Culture of Safety Survey

Culture of Safety Survey

An “event” is defined as any type of error, mistake, incident, accident, or deviation, regardless of whether or not it results in patient harm. “Patient safety” is defined as the avoidance and prevention of patient injuries or adverse events resulting from the processes of health care delivery.
  • Patient Safety Survey

    This survey asks for your opinions about patient safety issues, medical errors, and event reporting at your institution, and will take about 10 to 15 minutes to complete. If you do not wish to answer a question, or if a question does not apply to you, you may leave your answer blank. In this survey, think of your work area as the unit, department, or clinical area where you spend most of your work time or provide most of your clinical services.
  • 2. Work Area * Required
    Where do you conduct the majority of your clinical work? Please specify in 2a below.
  • Please specify your primary work area.
  • Select ONE answer that best describes your position.
  • SECTION A: Your Work Area

    Please indicate your agreement or disagreement with the following statements about your work area/unit.
  • 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.
  • SECTION C: Communications

    How often do the following things happen in your work area/unit?
  • SECTION D: Frequency of Events Reported

    In your work area/unit, when the following mistakes happen, how often are they reported?
  • SECTION E: Patient Safety Grade

  • SECTION F: Your Facility

  • SECTION G: Number of Events Reported

  • SECTION H: Quality Improvement

  • SECTION I: Your Comments

    Comments on Patient Safety
UAMS Culture of Safety Survey modified from AHRQ Surveys on Patient Safety CultureTM