The Collaborative Rounding in Long Term Care Project
Long-Term Care RESIDENT Experience Survey
Instructions for Interviewer
1. All long-term care residents are to be invited for the survey, including residents with dementia.
2. All long-term care residents have up to three opportunities to participate the interview.
3. Interviewers are to approach each assigned resident up to three times to conduct the interview, and the date/time of the three interview attempts are to be recorded at “Section 7: Interview Details”.
4. If any residents refuse to be interviewed for all the three attempts, the interviewers are to complete “Section 6” and “Section 7” , which includes documenting the refusal under the following question: Please evaluate how the whole interview went (choose all that apply). The resident refused to be interviewed.
5. Residents’ participation of the survey is completely voluntary. They can skip over any questions they do not want to answer, and they can stop participating at any time during the interview.
6. Interviewers are to make sure that interviews are conducted in a reasonably private area, so that the residents can feel at ease to share their thoughts. After the interviews, interviewers are to record the level of privacy of during the whole interview at “Section 7: Interview Details”.
7. The survey has a total of 36 closed-ended questions under five sections. At the end of each section, there is an open-ended question for residents to freely express their thoughts related to the subject.
8. To help residents understand survey questions, interviewers can use the suggested [Probe] in the survey. Not every survey question has a suggested [Probe]. For questions without a suggested [Probe], interviewers are NOT to rephrase the question, but could repeat it as many times as required (at least three times).
9. All the survey questions have two response options - “Generally, Yes” and “Generally, No”. “Generally, Yes” is associated with a happy face symbol; “Generally, No” is associated with a unhappy face symbol. A showcard with both response options is included at the last page of this document. When each question is asked, the interviewer should read aloud the two response options and also present the showcard.
10. A “No Answer” option is available to all survey questions. Interviewers should check off the “No Answer” option for the following circumstances:
(i) The resident refuses to answer the question;
(ii) The resident indicates that the question is not applicable to him/her;
(iii) The resident has difficulty answering the question in a decisive manner;
(iv) The resident does not appear to understand the question after the interviewer repeats the question at least three times;
(v) The resident responded by saying “I don’t know.”
(vi) The resident has no response to the question.
After completing a survey or after conducting the third interview with a resident, the interviewer is to complete “Section 6: Demographic Information” and “Section 7: Interview Details” before submitting it to the facility survey coordinator.
Before we start, I want to ensure you that all the information you provide will be completely confidential. Your answers will be combined with other people’s answers to produce a summary report to be used for quality improvements. No one at [facility name] will know what you said.
Your participation is completely voluntary. Whether you decide to participate or not, your care here will not be affected You can skip over any questions you do not want to answer, and you can stop participating at any time.
Do you have any questions before we start? If you have any questions before you complete this survey, we can contact:
Dr. Jan Rogerson, or Ellen Christie
Thank you for taking the time to complete our survey.
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