Appendix e-1: Neurological Provider Satisfaction Survey

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1 Appendix e-1: Neurological Provider Satisfaction Survey

Please complete the following questions. * indicates a required field.

Provider Background 1. Sex:

 Female

 Male 2. Age:

 26-35 years

 36-45 years

 46-55 years

 56-65 years

 66- 75 years

 >75 years 3. NI Center:

 Adult Neurology

 Adult Psychiatry & Psychology

 Alcohol & Drug Rehabilitation Center

 Brain Tumor & Neuro-oncology Center

 Center for Brain Health^†

 Center for Neurological Restoration

 Cerebrovascular Center

 Epilepsy & Pediatric Epilepsy

 Headache Center

 Mellen Center^†

 Neuromuscular Center

 Neurosurgery

 Pain Center

 Pediatric Neurology

 Pediatric Psychiatry & Psychology

 Physical Medicine & Rehabilitation

 Regional Neurology

 Sleep Center

 Spine Center

 Other

† Mellen Center treats patients with demyelinating disease, Center for Brain Health treats patients with cognitive disorders

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2 Neurological Provider Satisfaction Survey continued

4. Provider level*

 MD/DO

 Midlevel

 PhD

Provider Feedback

1. Do you discuss the health status measure results with your patients?

 Always

 Usually

 Sometimes

 Infrequently

 Never

2. Do you feel having a patient-reported tool that screens for depression (PHQ-9) is clinically useful?

 Strongly Agree

 Agree

 Indifferent

 Disagree

 Strongly disagree

3. How frequently does the PHQ-9/depression information impact your patient interactions or clinical management?

 Always

 Usually

 Sometimes

 Infrequently

 Never

4. Do you feel including DISEASE-SPECIFIC questions is clinically useful?

 Strongly Agree

 Agree

 Indifferent

 Disagree

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3 5. How frequently does the DISEASE-SPECIFIC information impact your patient

interactions or clinical management?

 Always

 Usually

 Sometimes

 Infrequently

 Never

6. Would you like to change the questions that currently are asked in your questionnaire?

 Yes

 No

7. Have you provided suggestions to your KP Clinical Representative?

 Yes

 No

8. Would you like to use the data derived from the KP for research or quality activities?

 Strongly Agree

 Agree

 Indifferent

 Disagree

9. Do you believe the KP patient/provider questionnaire data are helpful in PATIENT CARE?

 Strongly Agree

 Agree

 Indifferent

 Disagree

10. Do you believe the KP patient/provider questionnaire data are helpful for QUALITY IMPROVEMENT?

 Strongly Agree

 Agree

 Indifferent

 Disagree

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4 11. Do you believe the KP patient/provider questionnaire data are helpful for

RESEARCH PURPOSES?

 Strongly Agree

 Agree

 Indifferent

 Disagree

Thank you for your participation.

Comments or suggestions

Survey administration:

Surveys were deployed through an electronic survey tool used by Cleveland Clinic.

Neurological Institute staff providers were sent an email with invitation to complete the survey that included a link to the survey. Responses were anonymous.