too simple to be of help
I could understand the information
    
6. I used the information I received form PICS to: (Please select as many as apply)
Ask my physician questions about my treatment
Better follow my physician's directions
Better understand my condition/treatment
Investigate treatment alternatives
Make decisions regarding my treatment
Other
    
7. I feel that the information I received from the PICS program:
Aided in my overall treatment experience
Did not have an impact on my treatment experience
    
8. Would the PICS program influence you to return to Vanderbilt Medical Center for your healthcare needs in the future?
Would be a factor in my decision
Would not be a factor in my decision
    
9. I would rate my overall experience using the PICS as:
Very positive
Positive
Neutral
Negative
Very negative
    
10. Please suggest ways we might improve the Patient Informatics Consult Service.

We would like to contact you in a few months to follow-up on your opinions of our service. If you would like to help us by completing a follow-up survey please fill out the following form. Someone from the Patient Informatics Consult Service will be in touch with you in the future.

Name:
Address:
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