CPS Breaks Down the AHRQ Hospital Survey On Patient Safety™ (SOPS™) 2.0

The Agency for Healthcare Research and Quality (AHRQ) released the first Hospital Survey on Patient Safety™ (SOPS™) 15 years ago. Since 2004, the survey has been translated to dozens of languages for use around the world and administered to thousands of individual staff members at hundreds of hospitals across the country. Every two years, AHRQ allows organizations to submit their data to a comparative dataset. This dataset has provided essential material for countless research articles, revealing evidence of a strong correlation between an organization’s culture survey results and outcomes in patient safety, employee engagement, physician engagement, employee safety, financial stability and progress toward high reliability. AHRQ’s federally-supported program provides open-source access to its culture measurement tools and many resources to help hospitals get to the next steps in their journey to achieve a positive culture.

AHRQ released a new version of the survey in 2019, designed to align the survey more closely with efforts to support the development of just and accountable culture, and to remedy initial survey shortcomings. For example, AHRQ concluded that the existence of a neutral option skewed results on some questions. Pilot testing of the newest hospital survey, referred to as Hospital SOPS™ 2.0, began in 2017; changes were released and assessed again in 2019. The final result is a more concentrated and direct survey designed to generate more reliable results.

Pilot survey outcomes suggest the changes result in significantly different scores for hospitals that previously administered the original version of the survey, referred to now as Hospital SOPS™ 1.0. The most significant impact results from a new answer choice that allows respondents to indicate the question does not apply to them. Hospitals have been requesting this change for many years. Although the original survey instructed respondents to leave a question blank if it did not apply to them, most respondents would instead answer with the neutral middle rating on the survey’s Likert scale of 1-5 rather than skipping the question.

The flaw in the original form skewed the survey results. Scorers treat skipped questions as an “opt-out” which does not impact the results. When respondents selected the middle rating (3), they pulled down positive scores. The newest survey release offers the “does not apply” opt-out as a distinct answer choice for respondents, creating more valid responses. The change has resulted in higher patient safety culture scores.

This change and other significant wording changes throughout Hospital SOPS™ 2.0, make accurate trending from Hospital SOPS™ 1.0 an impossibility.

Hospitals and healthcare organizations should consider how, and when, to adopt the 2.0 version of the Hospital SOPS™. AHRQ will continue to support Hospital SOPS™ 1.0 for the next two years and has made the transition easy. There are several options available to organizations.

If you have never administered a Hospital SOPS™, consider administering 2.0. Patient Safety Awareness Week, March 8-14, 2020, is a great time to launch.

If you have administered the Hospital SOPS™in the recent past, consider this:

  • If it has been more then three years since you administered 1.0, you are ready for 2.0. It is not recommended to compare results with such a large gap between surveys. In this case, hospitals don’t lose a valid comparison opportunity.
  • If you don’t want to wait a year or more to gather new datapoints (AHRQ recommends surveying every 12-18 months), consider administering 2.0 followed by quarterly pulse surveys. Pulse surveys, when delivered appropriately, provide short-range, measurable data points that will validate your progress, or steer you back on the right path in a shorter period of time.
  • If you are a health system or hospital with more than 1000 staff and are looking for a way to cross reference the new survey to your historical data, consider offering both surveys. Using the results from both surveys can define commonalities and align previous results. This should only be done by experienced analysts. AHRQ offers more information on how to validate the results and compare surveys.
  • If you are not yet comfortable with transitioning to 2.0, you may continue to administer 1.0, but note the survey will not be supported, nor will benchmarks be collected and available, after 2022.

Administration of the patient safety culture survey is one of the easiest steps on your journey to patient safety. The hard part follows: making the day-to-day changes necessary to reduce preventable patient harm and achieve high reliability. The experts at the Center for Patient Safety (CPS) have developed state of the art processes and data reports for the AHRQ surveys. But CPS also recognizes clients’ challenges with the next steps. CPS experts provide assistance in the interpretation of survey results and offer tools and guidance to support improvement, keeping clients on track to achieve their goals.

CPS helps clients select the right survey and provides an easy and smooth administration process. Contact our experts to discuss the process and the post-survey services that move the needle on safety culture. Learn more about our safety culture survey services and about the patient safety culture survey for hospitals and other provider groups.

Attend a live webinar to learn more about available options and ask the CPS experts any questions you have about administering the survey.

SOPS Webinar from CPS

Visit: AHRQ's Transitioning to the SOPS™ Hospital Survey Version 2.0: What's Different and What to Expect, Part 1: Main Report