1. Default Section

Instructions: This survey asks for your opinions about patient safety issues, medical errors and event reporting at The Nebraska Medical Center or Bellevue Medical Center and will take about 15 to 20 minutes to complete.

Event - Any type of error, mistake, incident, accident or deviation, regardless of whether or not it results in patient harm.

Patient Safety - The avoidance and prevention of patient injuries or adverse events resulting from the process of health care delivery.

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* 1. Please select your department from the list provided below. If you are a Physician, APRN, PA or CRNA not employed by either The Nebraska Medical Center or Bellevue Medical Center, please skip to question 2.

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* 2. What is your position? Please mark only one.

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.

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

  Strongly Disagree Disagree Neither Agree Strongly Agree
A. People support one another in this unit.
B. We have enough staff to handle the workload.
C. When a lot of work needs to be done quickly, we work together as a team to get the work done.
D. In this unit, people treat each other with respect.
E. Staff in this unit work longer hours than is best for patient care.
F. We are actively doing things to improve patient safety.
G. We use more agency/temporary staff than is best for patient care.
H. Staff feel like their mistakes are held against them.
I. Mistakes have led to positive changes here.
J. It is just by chance that more serious mistakes don't happen around here.
K. When one area in this unit gets really busy, others help out.
L. When an event is reported, it feels like the person is being written up, not the problem.
M. After we make changes to improve patient safety, we evaluate their effectiveness.
N. We work in "crisis mode" trying to do too much, too quickly.
O. Patient safety is never sacrificed to get more work done.
P. Staff worry that mistakes they make are kept in their personnel file.
Q. We have patient safety problems in this unit.
R. Our procedures and systems are good at preventing errors from happening.
Section B: Your Supervisor/Manager

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* 4. 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
A. My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures.
B. My supervisor/manager seriously considers staff suggestions for improving patient safety.
C. Whenever pressure builds up, my supervisor/manager wants us to work faster, even it if means taking shortcuts.
D. My supervisor/manager overlooks patient safety problems that happen over and over.
Section C: Communications

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

  Never Rarely Sometimes Most of the Time Always
A. We are given feedback about changes put into place based on event reports.
B. Staff will freely speak up if they see something that may negatively affect patient care.
C. We are informed about errors that happen in this unit.
D. Staff feel free to question the decisions or actions of those with more authority.
E. In this unit, we discuss ways to prevent errors from happening again.
F. Staff are afraid to ask questions when something does not seem right.
Section D: Frequency of Events Reported

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

  Never Rarely Sometimes Most of the Time Always
A. When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?
B. When a mistake is made, but has no potential to harm the patient, how often is this reported?
C. When a mistake is made that could harm the patient, but does not, how often is this reported?
Section E: Patient Safety Grade

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* 7. Please give your work area/unit a overall grade on patient safety. Mark only one.

Section F: Your Hospital

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* 8. Please indicate your agreement or disagreement with the following statements.

  Strongly Diagree Disagree Neither Agree Strongly Agree
A. Hospital management provides a work climate that promotes patient safety.
B. Hospital units do not coordinate well with each other.
C. Things "fall between the cracks" when transferring patients from one unit to another.
D. There is good cooperation among hospital units that need to work together.
E. Important patient care information is often lost during shift changes.
F. It is often unpleasant to work with staff from other hospital units.
G. Problems often occur in the exchange of information across hospital units.
H. The actions of hospital management show that patient safety is a top priority.
I. Hospital management seems interested in patient safety only after an adverse event happens.
J. Hospital units work well together to provide the best care for patients.
K.Shift changes are problematic for patients.
Section G: Number of Events Reported

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

Section H: Outcomes Engineering Behavioral Benchmark Survey

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* 10. Please answer the following questions.

  Strongly Disagree Disagree Neutral Agree Strongly Agree
My manager's actions demonstrate that patient safety is an important organizational value.
Work systems and processes are changed to reduce patient safety risks in response to reported hazards.
My manager coaches the employee who engages in risky behavior choices involving patient safety.
Employees coach other employees who engage in risky behavioral choices involving patient safety.
The number of adverse events involving patient safety is going down.
Employees report hazards and near misses that could impact patient safety.
Near misses involving patient safety are investigated to understand any underlying system causes.
My manager openly discusses adverse events and lessons learned involving patient safety with my group.
My manager disciplines employees who make inadvertent human errors that jeopardize patient safety.
My manager disciplines employees who knowingly and intentionally endanger patient safety.
The severity of the harm in an adverse event determines whether my manger addresses a patient safety event.
My manager treats all employees fairly and equitably in response to an adverse patient safety event.
Section H: Background Information

This information will be helpful in the analysis of the overall survey results.

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* 11. How long have you worked for the organization reflected in the cost center you select (BMC or TNMC)?

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* 12. How long have you worked in your current work area/unit?

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* 13. Typically, how many hours per week do you work.

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

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* 15. How long have you worked in your current position or profession?

Section I: Your Comments

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* 16. Please feel free to type any comments about patient safety, error or event reporting in the organization. The space will expand to fit the length of your comments.

Thank you for completing this survey!
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