How do you decide when to administer a patient safety culture survey?

COVID-19 introduces new challenges when it comes to deciding when the time is right for patient safety culture surveying and improvement.

We've heard from many of our clients about the challenges they face when it comes to deciding if and when they should administer their next safety culture survey. In early 2020, it was easy to conceptualize waiting until the pandemic passed. However, we can now consider the current conditions to remain for an extended period of time.

We know during "normal" times, safety survey results are impacted by significant organizational actions and activities that make the “environment unstable” such as significant restructuring, finances, resizing, staffing model changes, leadership changes, etc.  It’s highly likely that COVID-19 will impact survey results, but we don’t know the extent.  This will undoubtedly be studied extensively in the years to come. For now, we can reasonably assume the pandemic is impacting all healthcare staff, both personally and professionally. Safety culture surveys remain important tools that allow organizations to hear from their staff and can be used to move an organization forward.

CPS encourages organizations to continue to administer safety culture surveys. We feel that listening to employees is more important now than ever. We also feel that with the right guidance, a healthcare organization can efficiently administer a safety culture survey during uncertain times. Consider the following steps to identify the right time for your organization.

STEP 1: Why do you administer a culture survey?

The first step in deciding when to survey is to ask yourself why you survey. Hopefully, the answer is because you want to hear the voice of your employees and proactively address culture concerns that impact patient and provider safety and quality of care. If so, administering a survey to gather feedback from your staff is imperative, especially during challenging times.

If you have administered a survey in the past, you may be seeking affirmation of improvements reflected in the data. At this time, it’s hard to know if organizations will sustain historical improvements through the current conditions. The pandemic has had enough of a global impact that any healthcare organization should not expect to see results “skip over" the pandemic without some sort of impact on their culture. It is likely most practical to consider COVID-19 a reset of your organization's culture. You can expect changes in your scores from previous years. Remember, you want to identify your greatest needs. The survey results will give you the ability to explain variances and implement proactive remedial steps that differentiate high-performing organizations from those that expect to wait out the pandemic and return to status quo.

If your organization has not yet administered the survey, or it has been several years, now is an ideal time to consider surveying. 

STEP 2: What are your greatest obstacles to administering a culture survey?

Multiple stakeholders should be involved to discuss challenges that may result in low response rates. Deciding when to administer a survey is rarely clear-cut, but consider these questions:

• Are other surveys planned, such as an employee engagement survey?
• Are any large projects being rolled out at the same time that would be a distraction, like implementation of an EHR?
• Are staff levels low due to self-quarantine or illness?
• Are staff levels low due to vacations, holidays, low census? 
• How much of a burden will the survey be on staff considering their current workload?
• Is there enough staff time and resources to coordinate messaging about the survey from leaders to staff? Are there staff committed to promoting the survey?
• If you are doing the survey internally, do you have a dedicated staff person to build and monitor the survey? Do you have dedicated staff to prepare the data for distribution and analyze the results?

If your organization is affected by any, or all, of the above, you’ll want to consider the level of impact. Will you be able to reach at least a 60% response rate? Can you capture responses in a timely manner (within 3-4 weeks)? Can you prepare thorough results and analytic reports within 4-8 weeks after the survey? How much time and how many resources can you commit?

STEP 3: What will you do with the results?

Think about how you will coordinate result evaluation, determine current progress on safety initiatives, and identify future direction.

1. Where are you on the culture maturity scale? What is necessary to get to the next level? 
2. Can you evaluate results as a whole and at the unit, location, or department level? What are your greatest opportunities for improvement? Where are your most valuable strengths? What are the causal factors that have led to your results?
3. Do you have an improvement methodology? Can results be integrated into a current work plan?
4. Can you develop action plans that include organizational strategies, alignment with goals, measurement monitoring, and accountability?

CPS can help you during these challenging times to make Step 2 and 3 easy and seamless. We assume much of the resource burden by creating the survey for you. In addition, we provide marketing tools, a method to monitor your response rate, and actionable detailed feedback reports with support from our experts to further diagnose and help with next steps. Contact us for more information and to schedule a time to discuss a custom survey administration for your organization.