Final Report ANDIAB2 2012 Quality Assurance of Patient Practices and Diabetes Centre Care - December 2012

Appendix 4 - Post Data Collection Questionnaire, Individual Site Report Questionnaire

Page last updated: 16 December 2013

NADC – ANDIAB2 2012 - [Australian National Diabetes Information Audit & Benchmarking2 2012] - Post Data Collection Questionnaire

Thankyou for completing the data collection phase of the project. We would now greatly appreciate your anonymous comments to the following brief questionnaire. Please mark your response to each question on the 1 - 5 ‘Lickert’ Scale or circle N/A [Not Applicable].

[A] Please comment on the ‘HOW TO FILL IN ANDIAB FORMS’ information package / letters you received about the data collection project:
N/A
[1] Poor / Insufficient [5] Excellent / Fully Explained
Information Package / Letters 1___________________________________5
Comments: ____________________________________________________________________
______________________________________________________________________________

[B] Please comment on the Data Definitions Forms :
N/A
[1] Unclear / Confusing [5] Clear / Concise
Data Definitions Forms 1___________________________________5
Comments: ____________________________________________________________________
______________________________________________________________________________

[C] Please comment on the following aspects of the Data Collection Forms :

[C1] Format (layout of data items) [1] Unclear / Confusing [5] Clear / Concise
1___________________________________5
Comments: ____________________________________________________________________
______________________________________________________________________________

[C2] Ease of completion [1] Difficult [5] Easy
1___________________________________5
Comments: ___________________________________________________________________
_____________________________________________________________________________

[C3] Time to complete the form
[1] Took Too Long [5] Time Not Excessive
1___________________________________5
Comments: ___________________________________________________________________
_____________________________________________________________________________

[D] Diabetes Distress Scale [DDS] Calculator
Our Site used [1] The Software Provided; [2] The Web Link Calculator; [3] Manual Scoring
N/A – [we did not complete the DDS on our patients]
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If you used [1] or [2] - Please comment on the DDS Calculator:
[1] Difficult to use [5] Easy to use
1___________________________________5
Comments: ___________________________________________________________________
_____________________________________________________________________________

[E] Please list any Data Items you feel should have ALSO been collected in ANDIAB2.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

[F] Please list any Data Items you feel should NOT have been collected in ANDIAB2.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

[G] Any other comments : ______________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Thank you for taking the time to complete this questionnaire.
Please post to: Ms Suzie Neylon or Ms Linda Valenzisi
Postal Address
C/- Australian Diabetes Society
145 Macquarie Street, Sydney NSW 2000
Telephone: 02 9256 5462
Fax: 02 9251 8174
Email: ANDIAB, Australian Diabetes Society


NADC – ANDIAB2 2012 - [Australian National Diabetes Information Audit & Benchmarking2 2012] - Individual Site Report Questionnaire

Thank you again for participating in the ANDIAB2 2012 data collection project. We would now greatly appreciate your anonymous comments to this brief questionnaire.

Please mark your response to each question on the 1 - 5 Lickert Scale.

[A] Please comment on your overall impression of the Individual Site Final Report you received:
[1] Poor/Limited Use [5] Excellent/Useful
Individual Site Final Report
1___________________________________5
Comments: __________________________________________________________
____________________________________________________________________
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[B] Please comment on the following aspects /sections of the REPORT:
[1] Explanatory Notes
[1] Unclear/Confusing [5] Clear/Concise/Instructive
1___________________________________5
Comments: __________________________________________________________
____________________________________________________________________

[II] 2 Year Comparitive Data If Applicable Yes / No / N/A


Is the comparative 2005-2100 Patient Outcomes & Missing Data Useful?

[1] Unclear/Confusing [5] Clear/Concise/Instructive
1___________________________________5
Comments: __________________________________________________________
____________________________________________________________________

[III] Diabetes Distress Scale Individual List If Applicable Yes / No / N/A

[1] Unclear/Confusing [5] Clear/Concise/Instructive
1___________________________________5
Comments : __________________________________________________________
____________________________________________________________________

[IV] Worked Examples [in the front of each Section]


[1] Unclear/Confusing [5] Clear/Concise/Instructive

1___________________________________5
Comments : __________________________________________________________
________________________________________________________________________________

[V] Frequency Count Data [1] Unclear/Confusing [5] Clear/Concise/Instructive
1___________________________________5
Comments: __________________________________________________________
____________________________________________________________________
[VI] Mean/Descriptive Data [1] Unclear/Confusing [5] Clear/Concise/Instructive
1___________________________________5
Comments: __________________________________________________________
____________________________________________________________________
[VII] Missing Data [1] Unclear/Confusing [5] Clear/Concise/Instructive
1___________________________________5
Comments: ____________________________________________________________________
____________________________________________________________________

[C] Please list any Data / Information you feel should have ALSO been reported.
____________________________________________________________________
____________________________________________________________________

[D] Please list any Data / Information you feel should NOT have been reported.
____________________________________________________________________
____________________________________________________________________

[E] Any other comments [in particular, how are you making use of your report?]:
____________________________________________________________________
____________________________________________________________________

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Thank you for taking the time to complete this questionnaire.
Please post to: Ms Suzie Neylon or Ms Linda Valenzisi
Postal Address
C/- Australian Diabetes Society
145 Macquarie Street, Sydney NSW 2000
Telephone: 02 9256 5462
Fax: 02 9251 8174
Email: ANDIAB, Australian Diabetes Society