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Monroe Community Hospital Ventilator and Pediatrics Project

Caregiver Questions for Health Equity Impact Assessment - Monroe Community Hospital Ventilator and Pediatrics Project

Elm and Oak Health is assessing a project reconfiguring pediatric beds and adult ventilator beds at Monroe Community Hospital. The number of pediatric beds will increase from 5 to 30. Adult ventilator beds will be reduced to between 15 and 17 from 20 beds, converted to private rooms. The total number of beds at the facility will be reduced from 566 to 516. However, the patient census is only 410, with sixteen occupied adult ventilator beds. The project increases pediatric capacity and is expected to increase the patient census. Units will be reconfigured to allow the additional pediatrics, and the adult ventilator beds to be converted to private rooms. The playground will also be renovated.

1. Please indicate your agreement: I support the project (as described above).

Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree
Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree

2. How might these changes affect you?

3. What is most important to you as caregiver about the services your family member receives?

4. If you would like to make a statement about the project, please write below:

5. Can we include your statement in a publicly available assessment of the project?

To help us make additional suggestions and recommendations for the project, please answer the following questions about your needs as a caregiver.

6. What aspects of caregiving have been challenging to you personally? (Check all that apply)

Meeting the financial burden of caregiving
Educating others about the disability or condition of the person I care for
Getting time with other family members, or meeting other family members' needs
Getting a short break from caregiving
Managing the emotional or mental distress of caregiving
Finding a temporary substitute to provide occasional care
Taking care of myself
Providing physical assistance, including lifting and carrying
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

7. In addition to what you currently have or use now, what additional programs or services would help as a caregiver? (Check all that apply)

We would like to ask about some specific needs you may have that may affect your ability to access care.

8. What is your living situation today? (Check one)

9. Within the past 12 months, have you worried that your food would run out before you got money to buy more. (Check one)

10. In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? (Check one)