Naval Hospital Rota Access to Care Survey

Naval Hospital Rota Access to Care Survey

OMB CONTROL NUMBER: 0704-0553

OMB EXPIRATION DATE: 05/31/2025

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information, 0704-0553, is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

1. What is your beneficiary status?

• Active Duty

• Active Duty Family Member

• Retiree

• Government Employee

• Contractor

• Other: _________________

2. I was able to make an appointment for Routine, Acute, and/or Specialty Care when I needed.

• Strongly disagree

• Disagree

• Neither agree nor disagree

• Agree

• Strongly agree

3. Which departments are the most difficult for you to access when you need care? Select all that apply.

• Medical Home Port (Primary Care)

• Operational Forces Medical Representative (Ship IDC, Battalion Surgeon, etc.)

• Emergency Room (ER)

• Dermatology

• Urology

• Orthopedics

• Pharmacy

• Laboratory

• Physical Therapy

• Radiology

• Obstetrics and Gynecology (OB/GYN)

• Immunizations

• Referrals Management/ Translations

• Appointment Line

• Occupational Health/ Preventive Medicine

• Nutrition

• Optometry

• Audiology

• Dental

• Network Services (Spanish)

• Telehealth Clinic (ENT, Sleep Medicine, etc.)

• General Surgery

• Behavioral Health

• None of the above

4. What are the main challenges you face when accessing care with the Departments mentioned in the previous question?

• Long wait times (time from checking in with reception until you are seen)

• Limited appointment availability (the appointments at the time slot I need are not available)

• Transportation to the hospital

• Unsatisfactory communication with hospital staff

• Chain of command/Operational Tempo is not able to support absence for appointments

• Other, please explain: ________________________________

5. Please provide any details about your concerns regarding these services. Do not include any personal identifiable information or personal health information.

6. Please describe any positive experiences you have had accessing care at Naval Hospital Rota. Do not include any personal identifiable information or personal health information.

7. What improvements would you suggest to enhance your experience at Naval Hospital Rota. Do not include any personal identifiable information or personal health information.

8. If you would like a hospital staff member to contact you, please leave your name and phone number and we will reach out to you as soon as possible.