Form 3 Crosswalk Between the Original AHRQ Hospital Survey on P

Attachment A: Crosswalk Between the Original AHRQ Hospital Survey on Patient Safety Culture and Draft Version 2.0

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

Crosswalk Between the Original AHRQ Hospital Survey on Patient Safety Culture and Draft Version 2.0

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. 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.

This document presents the crosswalk between the original AHRQ Hospital Survey on Patient Safety Culture and the draft AHRQ Hospital Survey on Patient Safety Culture Version 2.0. There are currently more items in the draft Version 2.0 survey for testing purposes, and the final Version 2.0 will have fewer items overall. In the tables below, the first column lists the survey items in the original AHRQ hospital survey, grouped according to the safety culture composites they are intended to measure. The item’s survey location is shown at the beginning of each item and negatively worded items are indicated. The second column lists the draft items for the draft hospital survey version 2.0 to be tested further.

Original Hospital Survey on Patient Safety Culture Composites and Items	Draft Hospital Survey on Patient Safety Culture Version 2.0 Composites and Items
1. Communication Openness
Response Scale: Never, Rarely, Sometimes, Most of the time, Always
C2. Staff will freely speak up if they see something that may negatively affect patient care.	Drop item
C4. Staff feel free to question the decisions or actions of those with more authority.	1. When we see someone with more authority doing something unsafe for patients, we speak up.
C6. Staff are afraid to ask questions when something does not seem right. (negatively worded)	2. We feel comfortable asking questions when something doesn’t seem right.
	3. When we see staff doing something unsafe for patients, we speak up.
	4. Our ideas and suggestions are valued.
	5. We are asked for our opinions about ways to improve patient safety.
2. Feedback and Communication About Error	2. Communication About Error
Response Scale: Never, Rarely, Sometimes, Most of the time, Always
C1. We are given feedback about changes put into place based on event reports.	Drop item
C3. We are informed about errors that happen in this unit.	1. Retain item
C5. In this unit, we discuss ways to prevent errors from happening again.	2. When errors happen, we discuss ways to prevent them from happening again.
	3. We discuss errors that happen in this unit.
	4. We are informed about errors that happen outside of this unit.
	5. In this unit, we are given feedback on what is done after we report events.
3. Frequency of Events Reported
Response Scale: Never, Rarely, Sometimes, Most of the time, Always
D1. When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?	Drop item
D2. When a mistake is made, but has no potential to harm the patient, how often is this reported?	Drop item
D3. When a mistake is made that could harm the patient, but does not, how often is this reported?	1. When you notice a mistake that could harm a patient, but does not, how often do you report it?

Original Hospital Survey on Patient Safety Culture Composites and Items	Draft Hospital Survey on Patient Safety Culture Version 2.0 Composites and Items
4. Management Support for Patient Safety	4. Hospital Leadership Support for Patient Safety
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree
F1. Hospital management provides a work climate that promotes patient safety.	Drop item
F8. The actions of hospital management show that patient safety is a top priority.	1. The actions of hospital leadership show that patient safety is a top priority.
F9. Hospital management seems interested in patient safety only after an adverse event happens. (negatively worded)	2. Hospital leadership seems interested in patient safety only after a serious error happens. (negatively worded)
	3. Hospital leadership provides adequate resources to improve patient safety.
	4. Hospital leadership encourages us to tell them about our patient safety concerns.
	5. Hospital leadership communicates that patient safety is everyone's responsibility.
5. Nonpunitive Response to Error	5. Response to Error
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree	Response Scale: Never, Rarely, Sometimes, Most of the time, Always
A8. Staff feel like their mistakes are held against them. (negatively worded)	1. Staff are treated fairly when they make errors.
A12. When an event is reported, it feels like the person is being written up, not the problem. (negatively worded)	Drop item
A16. Staff worry that mistakes they make are kept in their personnel file. (negatively worded)	Drop item
	2. We look at more than staff actions to understand why errors happen.
	3. Learning, rather than blame, is emphasized when staff make errors.
	4. We try to understand the factors that lead to patient safety errors.
	5. We review our policies and procedures to see if they contribute to errors.
6. Organizational Learning—Continuous Improvement
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree
A6. We are actively doing things to improve patient safety.	1. In this unit, we actively look for ways to improve patient safety.
A9. Mistakes have led to positive changes here.	2. Mistakes lead to improvements in patient safety in this unit.
A13. After we make changes to improve patient safety, we evaluate their effectiveness.	Drop item
	3. We make improvements when someone points out patient safety problems in this unit.
	4. After we make changes to improve patient safety in this unit, we check to see if the changes worked.
	5. Our processes are good at preventing errors from happening.
7. Overall Perceptions of Patient Safety	Drop Composite
A10. It is just by chance that more serious mistakes don’t happen around here. (negatively worded)	Drop item
A15. Patient safety is never sacrificed to get more work done.	Drop item
A17. We have patient safety problems in this unit. (negatively worded)	Drop item
A18. Our procedures and systems are good at preventing errors from happening.	Drop item

Original Hospital Survey on Patient Safety Culture Composites and Items	Draft Hospital Survey on Patient Safety Culture Version 2.0 Composites and Items
8. Staffing	7. Staffing, Work Pressure, and Pace
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree	Response Scale: Never, Rarely, Sometimes, Most of the time, Always
A2. We have enough staff to handle the workload.	1. Retain item
A5. Staff in this unit work longer hours than is best for patient care. (negatively worded)	Drop item
A7. We use more agency/temporary staff than is best for patient care. (negatively worded)	Drop item
A14. We work in “crisis mode” trying to do too much, too quickly. (negatively worded)	2. We feel rushed -- trying to do too much too quickly. (negatively worded)
	3. We have enough time to do our jobs thoroughly.
9. Supervisor/Manager Expectations & Actions Promoting Patient Safety	8. Supervisor, Manager, or Clinical Leader Support for Patient Safety
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree
	My supervisor, manager, or clinical leader…
B1. My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures.	Drop item
B2. My supervisor/manager seriously considers staff suggestions for improving patient safety.	1. Encourages everyone to suggest ways to improve patient safety.
B3. Whenever pressure builds up, my supervisor/manager wants us to work faster, even if it means taking shortcuts. (negatively worded)	2. Makes sure everyone follows patient safety rules and procedures.
B4. My supervisor/manager overlooks patient safety problems that happen over and over. (negatively worded)	3. Pays attention to patient safety problems.
	4. Works with individuals to change their behavior when they take shortcuts that put patient safety at risk.
	5. Takes action to address patient safety problems that are brought to his or her attention.
10. Teamwork Across Units	9. Teamwork Across Units & Handoffs
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree	Response Scale: Never, Rarely, Sometimes, Most of the time, Always
F2. Hospital units do not coordinate well with each other. (negatively worded)	Drop item
F4. There is good cooperation among hospital units that need to work together.	1. Retain item
F6. It is often unpleasant to work with staff from other hospital units. (negatively worded)	Drop item
F10. Hospital units work well together to provide the best care for patients.	2. Different hospital units work well together to provide the best care for patients.
11. Handoffs & Transitions	9. Teamwork Across Units & Handoffs
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree	Response Scale: Never, Rarely, Sometimes, Most of the time, Always
F3. Things “fall between the cracks” when transferring patients from one unit to another. (negatively worded)	Drop item
F7. Problems often occur in the exchange of information across hospital units. (negatively worded)	3. Retain item
F5. Important patient care information is often lost during shift changes. (negatively worded)	4. All key patient care information is communicated during shift changes.
F11. Shift changes are problematic for patients in this hospital. (negatively worded)	5. Patient needs are met during shift changes.
	6. Important patient care information is clearly communicated across hospital units.

Original Hospital Survey on Patient Safety Culture Composites and Items	Draft Hospital Survey on Patient Safety Culture Version 2.0 Composites and Items
12. Teamwork Within Units	10. Teamwork Within Units
Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree
A1. People support one another in this unit.	1. Retain item
A3. When a lot of work needs to be done quickly, we work together as a team to get the work done.	Drop item
A4. In this unit, people treat each other with respect.	2. In this unit, we treat each other with respect.
A11. When one area in this unit gets really busy, others help out.	3. In this unit, when someone gets really busy, others help out.
	4. In this unit, we work together as an effective team.
	5. We clearly understand the roles and responsibilities of the people we work with.
	6. In this unit, disrespectful or intimidating behavior by those working here is tolerated. (negatively worded)
N/A	11. Staff Training and Skills (NEW)
	Response Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree
	1. Staff who are new to this unit receive adequate orientation.
	2. Staff get thorough on-the-job training in this unit.
	3. Staff feel pressured to do tasks they haven't been trained to do (negatively worded)
	4. Staff in this unit have the skills they need to do their jobs well.
	5. Staff receive adequate training on patient safety.
N/A	12. Recommend (NEW)
	Would you recommend this hospital to your friends and family? Definitely no Probably no Probably yes Definitely yes
13. Number of Events Reported	13. Reporting
In the past 12 months, how many event reports have you filled out and submitted? None 1 to 2 3 to 5 6 to 10 11 to 20 21 or more	In the past 12 months, did you formally report any events? Yes No
14. Patient Safety Grade	14. Patient Safety Rating
Please give your work area/unit in this hospital an overall grade on patient safety. Excellent Very Good Acceptable Poor Failing	Please give your work area/unit in this hospital an overall rating on patient safety. Excellent Very Good Good Fair Poor

In this section of the document, for the background and demographic questions, the first column lists the survey items in the original AHRQ Hospital Survey on Patient Safety Culture. The second column lists the draft items for the Hospital Survey on Patient Safety Culture Version 2.0 to be tested further.

Original Hospital Survey on Patient Safety Culture Items

Draft Hospital Survey on Patient Safety Culture Version 2.0 Items

1. What is your staff position in this hospital? Select ONE answer that best describes your staff position. a. Registered Nurse b. Physician Assistant/Nurse Practitioner c. LVN/LPN d. Patient Care Asst/Hospital Aide/Care Partner e. Attending/Staff Physician f. Resident Physician/Physician in Training g. Pharmacist h. Dietician i. Unit Assistant/Clerk/Secretary j. Respiratory Therapist k. Physical, Occupational, or Speech Therapist l. Technician (e.g., EKG, Lab, Radiology) m. Administration/Management n. Other, please specify:

1. What is your position in this hospital? Check the ONE category that best applies to your job. Department Managers, Senior Leaders a. Manager, Department Manager b. Senior Leader, Executive, C-Suite Nursing Staff c. Advanced Practice Nurse (NP, CRNA, CNS, CNM) d. Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN) e. Patient Care, Nursing Assistant f. Registered Nurse (RN) Medical Staff g. Physician Assistant h. Graduate Medical Trainee: Fellow, Resident, Intern i. Staff Physician, Attending Other Clinical Staff j. Clinical Psychologist, Social Worker k. Dietician l. Pharmacist m. Pharmacy Technician n. Physical, Occupational, or Speech Therapist o. Respiratory Therapist p. Technologist, Technician (e.g. EKG, Lab, Radiology) Support Staff q. Unit Clerk, Secretary, Receptionist, Office Staff r. Environmental Services, Housekeeping Staff s. Facilities Staff t. Food Services, Dietary Staff u. Information Technology Staff, Health Information Services v. Security w. Transporter Other x. Other, please specify:

Original Hospital Survey on Patient Safety Culture Items	Draft Hospital Survey on Patient Safety Culture Version 2.0 Items
2.  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. What is your primary work area or unit in this hospital? Select ONE answer. a. Many different hospital units/No specific unit b. Medicine (non-surgical) c. Surgery d. Obstetrics e. Pediatrics f. Emergency department g. Intensive care unit (any type) h. Psychiatry/mental health i. Rehabilitation j. Pharmacy k. Laboratory l. Radiology m. Anesthesiology n. Other, please specify:	2. Think of your “unit” as the work area, department, or clinical area of the hospital where you spend most of your work time. What is your primary work area or unit in this hospital? Select ONE answer. a. Many different hospital units, No specific unit Patient Care Units b. Combined Medical/Surgical Unit c. Medical Unit (Non-Surgical) d. Surgical Unit e. Emergency Department f. Pediatrics (including NICU/PICU) g. ICU (all adult types) h. Labor & Delivery, Obstetrics & Gynecology i. Oncology, Hematology j. Psychiatry, Behavioral Health k. Rehabilitation/Physical Medicine Surgery l. Anesthesiology m. Surgical Services (Pre Op, Operating Room/Suite, Post Op, Peri Op) Clinical Services n. Pathology/Lab o. Pharmacy p. Radiology/Imaging q. Respiratory Therapy Management/Administration r. Information Technology, Health Information Management, Clinical Informatics s. Management, Administration, Quality, Risk Management, Patient Safety, Human Resources, Training Support Services t. Environmental Services, Housekeeping u. Facilities v. Food Service, Dietary w. Patient Financial Services, Billing, Admitting x. Security Services y. Transport Other z. Other, please specify:
3. How long have you worked in this hospital?	3. Retain item
4. How long have you worked in your current hospital work area/unit?	4. Retain item
5. Typically, how many hours per week do you work in this hospital?	5. Retain item
6. In your staff position, do you typically have direct interaction or contact with patients?	6. Retain item
7. How long have you worked in your current specialty or profession?	Drop item