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    Hospital Survey Form

    Uploaded by

    ongica james
    Silverbacks Pharmacy Ltd. installed and maintains oxygen plants in hospitals across the country. They conducted a survey to obtain feedback on plant performance and services. The survey gathered information on hospitals' oxygen needs and usage before and after plant installation, during the COVID pandemic, and currently. It asked about operational challenges, maintenance, and how Silverbacks can better serve hospitals.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Hospital Survey Form

    Uploaded by

    ongica james
    15 views6 pages
    Silverbacks Pharmacy Ltd. installed and maintains oxygen plants in hospitals across the country. They conducted a survey to obtain feedback on plant performance and services. The survey gathered information on hospitals' oxygen needs and usage before and after plant installation, during the COVID pandemic, and currently. It asked about operational challenges, maintenance, and how Silverbacks can better serve hospitals.

    Original Title

    HOSPITAL SURVEY FORM (1)

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    Silverbacks Pharmacy Ltd. installed and maintains oxygen plants in hospitals across the country. They conducted a survey to obtain feedback on plant performance and services. The survey gathered information on hospitals' oxygen needs and usage before and after plant installation, during the COVID pandemic, and currently. It asked about operational challenges, maintenance, and how Silverbacks can better serve hospitals.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    15 views6 pages

    Hospital Survey Form

    Uploaded by

    ongica james
    Silverbacks Pharmacy Ltd. installed and maintains oxygen plants in hospitals across the country. They conducted a survey to obtain feedback on plant performance and services. The survey gathered information on hospitals' oxygen needs and usage before and after plant installation, during the COVID pandemic, and currently. It asked about operational challenges, maintenance, and how Silverbacks can better serve hospitals.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 6

    SILVERBACKS PHARMACY LTD.

    OXYGEN PLANT SURVEY FORM 2023.

    Silverbacks Pharmacy Ltd. was contracted, by the Ministry of Health, to install


    and maintain Oxygen plants in a number of Hospitals across the country. In
    our effort to serve you better, we would appreciate your feedback regarding
    our services and plant performance ever since installation.

    Kindly take a few minutes to answer the following questions as we look


    forward to serving you better.

    Thank you.

    HOSPITAL NAME: ……………………………………………………………………………………………………………..

    BEFORE INSTALLATION

    1. Did you have oxygen administered to your patients in your hospital


    before installation of our medical oxygen plant?
    a) Yes
    b) No

    If yes,

    2. What was the source of your medical oxygen?

    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………

    3. How many oxygen cylinders did you consume daily/Weekly?

    ………………………………………………………………………………………………………………………………
    AFTER INSTALLATION

    1. Which year and month was your plant installed?

    …………………………………………………………………………………………………..

    2. How many cylinders did you fill per day within the first year;

    a) 0-3 months …………………………………………………………………….


    b) 4-6 months …………………………………………………………………….
    c) 7-12 months ……………………………………………………………………

    3. How many hours did you operate the plant in the first year of
    installation?

    a) Less than 8 hours


    b) Between 8- 12 hours
    c) More than 12 hours

    4. What challenges did you face during the first year of operating the
    plant?

    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
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    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………..
    DURING THE COVID PANDEMIC PERIOD

    5. How many cylinders did you fill in a day during the covid pandemic
    period?

    ……………………………………………………………………………………………..

    6. How many cylinders were dispatched averagely in a day?

    ………………………………………………………………………………………………

    7. How many hours was the plant operating in a day?

    a) Less than 8 hours


    b) Between 8- 12 hours

    c) More than 12 hours

    d) Others specify ……………………………………………………………………….

    8. What operational challenges did you experience during this season?

    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
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    …………………………………………………………………………………………………………………………………………………
    …………………………………………………………………………………………………………………………………………………
    POST COVID PANDEMIC PERIOD

    9.A) Is your oxygen plant currently functioning?

    a) YES

    b) NO

    B) If NO, How long has it been off?

    a) Between 1-2 months

    b) Between 3-6 months

    c) Between 6- 12 months

    d) Above 12 months

    e) Others specify

    ………………………………………………………………………………………………

    10. Who operates the plant?

    a) Plant operator

    b) Assistant/Engineering Technician

    c) Workshop manager

    d) Others Specify…………………………………………………

    11. Is the person operating the plant trained by Silverback Pharmacy Ltd.?

    a) YES

    b) NO

    12. How many hours does your plant operate?


    a) Less than 8 hours

    b) Between 8-12 hours

    c) More than 24 hours

    d) Others specify…………………………………………………………………

    13. Currently, How many cylinders do you fill in a day?

    ……………………………………………………………………………………………………

    14. How many hours does it take to fill a 40 liter cylinder?

    ……………………………………………………………………………………………………

    15. How do you describe our plant in terms of Operation?

    a) Easy

    b) Manageable

    c) Complicated

    16. What challenges have your operating team encountered during the use of
    this plant?

    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ……………………………………………………………………………………………………………………………………………………………..

    17. When was the plant last maintained?

    ………………………………………………………………………………………………………

    18. In your opinion, how can Silverbacks Pharmacy serve you better?
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………………………
    ……………………………………………………………………………………………………………………………………………………………..

    HOSPITAL DIRECTOR WORKSHOP MANAGER

    SIGNATURE: …………………………. SIGNATURE: ………………………….

    NAME: …………………………………….. NAME: ………...................................

    DATE: ………………………………………

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