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LISTENING TO ALBERTANS
SATISFACTION AND EXPERIENCE WITH
HEALTHCARE SERVICES: A SURVEY OF
ALBERTANS 2012
JANUARY 2013
www.hqca.ca
PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA
>
How does the HQCA define quality? In
2004, the HQCA developed the Alberta
Quality Matrix for Health, which defines six
dimensions of quality: acceptability,
accessibility, appropriateness, effectiveness,
efficiency and safety. All of these dimensions
focus on how our healthcare system should
deliver services. The HQCAs Satisfaction
and Experience with Healthcare Services survey
is an important tool for the HQCA to
assess how the health system is currently
performing in some of these key dimensions.
When assessing quality it is important to
gain the public/patient perspective on their
healthcare experience.This feedback paints
part of the overall picture for us as we strive
to fulfill our mandate to promote and improve
health service quality across Alberta.
You can find theAlberta Quality Matrix for
Health and more information atwww.hqca.ca.
PAVING THE WAY TO IMPROVED CARE
The Health Quality Council of Alberta (HQCA) has been conducting
population-based surveys on satisfaction and experience with the
healthcare system since 2003. The continuous monitoring of patient
experience is part of the HQCAs commitment to ongoing improvement
in the public health system in Alberta.
WHY ITS IMPORTANT TO HEAR FROM YOU
How Albertans feel about their healthcare experiences is an important
measure of what is working in Albertas health system and can also
help identify opportunities for improvement. This feedback provides
valuable information to Alberta Health, Alberta Health Services (AHS),
the health professions, healthcare providers and other stakeholders
responsible for healthcare service delivery.
The 2012 survey is of interest because it can be compared against
benchmark results from 2010, which was the first year we measured
patient satisfaction and experience since the formation of AHS.
WHO RESPONDED TO OUR SURVEY?
Our survey sampled 4,803 Albertans who were 18 years of age and
older, and had a land-line telephone. To ensure the respondents were
representative of Albertans, quotas were set for age and gender groupswithin each of the 5 Alberta Health Services zones. Some questions
were limited to only the respondents who had an experience with the
healthcare system in the previous 12 months. Survey weights were
used to make the results more representative of the population.
ALBERTAQUALITY MATRIXFOR HEALTH
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SOME OF THE KEY FINDINGS
Results of the 2012 survey remain relatively stable and comparable to the 2010 survey, and are a reflection
of Albertans experiences with healthcare services between February 24, 2011 and May 27, 2012.
64% of Albertans were satisfied with the healthcare services they received, compared to 62% in 2010.
Respondents in Alberta Health Services North zone were significantly less likely to be satisfied
with healthcare services (56%) as compared to the overall rating for Alberta (64%).
Albertans ingood health weremost likely to be satisfied with healthcare services received (71%),
and respondents considered the least healthy were lesslikely to be satisfied (56%) both ratings
differed significantly from the overall satisfaction rating of 64%.
The top three factors that influenced Albertans overall satisfaction rating were access to healthcare
services, quality of healthcare services, and how well healthcare professionals coordinate their efforts
to serve patient needs.
51% of Albertans rated access to healthcare services as easy, similar to 2010 (48%).
65% of Albertansbelieve the quality of healthcare services in the province is excellent or good, which
is the same as 2010 (65%). In comparison, 77% of respondents who actually received healthcare services
in Alberta in 2012 rated the quality of care as excellent or good, similar to 2010 (75%).
Less than 50% of respondents in 2012 rated how wellhealthcare professionals coordinated theirefforts to serve their needs as very good or excellent, which is unchanged since 2003. Healthy respondents
were more likely to report the healthcare professionals were excellent or very good at coordinating their
efforts (56%), compared to the least healthy respondents (44%).
54% of respondents who visited an emergency department in 2012 rated access to the emergency
department as easy the same result as 2010 (54%).
84% of respondents with apersonal family doctor were very satisfied with the healthcare services
they received from their doctor, similar to 2010 (83%).
13% of Albertans who received healthcare services in 2012 had a serious complaint unchanged
from 2010.
11% of Albertans said they or an immediate family member experienced unexpected harm within
Albertas healthcare system in 2012, significantly more than in 2010 (9%).
SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES: A SURVEY OF ALBERTANS 2012
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PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA
100
75
50
25
0
52% 58% 60% 62% 64%
2004 2006 2008 20122010
Overall satisfaction with healthcare services(4 or 5 out of 5)*
The vertical lines in the middle of each bar are confidence intervals that help gauge
statistically significant differences between numbers. Vertical lines that do not overlap
with each other mean differences are statistically significant. Overlapping lines indicate
no significant differences.
*4 or 5 out of 5 on a 5-point scale where 1 is very dissatisfied and 5 is very satisfied.
% SATISFIED (4 OR 5 OUT OF 5)**
HEALTHCARE SERVICE AREA
Family doctor
Community walk-in clinic
Emergency department
Specialist
Mental health
MRI (publicly funded)
Diagnostic imaging
Serious complaint handling
Satisfaction with specific healthcare services received
2010
83
58
59
79
78
85
87
20
2008
83
56
58
81
74
89
89
19
2006
84
57
51
81
72
79
88
24
2004
84
60
50
74
70
76
85
15
*
*
*
*
*
*Denotes statistically significant difference compared to the 2012 survey year. **4 or 5 out of 5 on a 5-point scale where 1 is very dissatisfied and 5 is very satisfied.
2012
84
62
59
80
74
82
89
20
WE ASKED ALBERTANS ABOUT
OVERALL SATISFACTIONThinking about all of your personal experiences within the
past year with the healthcare services in Alberta that we just
reviewed, to what degree are you satisfied or dissatisfied with
the services you have received?
SATISFACTION WITH HEALTHCARE SERVICES RECEIVED
64% of Albertans were satisfied with the healthcare services they received in 2012. This is relatively unchanged
from 2010 (62%), and a significant improvement from 2008 (60%) and 2006 (58%).
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SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES: A SURVEY OF ALBERTANS 2012
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1. ACCESS TO HEALTHCARE SERVICES
Access to healthcare services is the most important factor
that influences Albertans rating of overall satisfaction with
healthcare services received. The easier the access, the more
satisfied Albertans are with their healthcare experience.
Thinking of access and waiting times overall, how difficult or
easy was it to actually obtain the healthcare services you neededin Alberta within the past year?
WHAT WE HEARD
Just over half (51%) of Albertans rated overall access to
healthcare services as easy in 2012. This is relatively
unchanged from 2010 (48%) and is significantly higher
than 2008 (46%) and all other previous years.
The factor that was most important to Albertans concerning
ease of access was access to their personal family doctor.
Other factors associated with ease of access to healthcare
services include:
Ease of access to emergency department services
Ease of access to specialists
Ease of access to walk-in clinics
% EASY ACCESS (4 OR 5 OUT OF 5)**
HEALTHCARE SERVICE AREA
Family doctor
Community walk-in clinic
Emergency department
Specialist
Mental health
MRI (publicly funded)
Diagnostic imaging
Ease of access to specific healthcare services
2010
72
56
54
62
78
58
80
2008
73
53
51
59
79
59
79
2006
74
60
48
56
74
56
92
2004
NA
60
50
47
66
51
89
*Denotes statistically significant difference compared to the 2012 survey year. **4 or 5 out of 5 on a 5-point scale where 1 is very difficult and 5 is very easy.
*
**
*
*
*
*
*
2012
76
58
54
64
78
61
83
WHAT ARE THE TOP 5 FACTORS THAT INFLUENCE ALBERTANS RATING OFOVERALL SATISFACTION?
1. Access to healthcare services 2. Quality of healthcare services 3. Coordination of care4. Satisfaction with emergency department services 5. Satisfaction with handling of serious complaints
100
75
50
25
0
Overall ease of access to healthcare services(4 or 5 out of 5)*
The vertical lines in the middle of each bar are confidence intervals that help gauge
statistically significant differences between numbers. Vertical lines that do not overlap
with each other mean differences are statistically significant. Overlapping lines
indicate no significant differences.
*4 or 5 out of 5 on a 5-point scale where 1 is very difficult and 5 is very easy.
42% 46% 47% 46% 48% 51%
20042003 2006 2008 20122010
Q
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5PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA
Q
Q
2. QUALITY OF HEALTHCARE SERVICES
Quality of healthcare services is the second most important
factor that influences Albertans rating of overall satisfaction
with healthcare services received. If respondents rated
quality as excellent or good, they were more likely to be
satisfied with their heathcare experience.
Thinking about all of your personal experiences within
the past year with the healthcare services in Alberta that we
just reviewed, how would you describe the overall quality of
those services?
WHAT WE HEARD
65% of Albertans believe the quality of healthcare services
in Alberta is excellent or good. The rating increases to 77%
among those who actually received services in the past year.
Two factors with the greatest influence on respondents
rating of quality were the coordination of healthcare
professionals efforts and whether or not the respondent
had a serious complaint.
Other factors that influenced overall quality ratings:
Quality of care received from their personal family
doctor
Quality of emergency department services
Quality of care received from their walk-in clinic doctor
Quality of care received from a specialist
3. COORDINATION OF CARE
The third most important factor influencing Albertans
overall satisfaction rating with healthcare services received
is coordination of care.
Thinking about the healthcare services you received in
Alberta in the past year, how would you describe how well
all the healthcare professionals coordinated their efforts to
serve your needs?
WHAT WE HEARD
Less than 50% of respondents in 2012 rated how well
healthcare professionals coordinated their efforts toserve their needs as very good or excellent, which is
unchanged since 2003.
95% of respondents reported that in the past year,
there was never a time that doctors ordered a medical
test that they felt was unnecessary because the test
had already been done. This was a new survey question
in 2012.
The vertical lines in the middle of each bar are confidence intervals that help gauge
statistically significant differences between numbers. Vertical lines that do not overlap
with each other mean differences are statistically significant. Overlapping lines
indicate no significant differences.
100
75
50
25
0
74% 73% 75% 77%
2006 2008 20122010
Quality of received healthcare services(% good or excellent)
% EXCELLENT OR VERY GOOD
HEALTHCARE SERVICE AREA
Family doctor
Community walk-in clinic
Emergency department
Specialist
Quality of specific healthcare services received
2010
75
40
50
71
2012
71
43
51
70
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SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES: A SURVEY OF ALBERTANS 2012
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100
75
50
25
0
2006
Respondents were asked whether their family doctor had been informed about treatment, care or tests they hadreceived elsewhere in the system.
2008 2010 2012
EMERGENCY DEPARTMENT SPECIALIST MRI HOSPITAL CAREDIAGNOSTIC IMAGING
3. COORDINATION OF CARE - CONTINUED
PERCENTAGEWHOSTATED
THATDOCTORSWEREINFORMED
48%50%51%49%
64%65%63%64%
85%88%87%90%88%86%85%83%
68%66%68%69%
Q
100
75
50
25
0
Percent of respondents who went to the emergency department instead of somewhere else, by reason and survey year
2008
2010
2012
... THE ONLY CHOICE
AVAILABLE AT THE TIME
52%
55%
57%
... THE MOST CONVENIENT
PLACE TO GO
20%
27%
25%
... THE BEST PLACE FOR MY
MEDICAL PROBLEM
35%
37%
37%
... I WAS TOLD TO GO TO
THE EMERGENCY DEPARTMENT
20%
21%
19%
OTHER SPECIFIED
5%
1%
10%
4. SATISFACTION WITH EMERGENCY DEPARTMENT SERVICES
Satisfaction with emergency department services was the fourth most important factor influencing respondents overall
satisfaction rating.
How satisfied are you with emergency department services you or your family member most recently received?
WHAT WE HEARD
The percentage of respondents who were satisfied (4 or 5 out of 5) with emergency department services in 2012
(59%) has not changed since 2008 and 2010 (59%), but is significantly higher than in 2006 (51%), 2004 (50%) and
2003 (50%).
The percentage of respondents who rated access to emergency department services as easy (4 or 5 out of 5) is
unchanged from 2010 (54%).
The percentage of respondents who said they had gone to the emergency department instead of somewhere else
because it was the only choice available at the time (57%) is relatively unchanged from 2010 (55%).
PERCEN
TAGE
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100
75
50
25
0
2006
Respondents satisfaction with how their complaint was handled, by survey year
2008
2003
2004
2010
2012
5 VERY SATISFIED
9%
6%
8%
10%
10%
8%
4
12%
9%
16%
9%
10%
12%
3
19%
22%
19%
20%
19%
13%
1 VERY DISSATISFIED
41%
47%
35%
43%
40%
50%
2
20%
16%
23%
19%
21%
17%
PERCENTAGE
5. SATISFACTION WITH HANDLING OF SERIOUS COMPLAINTS
Satisfaction with handling of patient complaints was the fifth most important factor influencing respondents overall
satisfaction rating.
To what extent were you satisfied or dissatisfied with how your complaint was handled and addressed?
WHAT WE HEARD
13% of Albertans who received healthcare services had a serious complaint, unchanged from 2010.
Of the respondents who had a serious complaint, 43% did not report their complaint, and 41% voiced their complaint
directly to a healthcare professional. These results are relatively unchanged from previous years.
67% of respondents who had a serious complaint were dissatisfied (1 or 2 out of 5) with how their complaint
was handled, which is relatively unchanged from 2010 and 2008 (61%).
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MORE FINDINGS
Family Doctors
The majority of respondents who do not have a
family doctor use community walk-in clinics (55%)
and 7% say they use the emergency department.
33% of respondents who had visited their family
doctor in the previous year said that they needed
their doctors help in making changes to prevent
illness, and of those respondents, 91% indicated
that their doctor gave them the help they needed. 55% of respondents had talked with their family
doctor in the previous year about their exercise and
physical activity. This result is relatively unchanged
from 2010 (54%).
46% of respondents said they had talked to their
family doctor in the previous year about their diet
and eating habits. This result is relatively unchanged
from 2010 (45%).
Patient Safety
When asked about experiences of unexpected harm,
11% of respondents reported that they or an
immediate family member experienced harm while
receiving healthcare sometime in the past year,
which is significantly more than 2010 (9%) but
significantly less than 2003, 2004 and 2006.
Health Link
Albertans awareness of Health Link has increased
over time, rising from 66% in 2006 to 79% in 2012.
78% of Albertans who used Health Link in the past
year were satisfied (4 or 5 out of 5) with Health Link,
a significant increase from 2010 (72%).
At 83% in 2012, the number of Albertans who have a
family doctor has remained relatively unchanged since
the first survey in 2003 (81%).
100
75
50
25
0
Respondents who currently have a family doctor
81% 85% 81% 81% 82% 83%
20042003 2006 2008 20122010
100
75
50
25
0
Percent of respondents who indicated that they or an
immediate family member experienced unexpectedharm while receiving healthcare in Alberta
The vertical lines in the middle of each bar are confidence intervals that help gauge
statistically significant differences between numbers. Vertical lines that do not
overlap with each other mean differences are statistically significant. Overlapping
lines indicate no significant differences.
14% 13% 13% 10% 9% 11%
20042003 2006 2008 20122010
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The majority of respondents who received mental health services
in the past year said they obtained the services at a private counsellor/
therapist office (33%). Mental health services were also obtained
at a family doctor's office (23%), mental health clinic (15%) or
hospital (15%). These results are relatively similar to 2008 and 2010.
Hospital Care
84% of respondents rated the quality of their inpatient care duringan overnight hospital stay as excellent or good, which is relatively
unchanged from 2010 (79%). Only 2% rated the quality as poor,
which is significantly less than 2010 (10%).
85% of respondents rated the quality of their daytime outpatient
hospital care as excellent or good, which is relatively unchanged
from 2010 (86%).
Diagnostic Imaging
12% of respondents indicated that they had received magnetic
resonance imaging (MRI) services, which is unchanged from 2010
and 2008, but a significant increase from 2006 (8%) and 2004 (6%).
Among respondents who received a private MRI (7%), 87% agreed
they went to the private sector because the funded MRI wait time
was too long, which is unchanged from 2010.
The proportion of respondents who received some form of diagnostic
imaging other than an MRI in the past year (42%) is relatively
unchanged from 2010 (41%).
100
75
50
25
0
Percent of respondents who received mental health services in specific locations, by survey year.
2008 2010 2012
HOSPITAL EMERGENCY
DEPARTMENT
MENTAL HEALTH
CLINIC
FAMILY DOCTORS
OFFICE
OTHER SPECIFIEDTELEMENTAL
HEALTH
PRIVATE COUNSELLOR/
THERAPIST OFFICE
10%12%15%
0%1%2%
14%17%15%
31%24%23%
0%1%1%
8%11%12%
37%33%33%
Mental Health
SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES: A SURVEY OF ALBERTANS 2012
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COMPARISON: HEALTH STATUS AND PATIENT EXPERIENCE
Our survey results were analyzed by Albertans self-reported health status to compare the experience
of those categorized as less healthy to those categorized to be in good health. The respondents state of
health greatly influenced how they rated their experience.
Satisfaction Albertans in good health were more likely to be satisfied with healthcare services received (71%); respondents who
were the least healthy were less likely to be satisfied (56%). Both ratings differed significantly from Albertans
overall satisfaction rating of 64%.
Access
Overall, just over half (51%) of Albertans rated access to healthcare services as easy. This rating increased to 57%
among healthiest respondents and decreased to 42% among those who are least healthy.
Quality of Care
When Albertans were asked to rate the quality of healthcare services they received in 2012, 77% reported it was
good or excellent. This number increased to 81% among the healthy group. Results from the least healthy category
were below the provincial rating at 71%.Coordination of Care
While less than half (49%) of Albertans rated how well healthcare professionals coordinated their efforts to serve their
needs as good or excellent, this number increased significantly to 56% among the most healthy and decreased to 44%
among the least healthy.
Serious Complaints
The least healthy category of respondents were the most likely to have a serious complaint about healthcare services
(16%) compared to the healthiest group (11%).
MORE FINDINGS continued
Pharmacist ServicesSeveral new questions were added to the 2012 survey in relation to medication use and pharmacy services.
73% of respondents who were taking on average, two different prescribed medications on a regular basis,
reviewed and discussed the different medicines they were taking with a pharmacist or doctor during the past year.
41% of respondents do not have a written list of all the medications they are currently taking.
20% of respondents had difficulty filling a prescription for their medicine because a pharmacy did not have
enough medicine or the right medicine.
Public Health
28% of Albertans have never had a flu shot. The North zone has significantly more respondents who have never
had a flu shot (38%) compared to the Edmonton (27%), Central (31%), Calgary (26%), and South (26%) zones.
The most common reason respondents reported that they did not have a flu shot in the past year is because they
did not think it was necessary (47%), followed by they had not gotten around to it (21%). Other reasons were
because they had a bad reaction to a previous shot (10%) or they were fearful (3%).
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PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA
RESULTS BY ALBERTA HEALTH SERVICES ZONES
2012 Satisfaction, access and quality ratings across Alberta Health Services zones and by healthcare service area
EMERGENCY FAMILY WALK-IN DIAGNOSTICDEPARTMENT DOCTOR CLINIC SPECIALIST MRI IMAGING
ALBERTA
SOUTH
ZONE
CALGARY
ZONE
CENTRAL
ZONE
EDMONTON
ZONE
NORTH
ZONE
Satisfaction % satisfied
Access % easy access
Quality % excellent/very good
Satisfaction % satisfied
Access % easy access
Quality % excellent/very good
Satisfaction % satisfied
Access % easy access
Quality % excellent/very good
Satisfaction % satisfied
Access % easy access
Quality % excellent/very good
Satisfaction % satisfied
Access % easy access
Quality % excellent/very good
Satisfaction % satisfied
Access % easy access
Quality % excellent/very good
59
54
50
63
58
53
61
54
53
60
59
54
55
49
46
59
49
44
84
76
71
87
80
72
84
78
70
82
68
70
86
80
73
80
64
66
62
58
43
65
62
47
64
57
43
73
65
51
56
56
40
63
60
44
80
64
70
78
66
73
83
63
70
80
62
71
78
65
69
77
66
66
82
61
84
66
80
61
88
58
83
59
82
63
89
83
89
84
89
83
87
85
89
85
87
74
Note: Differences may not be statistically significant. See Technical Report for details.
2012 Overall satisfaction, access and quality scores by Alberta Health Services zones
OVERALL OVERALL OVERALLSATISFACTION % ACCESS % QUALITY %
(4 OR 5 OUT OF 5)* (4 OR 5 OUT OF 5)** (GOOD OR EXCELLENT)
ALBERTA
SOUTH ZONE
CALGARY ZONE
CENTRAL ZONE
EDMONTON ZONE
NORTH ZONE
64
67
64
62
66
56
51
56
51
48
53
43
77
79
78
75
79
71
* 4 or 5 out of 5 on a 5-point scale where 1 is very dissatisfied and 5 is very satisfied. ** 4 or 5 out of 5 on a 5-point scale were 1 is very difficult and 5 is very easy.
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SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES A SURVEY OF ALBERTANS 2012
12
HOW WE DID THE SURVEY
The Population Research Laboratory at the University
of Alberta conducted the 2012 survey by polling 4,803
Albertans across the five AHS zones. Adults 18 years
of age and older were contacted by phone between
February 24, 2012 and May 27, 2012. The 2012 response
rate was 29.3% and the margin of error was comparable
to previous years at approximately +/- 1.4%, 19 timesout of 20.
The Health Quality Council of Alberta gathers and analyzes
information and collaborates with Alberta Health, Alberta Health
Services, health professions, academia and other stakeholders to
translate that knowledge into practical improvements to health
service quality and patient safety in the healthcare system.
To see the complete results, technical analysis and all
the survey questions, download our Technical Report
at www.hqca.ca.
RESULTS BY ALBERTA HEALTH SERVICES ZONES continued
2012 Summary of other ratings across Alberta Health Services zones
COORDINATION OF CARE SERIOUS COMPLAINT UNEXPECTED HARM HEALTH LINK(% EXCELLENT/VERY GOOD) (% YES) (% EXPERIENCED) (% AWARE)
ALBERTA
SOUTH ZONE
CALGARY ZONE
CENTRAL ZONE
EDMONTON ZONE
NORTH ZONE
Note: Differences may not be statistically significant. See Technical Report for details.
49
49
50
46
50
45
13
15
12
14
13
15
11
11
11
11
11
10
79
76
81
76
80
76