Form #2 Form #2 Organizational leader questionnaire

Assessing the Impact of the Patient Safety Improvement Corps (PSIC) Training Program

Attachment D -- PSIC leadership questionnaire 06-23-08

Organizational Leader Questionnaire

OMB: 0935-0145

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Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

rganizational Leader PSIC Web-based Questionnaire

Introduction

Thank you for accessing this questionnaire. It is intended to obtain your perceptions of the Agency for Healthcare Research and Quality’s/VA’s Patient Safety Improvement Corps (PSIC) training program. As part of this questionnaire, you, as a leader in your organization, are being asked to assess the usefulness of the training program to your organization and to identify the types of patient safety improvement activities in which your organization has engaged since your staff attended the PSIC training. Please note that we are also sending a questionnaire to PSIC participants for their input.

Please answer each question as candidly as possible. Your responses will be used to help AHRQ understand how the PSIC program has influenced patient safety efforts in your organization or organizations that your staff support.

Please note that if you do not wish to answer a specific question, you can skip it. We do, however, encourage you to respond to all questions. Please note that all of your information will remain confidential and that all information provided to AHRQ as a result of this questionnaire will be reported at the aggregate level to ensure your confidentiality.

Should you have any questions or comments about this questionnaire or the PSIC evaluation project, please do not hesitate to contact Dr. Laura Steighner of the American Institutes for Research (AIR) at 202-403-5064 or [email protected]. Dr. Steighner is the project director for the PSIC evaluation contract, which AHRQ awarded to AIR in September 2007.

If you have concerns or questions about your rights as a participant, contact AIR’s Institutional Review Board (which is responsible for the protection of project participants) at [email protected]  toll free at 1-800-634-0797 or c/o IRB, 1000 Thomas Jefferson Street, NW, Washington, DC  20007. 



Public reporting burden for this collection of information is estimated to average 15 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Form Approved: OMB Number 0935-XXXX  Exp. Date xx/xx/20xx. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.










Instructions


Please read carefully each question on this questionnaire. There are five primary sections:


  1. Participant Characteristics

  2. Transfer of PSIC Training to Your Organization

  3. Post-PSIC Activities

  4. Barriers and Facilitators to Use of PSIC Material in the Workplace

  5. Outcomes of PSIC Participation


Note that the response scale for each question will vary from section to section. For example, in the Transfer of PSIC Training section you may be asked to respond to a given statement using a response scale wherein 1=Disagree, 2 = Neutral, 3= Agree, and 4=Don’t Know. By contrast, in the Post-PSIC Activities section, you will be asked to indicate whether a statement is applies for your organization using a response scale wherein 1=Yes, 2=No, and 3=Unsure. Please read each question carefully, and make sure that your selected response is what you intended.


Participant Characteristics

In this section, you will be asked to provide information about yourself, your organization’s participation in the PSIC program, and your organization. Please answer candidly and note that your information will not be provided to any entity. All information will be reported to AHRQ on an aggregate level.


  1. When did your organization participate in the Patient Safety Improvement Corps (PSIC) training program? [Select one]

    1. 2003-2004

    2. 2004-2005

    3. 2005-2006

    4. 2007-2008


  1. Which of the following best characterizes your organization? [Select one]

    1. State health department

    2. Hospital or health care system

    3. Quality Improvement Organization (QIO)

    4. Hospital association

    5. Patient safety center/commission

    6. Long term care facility, assisted living facility, or home health agency

    7. Critical access health system

    8. Regional or state-based healthcare professional association or institution

    9. Other: [Fill in the blank]


  1. In what state is your organization located? [Provide drop-down menu of states]


  1. What is your role within your organization? [Select one]

    1. Chief Executive Officer

    2. Chief Operations Officer

    3. Director of Patient Safety or Quality Improvement

    4. Patient Safety Officer

    5. Administrator of Patient Safety or Quality Improvement

    6. Director of Standards and Compliance

    7. Medical Director

    8. Chief Medical Officer

    9. Other: [Fill in the blank]


  1. How long have you served in this role (at your organization?)

    1. 0-1 years

    2. 2-5 years

    3. 6-10 years

    4. 11 or more years


  1. How long has your organization been actively engaged in patient safety initiatives?

    1. 0-1 years

    2. 2-5 years

    3. 6-10 years

    4. 11 or more years



Transfer of PSIC Training to Your Organization

In this section, you, as a leader in your organization, are being asked to assess the ease with which your organization has been able to transfer the PSIC concepts, tools, information, techniques, and resources into the workplace or to other organizations you support.


  1. To what extent do you agree with the following statements about the PSIC training in relation to the patient safety needs of your organization?



Statements

1
Disagree


2

Neutral

3

Agree


4

Don’t Know

  1. The PSIC course content matched the patient safety needs of my organization





  1. The PSIC course content has been disseminated to staff in my organization





  1. The PSIC course content has been employed in my organization





  1. The PSIC course content has been used by individuals in my organization to improve the quality of care provided





  1. The PSIC course content was easily adopted by my organization







  1. For QIO and State Health Department Leaders Only: To what extent do you agree with the following statements about the PSIC training in relation to the patient safety needs of the organizations you support?



Statements

1
Disagree


2

Neutral

3

Agree


4

Don’t Know

  1. The PSIC course content matched the patient safety needs of the organizations we support





  1. My organization has been able to disseminate the PSIC course content to various organizations we support





  1. The PSIC course content we disseminated has been employed by the organizations we support in an effort to improve patient safety





  1. The PSIC course content was easily used by organizations we support







Post-PSIC Activities

In this section, you are being asked to identify what post-PSIC training patient safety activities have begun or are underway at your organization and/or those organizations you support since your organization’s participation in the PSIC program.


  1. In which of the following activities has your organization engaged since participating in the PSIC program?


As a result of PSIC training, I am aware that my organization has:

1

Yes

2

No

3

Unsure

Does Not Apply

  1. Developed policies, standards, or processes regarding patient safety





  1. Provided training to others on developing or implementing patient safety processes





  1. Established new or strengthened existing relationships with the State health department about patient safety

FOR Hospital/Providers & QIOs Only





  1. Created a new or expanded an existing network of patient safety stakeholders






  1. If you responded “1-Yes” to any of the statements listed above, please describe in detail the patient safety activity or activities and how the PSIC concepts, tools, information, techniques, and resources contributed to the effort.


  1. For QIOs and State Health Department Leaders ONLY: Which of the following activities are true of the organizations you have supported with PSIC concepts, tools, information, techniques, and resources since your organization participated in the PSIC program?

As a result of PSIC training, I am aware that organizations we support have:

1

Yes

2

No

3

Unsure

Does Not Apply

  1. Developed policies, standards, or processes regarding patient safety





  1. Provided training to others on developing or implementing patient safety processes





  1. Established new or strengthened existing relationships with hospitals in my state about patient safety





  1. Established new or strengthened existing relationships with the State health department about patient safety

FOR QIOs Only





  1. Created a new or expanded an existing network of patient safety stakeholders






  1. If you responded “1-Yes” to any of the statements listed above, please describe in detail the patient safety activity or activities and how PSIC concepts, tools, information, techniques, and resources contributed to the effort.


Facilitators and Barriers to Use of PSIC Material in the Workplace

In this section, you are being asked to identify any facilitators and barriers you have encountered when trying to use or support others in the use of PSIC concepts, tools, information, techniques, and resources. Please keep in mind that we ask you to select the facilitators and barriers that are most important or significant for you in your experience as an organizational leader.


  1. Which of the following factors have helped your organization or organizations that you have supported implement the PSIC concepts, tools, information, and/or techniques? [Check all that apply]


    • Ample time or resources made available to support the use of PSIC concepts, tools, information, techniques, and resources

    • Information sharing between parties to support the use of PSIC concepts, tools, information, techniques, and resources

    • Organizational events that draw attention to the need for use of PSIC concepts, tools, information, techniques, and resources

    • Reported staff enthusiasm to engage in the use of PSIC concepts, tools, information, techniques, and resources

    • Reported staff work redistribution leading to willingness to engage in use of new concepts, tools, information, techniques, and resources


  1. Please identify any other significant factors that have helped your organizational members implement PSIC concepts, tools, information, techniques, and/or resources in your organization or in the organizations you support since attending training.


  1. Which of the following barriers has your organization or organizations that you have supported encountered when implementing the PSIC concepts, tools, information, techniques, and resources? [Check all that apply]


    • Lack of time or resources made available to support the use of PSIC concepts, tools, information, techniques, and resources

    • Lack of information sharing between parties to support the use of PSIC concepts, tools, information, techniques, and resources

    • Distractions or organizational events that draw priorities away from using the new PSIC concepts, tools, information, techniques, and resources

    • Reported work overload leading to resistance to using PSIC concepts, tools, information, techniques, and resources


  1. Please identify any other significant barriers to the use of PSIC concepts, tools, information, techniques, and resources implementation you have experienced or that others have brought to your attention.

Outcomes of PSIC Participation

In this section, you are being asked to assess what patient safety changes have occurred in your organization or the organizations you support as a result of your organization’s participation in PSIC and post-PSIC patient safety activities. These outcomes can range from increased awareness to changes in processes or policies. Consider all potential outcomes of your organization’s participation in the PSIC and post-training activities.


  1. As a result of your organization’s participation in the PSIC program and conducting post-PSIC patient safety activities, have the following aspects changed at your organization?


As a result of my organization’s participation in PSIC training and post-PSIC patient safety activities, I have noticed that in my organization, …

1

Disagree

2

Neutral

3

Agree

4

Don’t Know

  1. There is an increased level of awareness of the importance of patient safety among non-clinicians (e.g., administrators, managers)





  1. There is an increased level of awareness of the importance of patient safety among clinicians (e.g., nurses, physicians)

For Hospital/Providers Only





  1. Better patient safety interventions have been identified than before our participation

For Hospital/Providers Only





  1. More effective patient safety interventions have been applied in my organization than before our participation.

For Hospital Providers Only





  1. There are more effective communications about patient safety within my organization





  1. There are more effective communications about patient safety with other organizations who support patient safety improvement initiatives





  1. There is increased use of a patient safety or medical error event reporting system

For Hospital/Providers Only





  1. There have been improvements in the quality of the process to review or analyze patient safety events and medical errors





  1. There is increased sharing of patient safety and medical error event data with hospital staff

For Hospital/Providers Only






  1. There are more staff trained on patient safety, as a result of PSIC, within my organization






  1. For QIO & State Health Department Leaders Only: As a result of your organization’s participation in the PSIC program and conducting post-PSIC patient safety activities, have the following aspects changed at organizations you support?


As a result of my organization’s participation in PSIC training and post-PSIC patient safety activities, other organizations have reported that…

1

Disagree

2

Neutral

3

Agree

4

Don’t Know

  1. There is an increased level of awareness of the importance of patient safety among non-clinicians (e.g., administrators, managers)





  1. There is an increased level of awareness of the importance of patient safety among clinicians (e.g., nurses, physicians)





  1. Better patient safety interventions have been identified than before our participation





  1. More effective patient safety interventions have been applied in my organization than before our participation.





  1. There are more effective communications about patient safety within organizations we support





  1. There are more effective communications about patient safety with other organizations





  1. There is increased use of a patient safety or medical error event reporting system





  1. There have been improvements in the quality of the process to review or analyze patient safety events and medical errors





  1. There has been increased sharing of patient safety anecdotes to educate staff at organizations we support





  1. The state has defined better regulations, policies, standards, and processes on patient safety





  1. There are more staff trained in patient safety, as a result of PSIC, within the organizations we support





3. As an organizational leader, think back upon your organization’s participation in the PSIC program and indicate the degree to which you agree with the following statements about the impact of the program as a whole.


Statements

1

Disagree

2

Neutral

3

Agree

4

Don’t Know

  1. The PSIC program mobilized our organization to engage in new or different patient safety activities





  1. The PSIC program mobilized the organizations we support to engage in patient safety improvement activities

For State Health Department or QIOs only





  1. The PSIC program resulted in other patient safety improvement initiatives outside my organization





  1. The PSIC program was a worthwhile venture for my organization as a whole






4. As an organizational leader, please describe other major patient safety improvement initiatives taking place locally, regionally, or within your state.


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File Typeapplication/msword
File TitleParticipant Characteristics
AuthorAlexander Alonso
Last Modified Bywcarroll
File Modified2008-07-21
File Created2008-06-23

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