Attachment C
Draft Pharmacy Survey on Patient Safety: Dimensions and Items
In this document, draft items for a Pharmacy Survey on Patient Safety are grouped according to the safety culture dimensions they are intended to measure. Negatively worded items are indicated.
1. Common Mistakes in This Pharmacy
(Daily, Weekly, Monthly, Several times in the past 12 months, Once or twice in the past 12 months, Not in the past 12 months, Does Not Apply or Don’t Know)
The following items describe common dispensing mistakes that may happen in pharmacies.
In your best estimate, how often did the following things happen in this pharmacy over the past 12 months?
1. Not noticing changes in a prescription (e.g., change in strength, dose)
2. Incorrect data entry of prescription information
3. Grabbing the wrong drug from the shelf
4. Not double-checking high-alert medications before dispensing
5. Insufficient checking of patient ID information at time of pickup
6. Other (Please specify): ________________
2. Reasons Dispensing Mistakes Happen
(Daily, Weekly, Monthly, Several times in the past 12 months, Not in the past 12 months, Does Not Apply or Don’t Know)
The following items describe reasons dispensing mistakes may happen.
Over the past 12 months, how often has this pharmacy had problems with the following:
1. Unclear handwriting on paper prescriptions?
2. Look-alike/sound-alike drugs?
3. Interruptions/distractions (phone calls, faxes, customers, etc.)?
4. Technology or equipment?
5. Technicians not asking a pharmacist for help or clarification?
6. Too many prescriptions to fill given the number of staff?
7. The physical environment (e.g., lighting, noise, limited space)?
8. Insufficient knowledge about new medications?
9. Inadequate work breaks?
10. Expired medications not removed from stock?
11. Other? (Please specify): ________________
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
3. Resolving Problems with Prescriptions
(Problems daily, Problems weekly, Problems monthly, Problems several times in the past 12 months, Problems once or twice in the past 12 months, No problems in the past 12 months, Does Not Apply or Don’t Know)
Pharmacies often have to interact with others to resolve prescription issues. Over the past 12 months, how often has this pharmacy had problems in providing information to, or getting information from, the following persons or organizations:
1. Prescribers/providers/medical offices?
2. Hospital emergency departments?
3. Other pharmacies?
4. Insurers/insurance companies/pharmacy benefit managers (PBMs)?
5. Suppliers/wholesalers?
6. Patients, their family members, or representatives?
7. Corporate office/pharmacy owner?
8. Nursing homes?
9. Other? (Please specify): ________________
4. Teamwork
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. Staff in this pharmacy clearly understand their roles and responsibilities.
2. Staff treat each other with respect.
3. When a lot of work needs to be done quickly, staff work as a team to get the work done.
4. Staff help one another during busy times.
5. There is a good working relationship among all staff.
6. In this pharmacy, we emphasize teamwork.
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
5. Handoffs Within and Across Shifts
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. In this pharmacy, important prescription information is often lost from one shift to the next shift. (negatively worded)
2. The status of problematic prescriptions is well communicated across shifts.
3. Staff clearly, completely, and accurately communicate important prescription information to staff on the next shift.
4. We have clear expectations about exchanging important prescription information across shifts.
5. We have standard procedures for communicating prescription information across shifts.
6. We sometimes forget to communicate important prescription information to other pharmacy staff. (negatively worded)
7. Within a shift, staff handling the same prescription make sure to share important information.
6. Staff Training & Skills
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. All staff get adequate on-the-job training in this pharmacy.
2. Technicians in this pharmacy receive the training they need to do their jobs.
3. Pharmacy staff get special training on medication error prevention.
4. Technicians and clerks understand when it is necessary to refer patients to a pharmacist for assistance.
5. Staff who are new to this pharmacy receive adequate orientation.
6. Staff in this pharmacy have the skills they need.
7. Staffing
(Never, Rarely, Sometimes, Most of the Time, Always, Does Not Apply or Don’t Know)
How often do the following happen in this pharmacy?
We have enough staff to handle the workload.
When we use temporary/floater staff, we have problems with our work process. (negatively worded)
Pharmacists have enough technicians to help get the work done.
We have good backup plans for pharmacists who go on vacation or take extended leave.
We have good backup coverage for technicians who call in sick.
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
8. Work Pressure & Pace
(Never, Rarely, Sometimes, Most of the time, Always, Does Not Apply or Don’t Know)
How often do the following happen in this pharmacy?
1. We have too many prescriptions to dispense for the number of staff. (negatively worded)
2. We work in “crisis mode” trying to do too much, too quickly. (negatively worded)
3. We feel rushed when dispensing prescriptions. (negatively worded)
4. Technicians take adequate breaks during their shifts.
5. Pharmacists take adequate breaks during their shifts.
9. Compliance with Procedures
(Never, Rarely, Sometimes, Most of the time, Always, Does Not Apply or Don’t Know)
How often do the following happen in this pharmacy?
1. When staff do not follow pharmacy procedures, another staff member brings it to their attention.
2. Pharmacy staff double check their own work.
3. Staff follow established procedures to dispense prescriptions.
4. Staff are monitored to make sure they follow standard procedures.
5. Staff use shortcuts that are not as safe as following standard procedures. (negatively worded)
10. Communication Openness
(Never, Rarely, Sometimes, Most of the time, Always, Does Not Apply or Don’t Know)
How often do the following happen in this pharmacy?
1. Staff freely speak up to a supervisor if they see something that may negatively affect patient care.
2. It is easy for staff to speak up to a supervisor about patient safety concerns.
3. Staff feel comfortable asking questions when they are unsure about something.
4. Staff ideas and suggestions are valued in this pharmacy.
5. When patient safety issues occur in this pharmacy, staff discuss them.
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
11. Physical Space and Environment
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. This pharmacy is well organized.
2. This pharmacy is free of clutter.
3. It is easy for staff new to this pharmacy to find what they need.
4. The physical layout of this pharmacy supports good work flow.
5. Our patient counseling area is private enough for confidential discussions.
6. In this pharmacy, interruptions/distractions (from phone calls, faxes, customers, etc.) make it difficult to dispense accurately. (negatively worded)
12. Patient Counseling
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. Our pharmacists spend enough time talking to patients about how to use their medications.
2. Our pharmacists always tell patients important information about their new prescriptions.
3. Our pharmacists do not counsel patients as often as they should. (negatively worded)
4. We encourage patients to talk to pharmacists about their medications.
5. Our pharmacists are thorough when talking to patients about their new prescriptions.
6. Our pharmacists spend enough time talking to patients about possible side effects from their medications.
13. Communication about Mistakes
(Never, Rarely, Sometimes, Most of the time, Always, Does Not Apply or Don’t Know)
How often do the following happen in this pharmacy?
1. In this pharmacy, we talk about ways to prevent mistakes from happening again.
2. Staff are told about errors that happen in this pharmacy.
3. Staff in this pharmacy discuss dispensing mistakes.
4. Staff who see another staff member making a dispensing mistake will talk to the person about it.
5. We discuss how errors that have occurred in other pharmacies can be prevented in our pharmacy.
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
14. Response to Mistakes
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. All staff are treated fairly when they make mistakes.
2. Staff feel like their mistakes are held against them. (negatively worded)
3. When a pharmacy error is reported, it feels like the person is being reported, not the problem. (negatively worded)
4. When an error reaches the patient, management looks for possible problems with our procedures.
5. When staff make mistakes, pharmacy supervisors/managers respond fairly.
6. This pharmacy helps staff learn from their unintended mistakes rather than punishing them.
7. Pharmacy supervisors/managers respond to mistakes by talking to staff about patient safety.
8. We look at staff actions and the way we do things to understand why mistakes happen in this pharmacy.
9. When staff make a mistake that leads to patient harm, they are offered counseling as a support.
15. Organizational Learning—Continuous Improvement
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. In this pharmacy, we are actively doing things to improve patient safety.
2. Mistakes have led to positive changes in this pharmacy.
3. When the same mistake keeps happening, we change the way we do things.
4. When a mistake happens, we try to figure out what problems in the work process led to the mistake.
5. We are good at changing processes to make sure the same problems don’t happen again.
6. When changes are needed to improve patient safety, we make the changes.
7. Staff understand that reporting mistakes is important to patient safety improvement.
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
16. Your Pharmacy Supervisor’s/Manager’s Support for Patient Safety
► A. Do you report to a supervisor/manager who works regularly in this pharmacy? 1 Yes (ANSWER ITEMS 1- 3 BELOW) 2 No (SKIP TO SECTION G) |
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
My supervisor/manager in this pharmacy tells staff they have done a good job when they follow safe dispensing procedures.
My supervisor/manager in this pharmacy listens to staff ideas and suggestions about patient safety.
My supervisor/manager in this pharmacy addresses patient safety problems to make sure they do not happen again.
My supervisor/manager in this pharmacy pays close attention to all dispensing mistakes made by staff.
My supervisor/manager in this pharmacy encourages staff to suggest ways to improve patient safety.
My supervisor/manager pays attention to patient safety only after a serious error occurs. (negatively worded)
My supervisor’s/manager’s actions demonstrate that patient safety is a top priority in this pharmacy.
17. Pharmacy Management Support for Patient Safety
► A. Are you an owner of this pharmacy? (JA) 1 Yes (SKIP TO SECTION K) 2 No (ANSWER ITEMS 1-4 BELOW) |
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
►Pharmacy management includes persons who make important financial decisions about technology and business goals for this pharmacy. Management may include the pharmacy owner(s), district or area management, or corporate management.
How much do you agree or disagree with the following statements about your pharmacy management?
Pharmacy management listens to pharmacy staff ideas and suggestions about patient safety.
Pharmacy management addresses patient safety problems to make sure they do not happen again.
Pharmacy management pays attention to staff suggestions for improving patient safety.
Pharmacy management pays attention to patient safety only after a serious error occurs. (negatively worded)
The actions of pharmacy management demonstrate that patient safety is a top priority.
Pharmacy management emphasizes customer wait time more than patient safety. (negatively worded)
Pharmacy management places more emphasis on sales than on patient safety. (negatively worded)
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
18. Frequency of Reporting Dispensing Mistakes
(Never, Rarely, Sometimes, Most of the time, Always, Does Not Apply or Don’t Know)
How often do pharmacy staff report the following types of dispensing mistakes to someone?
1. When a dispensing mistake harms a patient, how often is it reported to management?
2. When a dispensing mistake reaches the patient and could cause harm but does not, how often is it reported to management?
3. When a dispensing mistake reaches the patient but has no potential to harm the patient, how often is it reported to management?
4. When a dispensing mistake could have harmed the patient but is corrected before the medication leaves the pharmacy, how often is it reported to a supervisor?
5. When a dispensing mistake that has no potential to harm the patient is corrected before the medication leaves the pharmacy, how often is it reported to a supervisor?
19. Overall Perceptions of Patient Safety
(Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree, Does Not Apply or Don’t Know)
How much do you agree or disagree with the following statements?
1. We have problems with dispensing accuracy in this pharmacy. (negatively worded)
2. We need to do a better job of preventing common mistakes in this pharmacy. (negatively worded)
3. Filling prescriptions too quickly leads to dispensing mistakes in this pharmacy. (negatively worded)
4. In this pharmacy, all staff are on the alert for possible patient safety problems.
5. This pharmacy dispenses too many prescriptions to ensure patient safety. (negatively worded)
6. In this pharmacy, staff members are valued as equal partners in improving patient safety.
20. Overall Rating on Patient Safety
(Poor, Fair, Good, Very good, Excellent)
How do you rate this pharmacy on patient safety? Think back on the survey topics and the definition of patient safety—dispensing the right medication accurately and making sure patients understand their medications and how to use them.
Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composites.
DRAFT Dimensions and Items, February 8, 2011 - Developed by Westat
– Do Not Circulate
| File Type | application/msword |
| Last Modified By | Suzanne Streagle |
| File Modified | 2011-02-08 |
| File Created | 2011-02-08 |