Question

How could one improve the questions asked in the survey by the Agency for Healthcare Research and Quality (AHRQ) on Patient Safety Culture from 2004?

SECTION A: Your Work Area/Unit

In this survey, think of your “unit” as the work area, department, or clinical area of the hospital where you spend

most of your work time or provide most of your clinical services.

What is your primary work area or unit in this hospital? Select ONE answer.

 a. Many different hospital units/No specific unit

 b. Medicine (non-surgical)  h. Psychiatry/mental health  n. Other, please specify:

 c. Surgery  i. Rehabilitation

 d. Obstetrics  j. Pharmacy

 e. Pediatrics  k. Laboratory

 f. Emergency department  l. Radiology

 g. Intensive care unit (any type)  m. Anesthesiology

Please indicate your agreement or disagreement with the following statements about your work area/unit.

Think about your hospital work area/unit…

Strongly

Disagree



Disagree



Neither



Agree



Strongly

Agree



1. People support one another in this unit ..................................................... 1 2 3 4 5

2. We have enough staff to handle the workload ........................................... 1 2 3 4 5

3. When a lot of work needs to be done quickly, we work together as a

team to get the work done ......................................................................... 1 2 3 4 5

4. In this unit, people treat each other with respect ....................................... 1 2 3 4 5

5. Staff in this unit work longer hours than is best for patient care ................ 1 2 3 4 5

2

SECTION A: Your Work Area/Unit (continued)

Think about your hospital work area/unit…

Strongly

Disagree



Disagree



Neither



Agree



Strongly

Agree



6. We are actively doing things to improve patient safety ............................. 1 2 3 4 5

7. We use more agency/temporary staff than is best for patient care ........... 1 2 3 4 5

8. Staff feel like their mistakes are held against them ................................... 1 2 3 4 5

9. Mistakes have led to positive changes here .............................................. 1 2 3 4 5

10. It is just by chance that more serious mistakes don’t happen around

here ............................................................................................................ 1 2 3 4 5

11. When one area in this unit gets really busy, others help out ..................... 1 2 3 4 5

12. When an event is reported, it feels like the person is being written up,

not the problem .......................................................................................... 1 2 3 4 5

13. After we make changes to improve patient safety, we evaluate their

effectiveness .............................................................................................. 1 2 3 4 5

14. We work in "crisis mode" trying to do too much, too quickly ..................... 1 2 3 4 5

15. Patient safety is never sacrificed to get more work done .......................... 1 2 3 4 5

16. Staff worry that mistakes they make are kept in their personnel file ......... 1 2 3 4 5

17. We have patient safety problems in this unit ............................................. 1 2 3 4 5

18. Our procedures and systems are good at preventing errors from

happening .................................................................................................. 1 2 3 4 5

SECTION B: Your Supervisor/Manager

Please indicate your agreement or disagreement with the following statements about your immediate

supervisor/manager or person to whom you directly report.

Strongly

Disagree



Disagree



Neither



Agree



Strongly

Agree



1. My supervisor/manager says a good word when he/she sees a job

done according to established patient safety procedures ......................... 1 2 3 4 5

2. My supervisor/manager seriously considers staff suggestions for

improving patient safety ............................................................................. 1 2 3 4 5

3. Whenever pressure builds up, my supervisor/manager wants us to

work faster, even if it means taking shortcuts ............................................ 1 2 3 4 5

4. My supervisor/manager overlooks patient safety problems that happen

over and over ............................................................................................. 1 2 3 4 5

3

SECTION C: Communications

How often do the following things happen in your work area/unit?

Think about your hospital work area/unit…

Never



Rarely



Sometimes



Most of

the time



Always



1. We are given feedback about changes put into place based on event

reports ........................................................................................................ 1 2 3 4 5

2. Staff will freely speak up if they see something that may negatively

affect patient care ...................................................................................... 1 2 3 4 5

3. We are informed about errors that happen in this unit .............................. 1 2 3 4 5

4. Staff feel free to question the decisions or actions of those with more

authority ..................................................................................................... 1 2 3 4 5

5. In this unit, we discuss ways to prevent errors from happening again ...... 1 2 3 4 5

6. Staff are afraid to ask questions when something does not seem right .... 1 2 3 4 5

SECTION D: Frequency of Events Reported

In your hospital work area/unit, when the following mistakes happen, how often are they reported?

Never



Rarely



Sometimes



Most of

the time



Always



1. When a mistake is made, but is caught and corrected before affecting

the patient, how often is this reported? ...................................................... 1 2 3 4 5

2. When a mistake is made, but has no potential to harm the patient, how

often is this reported? ................................................................................ 1 2 3 4 5

3. When a mistake is made that could harm the patient, but does not,

how often is this reported? ......................................................................... 1 2 3 4 5

SECTION E: Patient Safety Grade

Please give your work area/unit in this hospital an overall grade on patient safety.

    

A

Excellent

B

Very Good

C

Acceptable

D

Poor

E

Failing

SECTION F: Your Hospital

Please indicate your agreement or disagreement with the following statements about your hospital.

Think about your hospital…

Strongly

Disagree



Disagree



Neither



Agree



Strongly

Agree



1. Hospital management provides a work climate that promotes patient

safety .......................................................................................................... 1 2 3 4 5

2. Hospital units do not coordinate well with each other ................................ 1 2 3 4 5

3. Things “fall between the cracks” when transferring patients from one

unit to another ............................................................................................ 1 2 3 4 5

4. There is good cooperation among hospital units that need to work

together ...................................................................................................... 1 2 3 4 5

4

SECTION F: Your Hospital (continued)

Think about your hospital…

Strongly

Disagree



Disagree



Neither



Agree



Strongly

Agree



5. Important patient care information is often lost during shift changes ........ 1 2 3 4 5

6. It is often unpleasant to work with staff from other hospital units .............. 1 2 3 4 5

7. Problems often occur in the exchange of information across hospital

units ............................................................................................................ 1 2 3 4 5

8. The actions of hospital management show that patient safety is a top

priority ........................................................................................................ 1 2 3 4 5

9. Hospital management seems interested in patient safety only after an

adverse event happens .............................................................................. 1 2 3 4 5

10. Hospital units work well together to provide the best care for patients ..... 1 2 3 4 5

11. Shift changes are problematic for patients in this hospital ......................... 1 2 3 4 5

SECTION G: Number of Events Reported

In the past 12 months, how many event reports have you filled out and submitted?

 a. No event reports  d. 6 to 10 event reports

 b. 1 to 2 event reports  e. 11 to 20 event reports

 c. 3 to 5 event reports  f. 21 event reports or more

SECTION H: Background Information

This information will help in the analysis of the survey results.

1. How long have you worked in this hospital?

 a. Less than 1 year  d. 11 to 15 years

 b. 1 to 5 years  e. 16 to 20 years

 c. 6 to 10 years  f. 21 years or more

2. How long have you worked in your current hospital work area/unit?

 a. Less than 1 year  d. 11 to 15 years

b. 1 to 5 years  e. 16 to 20 years

 c. 6 to 10 years  f. 21 years or more

3. Typically, how many hours per week do you work in this hospital?

a. Less than 20 hours per week d. 60 to 79 hours per week

 b. 20 to 39 hours per week  e. 80 to 99 hours per week

c. 40 to 59 hours per week  f. 100 hours per week or more

5

SECTION H: Background Information (continued)

4. What is your staff position in this hospital? Select ONE answer that best describes your staff position.

 a. Registered Nurse  j. Respiratory Therapist

 b. Physician Assistant/Nurse Practitioner  k. Physical, Occupational, or Speech Therapist

 c. LVN/LPN  l. Technician (e.g., EKG, Lab, Radiology)

 d. Patient Care Asst/Hospital Aide/Care Partner  m. Administration/Management

 e. Attending/Staff Physician  n. Other, please specify:

 f. Resident Physician/Physician in Training

 g. Pharmacist

 h. Dietician

 i. Unit Assistant/Clerk/Secretary

5. In your staff position, do you typically have direct interaction or contact with patients?

 a. YES, I typically have direct interaction or contact with patients.

 b. NO, I typically do NOT have direct interaction or contact with patients.

6. How long have you worked in your current specialty or profession?

a. Less than 1 year  d. 11 to 15 years

 b. 1 to 5 years  e. 16 to 20 years

 c. 6 to 10 years  f. 21 years or more

SECTION I: Your Comments

Please feel free to write any comments about patient safety, error, or event reporting in your hospital.

THANK YOU FOR COMPLETING THIS SURVEY.

Answer 1

SECTION A: Work Area/Unit

In this survey, think of your “unit” as the work area, department, or clinical area of the hospital where you spend

most of your work time or provide most of your clinical services.

What is your primary work area or unit in this hospital? Select ONE answer.

 a. Many different hospital units

 b. No specific unit

 c. Medical Ward (specify : ..........)   j. Psychiatry/mental health  k. Other, please specify:

 d. Surgical ward (specify: .........)

 e .OT  i. Rehabilitation

 f. Obstetrics  l. Pharmacy

 g. Pediatrics  m. Laboratory

h. Emergency department  n. Radiology

 i. Intensive care unit (any type)  o. Anesthesiology

Section B : work unit/area & supervisor

Please indicate your agreement or disagreement with the following statements

( where  1. Strongly Disagree   2. Disagree   3. Neither  4. Agree   5. Strongly Agree  )

(i) Think about your hospital work area/unit…

1. People support one another in this unit ..................................................... 1 2 3 4 5

2. You have enough staff to handle the workload ........................................... 1 2 3 4 5

3. When a lot of work needs to be done quickly, you work together as a

team to get the work done ......................................................................... 1 2 3 4 5

4. In this unit, people treat each other with respect ....................................... 1 2 3 4 5

5. Staff in this unit work longer hours than is best for patient care ................ 1 2 3 4 5

6. You  are actively doing things to improve patient safety ............................. 1 2 3 4 5

7. We use more agency/temporary staff than is best for patient care ........... 1 2 3 4 5

8. Staff feel like their mistakes are held against them ................................... 1 2 3 4 5

9. Mistakes have led to positive changes here .............................................. 1 2 3 4 5

10. It is just by chance that more serious mistakes don’t happen around

here ............................................................................................................ 1 2 3 4 5

11. When one area in this unit gets really busy, others help out ..................... 1 2 3 4 5

12. When an event is reported, it feels like the person is being written up,

not the problem .......................................................................................... 1 2 3 4 5

13. After you make changes to improve patient safety, you evaluate their

effectiveness .............................................................................................. 1 2 3 4 5

14. Staffs work in "crisis mode" trying to do too much, too quickly ..................... 1 2 3 4 5

15. Patient safety is never sacrificed to get more work done .......................... 1 2 3 4 5

16. Staffs worry that mistakes they make are kept in their personnel file ......... 1 2 3 4 5

17. We have patient safety problems in this unit ............................................. 1 2 3 4 5

18. The  procedures and systems are good at preventing errors from

happening .................................................................................................. 1 2 3 4 5

(ii) think about your immediate supervisor/manager or person to whom you directly report.

1. Yoyr supervisor/manager says a good word when he/she sees a job

done according to established patient safety procedures ......................... 1 2 3 4 5

2. Your supervisor/manager seriously considers staff suggestions for

improving patient safety ............................................................................. 1 2 3 4 5

3. Whenever pressure builds up, supervisor/manager wants staffs to

work faster, even if it means taking shortcuts ............................................ 1 2 3 4 5

4. Supervisor/manager overlooks patient safety problems that happen

over and over ............................................................................................. 1 2 3 4 5

SECTION C: Communications & Frequency of Events Reported

How often do the following things happen in your work area/unit?

(where  1. Never  2. Rarely  3. Sometimes   4. Most of the time  5. Always )

(i) Think about your hospital work area/unit…

1. Have you ever been asked to give feedbacks about changes put into place based on event

reports ? ........................................................................................................ 1 2 3 4 5

2. Staffs can freely speak up if they see something that may negatively affect patient care ...................................................................................... 1 2 3 4 5

3. have you ever informed about errors that happen in your unit ?.............................. 1 2 3 4 5

4. Staffs are free to question the decisions or actions about changes put into place with more

authority ..................................................................................................... 1 2 3 4 5

5. In your unit, staffs discuss ways to prevent errors from happening again ...... 1 2 3 4 5

6. Staff are afraid to ask questions when something does not seem right .... 1 2 3 4 5

7. how often patients safety meetings are conducted in the unit ....... 1 2 3 4 5

(ii) In your hospital work area/unit, when the following mistakes happen, how often are they reported?

1. When a mistake is made, but is caught and corrected before affecting

the patient, how often is this reported? ...................................................... 1 2 3 4 5

2. When a mistake is made, but has no potential to harm the patient, how

often is this reported? ................................................................................ 1 2 3 4 5

3. When a mistake is made that could harm the patient, but does not,

how often is this reported? ......................................................................... 1 2 3 4 5

SECTION E: Patient Safety Grade

Please give your work area/unit in this hospital an overall grade on patient safety.

  Excellent   Very Good   Acceptable   Poor   Failing

SECTION F: Your Hospital

Please indicate your agreement or disagreement with the following statements about your hospital.

( where 1. Strongly Disagree  2. Disagree 3. Neither 4. Agree 5. Strongly Agree )

Think about your hospital…

1. Hospital management provides a work climate that promotes patient safety ......1 2 3 4 5

2. Hospital units do not coordinate well with each other ................................ 1 2 3 4 5

3. Things “fall between the cracks” when transferring patients from one unit to another ............................... 1 2 3 4 5

4. There is good cooperation among hospital units that need to work together .................................... 1 2 3 4 5

5. Important patient care information is often lost during shift changes ........ 1 2 3 4 5

6. It is often unpleasant to work with staff from other hospital units .............. 1 2 3 4 5

7. Problems often occur in the exchange of information across hospital units ................................... 1 2 3 4 5

8. The actions of hospital management show that patient safety is a top priority ...................................... 1 2 3 4 5

9. Hospital management seems interested in patient safety only after an adverse event happens ............... 1 2 3 4 5

10. Hospital units work well together to provide the best care for patients ..... 1 2 3 4 5

11. Shift changes are problematic for patients in this hospital ......................... 1 2 3 4 5

SECTION G: Number of Events Reported

In the past 12 months, how many event reports have you filled out and submitted?

 a. No event reports  d. 6 to 10 event reports

 b. 1 to 2 event reports  e. 11 to 20 event reports

 c. 3 to 5 event reports  f. 21 event reports or more

SECTION H: Background Information

This information will help in the analysis of the survey results.

(i). How long have you worked in this hospital?

 a. Less than 1 year  d. 11 to 15 years

 b. 1 to 5 years  e. 16 to 20 years

 c. 6 to 10 years  f. 21 years or more

(ii). How long have you worked in your current work area/unit?

 a. Less than 1 year  d. 11 to 15 years

b. 1 to 5 years  e. 16 to 20 years

 c. 6 to 10 years  f. 21 years or more

(iii). Typically, how many hours per week do you work in this hospital?

a. Less than 20 hours per week d. 60 to 79 hours per week

 b. 20 to 39 hours per week  e. 80 to 99 hours per week

c. 40 to 59 hours per week  f. 100 hours per week or more

(iv) Select ONE answer that best describes your staff position in this hospital.

 a. Registered Nurse  j. Respiratory Therapist

 b. Physician Assistant/Nurse Practitioner  k. Physical, Occupational, or Speech Therapist

 c. LVN/LPN  l. Technician (e.g., EKG, Lab, Radiology)

 d. Patient Care Asst/Hospital Aide/Care Partner  m. Administration/Management

 e. Attending/Staff Physician  n. Other, please specify:

 f. Resident Physician/Physician in Training

 g. Pharmacist

 h. Dietician

 i. Unit Assistant/Clerk/Secretary

(v). In your staff position, do you typically have direct interaction or contact with patients?

 a. YES, I typically have direct interaction or contact with patients.

 b. NO, I typically do NOT have direct interaction or contact with patients.

(iv). How long have you worked in your current specialty or profession?

a. Less than 1 year  d. 11 to 15 years

 b. 1 to 5 years  e. 16 to 20 years

 c. 6 to 10 years  f. 21 years or more

SECTION I: Your Comments

Please feel free to write any comments/ suggestions about patient safety, error, or event reporting in your hospital.

......................................................................................................................................................................................................

......................................................................................................................................................................................................

THANK YOU FOR COMPLETING THIS SURVEY.