Administering a Culture Survey

IF IT'S EASY, YOUR PROBABLY NOT DOING IT RIGHT.

Why assess your culture?

You can improve what you measure. Without measuring, you have no way to know if you are improving.

These statements are especially true when it comes to assessing your culture. It may be easy to take a quick poll of staff and infer their perceptions to that of the rest of your organization’s employees, but there’s no certainty in your results. Using a standardized survey tool can provide measurable and meaningful feedback.

Another reason to assess your culture is because many regulatory and certifying bodies now require or recommend measurement of an organization’s patient safety culture. This is because they, too, recognize the clear connection between strong cultures with open communication and the effective implementation and sustainability of patient safety and quality improvement programs.

• The Joint Commission
• Leap Frog
• CMS Merit-based Incentive Payment
  System (MIPS)
• CMS Quality Assurance and Performance Improvement (QAPI)

The Center for Patient Safety has been administering culture assessments since 2010, and we understand the most successful organizations have a fine-tuned process for administering the survey and analyzing their results. In this article, we’ll discuss some of the most pertinent planning details when preparing to launch a survey. Subsequent articles will include diagnostic tips for evaluating your survey data.

While standard online survey templates may ease the burden of survey administration, there are four key areas that, if addressed upfront, can save time, resources, and frustration in the long run.

1. Which Tool.
The Center has always supported the Agency for Healthcare Research and Quality’s (AHRQ) Survey on Patient Safety (SOPS) tools though there are many other surveys that can provide a similar analysis. The SOPS tools have been developed for a multitude of healthcare provider types with specific, relevant questions asked, based on varying care settings, such as nursing homes, hospitals, ambulatory surgery centers, pharmacies and medical offices. These surveys have also been psychometrically tested and validated and are available in more than 40 languages.

2. Which Medium.
How do you normally administer surveys to your staff? Are they at ease with an online version, or are they most comfortable with a paper survey? While this seems like an insignificant question, it is quite important. If staff are fearful, they will hesitate to write unfavorable feedback on a paper survey because they think their handwriting will be recognized. However, they may also think the organization will track their online response back to them for purposes of punishment. Using a third party vendor often works best and creates a neutral environment for staff to respond. Consider offering a combination of online and paper surveys. Allow staff to take the survey in a confidential environment with varying options for submitting them. Providing options other than submitting them to their manager increases anonymity, resulting in truer results.

3. Custom Questions.
We often get question-happy when it comes to surveys. It’s efficiency at its finest: “While we have our staff’s attention, let’s just go ahead and ask a few more questions, like what they thought about the EHR implementation, their employee engagement for the year and what sport the organization should have at the next company picnic.” This is a big no-no. If you’re using a standardized survey, keep the list of questions short and relevant. The AHRQ SOPS ask about 45-50 questions and can take up to 15 minutes to complete. Limit additional questions to no more than five and keep it related to culture. More than five questions on an unrelated topic will cause confusion and create survey fatigue.

4. Promotion.
Staff won’t do something if they don’t know they need to do it. Put a little effort into marketing the survey and you’ll get a very valuable return. The more staff that take your survey, the more accurately your results will reflect the culture of your organization. This in turn gives you better data to analyze. Plan with your marketing department, do a search on Google, or harness your creativity to develop posters and email templates. Ask your CEO or President to write a brief memo about the value and importance of all staff taking the assessment and their desire to see honest feedback. Put a link to the survey on your Intranet; distribute surveys at a monthly staff meeting; offer a certificate for a free drink for turning in a completed survey; or host a pizza party if you reach your target response goal. These are small tokens of appreciation that can have a big impact on getting valuable insight.

In Summary 

Your time will be most efficiently spent analyzing the results and preparing action plans post-survey, so addressing these four areas upfront will remove many of the headaches that can go along with planning and administering a survey. If a third-party option is a better choice for you, please contact the Center for Patient Safety to discuss our custom options. We’ll even help in the analysis of your survey results. Find out more information about our survey services.