One Brooklyn Health
The Research and Clinical Project Committee/Institutional Review Board (IRB)
Brookdale Hospital Medical Center | One Brookdale Plaza, CHC Room 175
Brooklyn, NY 11212 | E. firstname.lastname@example.org
Study Sponsor: NYS Health Foundation
Principal Investigator: Dr. Gwendolyn Lewis, DNP, RN, CMCN
Principal Investigator’s Phone Number: 718-613-6835
The goal of this research project is to improve the patient experience by identifying themes that underlie the root of patient experience, especially any inequalities between different patients’ experiences. You will be asked to complete the Brooklyn Health Equity Index (BKHI), a brief questionnaire. The purpose of this project is to capture and aggregate critical data absent from existing patient experience survey tools, such as discrimination, implicit bias, medical mistrust, and patient safety. Data will be used to develop a patient experience survey to help better serve the patients of the Brooklyn area.
Your name will not be associated with the completed questionnaire. Any personal information (age, race, ethnicity) will be kept in a confidential and protected database and only available to the research team.
On average, we estimate it will take no more than 10 minutes to complete the survey.
There are no physical risks related to participating in this research study. This research is no more than minimal risk. You might experience some discomfort or feel that some items are too sensitive or may not wish to respond. You do not have to respond to any questions you do not wish to, and you may choose to withdraw from the study at any time without penalty.
Participation in this research study is entirely voluntary and you may refuse to take part or withdraw from the study at any time without interfering with your medical treatment.
If you have any questions or concerns about your participation in the study, please contact Dr. Gwendolyn Lewis at 718-613-6835.
Please return to the text message and complete the survey.