NASA Safety Culture Survey 2016-2017

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

NASA Safety Culture Survey 2016 to 2017. v 1.0

NASA Safety Culture Survey 2016-2017

OMB: 2700-0153

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NASA Safety Culture Survey




PURPOSE:


This survey provides basic feedback to your center on the safety culture with the goal of preventing incidents from occurring.



FOR IMMEDIATE SAFETY CONCERNS:


1.

Please contact your supervisor or Center Safety Representative.


2.

Or, go to the NASA Safety Center web page, where you can select your home center for more specific information: http://www.nasa.gov/audience/safety/reporting/Safety_reporting.html



SURVEY INSTRUCTION:


1.

Please read the short description of each component of safety culture (Reporting, Just, Flexible, Learning, and Engaged), then select the responses that most accurately match your perceptions.


2.

Comment blocks are available for each question (400 words max. for each, and 600 words max. for the open-ended items at the end).


3.

When you are done, click the Submit button. A "Thank You" note will let you know you have successfully completed the survey.


4.

An individual must be free to respond without fear of reprisal, whether the fear is real or perceived. Without this, the data gathered may be inaccurate and of minimal use.

  • Data analysis will not include individual scores or identify individuals.

  • We welcome comments, and will keep them word for word, (inappropriate language may be modified or removed.)

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. The OMB control number for this information collection is 2700-0153 and it expires on 07/31/2018. We estimate that it will take about 6 minutes to read the instructions, gather the facts, and answer the questions. You may send comments on our time estimate above to [email protected] Send only comments relating to our time estimate to this address.







Your AFFILIATION:







 

Your DEPARTMENT
(Directorate)







 

Your OCCUPATION:







 

Your LEVEL:







 

YEARS at your center (Civil Service or Contractor)







 

Reporting Culture:  We report our concerns.  Identification of hazards or safety concerns is encouraged, including a system that’s easy to use. The reporting system maintains anonymity and is separate from the disciplinary processes. Useful feedback based on reporting is quick and insightful. An atmosphere of trust exists between managers and workers, with employees knowing important information will be voiced, heard, and acted on appropriately.


   


1.  Please rate your Immediate work area with respect to its Reporting Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape8



 



   


2.  Please rate your Department with respect to its Reporting Culture.

       


 

Shape9

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape16



 



   


3.  Please rate your Center with respect to its Reporting Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape24



 



   


4.  Please rate the Agency with respect to its Reporting Culture.

       


 

Shape25

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Shape31

Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape32



 





Just Culture: We have a sense of fairness.  Balances the need for discipline when warranted, with rewards when earned. People are held accountable for deliberate violations of rules and recognized for outstanding performance. There’s a clear understanding of acceptable and unacceptable behaviors. There’s a sense of fairness about how business is conducted, where people aren’t punished for reporting and aren’t afraid of reprisal if they do.


   


5.  Please rate your Immediate work area with respect to its Just Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

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6.  Please rate your Department with respect to its Just Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape48



 



   


7.  Please rate your Center with respect to its Just Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape56



 



   


8.  Please rate the Agency with respect to its Just Culture.

       


 

Shape57

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape64



 





Flexible Culture: We change to meet new demands.  The organization effectively balances and adapts to changing demands while managing complex technologies and maintaining productivity. A healthy flexible culture uses safety data to make meaningful changes when there’s a concerning trend or issue.


   


9.  Please rate your Immediate work area with respect to its Flexible Culture.

       


 

Shape65

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape72



 



   


10.  Please rate your Department with respect to its Flexible Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape80



 



   


11.  Please rate your Center with respect to its Flexible Culture.

       


 

Shape81

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape88



 



   


12.  Please rate the Agency with respect to its Flexible Culture.

       


 

Shape89

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape96



 





Learning Culture: We learn from our successes and mistakes.  Collecting, assessing, and sharing from experience is a priority. Information is available to everyone from novice to expert. In a learning culture members value and commit to proactively “learning from our mistakes,” both formally and informally.


   


13.  Please rate your Immediate work area with respect to its Learning Culture.

       


 

Shape97

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape104



 



   


14.  Please rate your Department with respect to its Learning Culture.

       


 

Shape105

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Shape111

Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape112



 



   


15.  Please rate your Center with respect to its Learning Culture.

       


 

Shape113

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Shape119

Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape120



 



   


16.  Please rate the Agency with respect to its Learning Culture.

       


 

Shape121

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Shape127

Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape128



 





Engaged Culture: Everyone does their part.  All members regardless of status or occupation are involved and actively participate in safely accomplishing the mission. The key is to have leaders and employees who demonstrate they value safety by “walking the talk.”


   


17.  Please rate your Immediate work area with respect to its Engaged Culture.

       


 

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape136



 



   


18.  Please rate your Department with respect to its Engaged Culture.

       


 

Shape137

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Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

Shape144



 



   


19.  Please rate your Center with respect to its Engaged Culture.

       


 

Shape145

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Shape151

Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

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20.  Please rate the Agency with respect to its Engaged Culture.

       


 

Shape153

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Shape159

Don't Know


 

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied


 


 

Enter any comment here: 

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General


   


21.  Please specify the characteristic of safety culture that you feel is the most significant.

       

 

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N/A


Don't Know




 

Reporting Culture

Just Culture

Flexible Culture

Learning Culture

Engaged Culture




 

 

Enter any comment here: 

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NASA HQ-specific


   


22.  I understand my safety and health responsibilities for the work I perform at HQ.

       


 

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Don't Know


 

Strongly Disagree

Disagree

Slightly Disagree

Slightly Agree

Agree

Strongly Agree


 


 

Enter any comment here: 

Shape176



 





   


23.  HQ supervisors/managers are doing enough to prevent work related injuries/illnesses.

       


 

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Don't Know


 

Strongly Disagree

Disagree

Slightly Disagree

Slightly Agree

Agree

Strongly Agree


 


 

Enter any comment here: 

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24.  I actively think about my own and others' safety.

       




 

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Don't Know



 

Strongly Disagree

Disagree

Slightly Disagree

Slightly Agree

Agree

Strongly Agree



 



 

Enter any comment here: 

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25.  I am comfortable taking my safety concerns to my management.

       


 

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Don't Know


 

Strongly Disagree

Disagree

Slightly Disagree

Slightly Agree

Agree

Strongly Agree


 


 

Enter any comment here: 





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