Chapter 3. Using Paper Surveys
In this chapter, we present information to help you decide how your paper surveys will be distributed and
returned, suggest ways to promote and publicize your survey, and describe survey administration steps and the survey materials you will need to develop.
Decide How Paper Surveys Will Be Distributed and Returned
When deciding how surveys will be distributed and returned, consider any previous experience your pharmacy has had with employee surveys.
Distributing surveys. We recommend that a designated point of contact (POC) distribute the surveys directly to staff in the pharmacy. To promote high participation, you can distribute the surveys at staff meetings and serve refreshments. Regardless of how you distribute the surveys, follow these guidelines:
- Provide explicit instructions for completing the survey.
- Inform staff that completing the survey is voluntary.
- Assure staff that their responses will be kept confidential. Emphasize that reports of findings will include only summary data and will not identify individuals.
- Caution staff (especially if they are completing the survey during a meeting) not to discuss the survey with other staff while answering the survey.
- Permit staff to complete the survey during work time to emphasize that pharmacy leaders support the data collection effort.
Returning surveys. If your budget is limited, completed surveys can be returned to a designated POC in the pharmacy or to drop boxes in the pharmacy. These methods of returning surveys, however, may raise staff concerns about the confidentiality of their responses. Rely on your past experience with these methods in your pharmacy when making decisions about how surveys should be returned.
Your pharmacy may have limited experience administering employee surveys, or staff may have confidentiality
concerns. In such cases, it is best to have staff mail their completed surveys directly to an outside vendor or to an address outside the pharmacy via postage-paid return envelopes included with the survey.
If you do not use a vendor and are part of a larger pharmacy chain or health care system, consider having the surveys returned to a chain or system headquarters address. This can help reassure staff that no one at their pharmacy will see the completed surveys. Remember, if surveys are returned through the mail, you will need to account for return postage in your budget.
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Publicize and Promote the Survey
We strongly recommend publicizing the survey before and during data collection. Be sure to advertise that the survey is supported by pharmacy, chain, or system leaders. Publicity activities may include:
- Posting flyers or posters in the pharmacy, promoting the survey during staff meetings and shift changes, sending staff emails, and posting information about the survey on a pharmacy Intranet.
- Promoting the survey during meetings.
- Having a senior leader or executive send a supportive email during data collection, thanking staff if they have completed the survey and encouraging others to do so.
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Follow Survey Administration Steps
We recommend the following basic data collection steps to achieve high response rates.
- Optional prenotification letter for paper surveys. If you have publicized your survey well and your survey cover letter includes important information about the purposes of the survey, distributing a prenotification letter announcing the upcoming survey is optional.
- First paper survey. About 1 week after publicizing the survey, distribute a survey packet to each staff member in your pharmacy. The packet should include the survey, a supporting cover letter, and a return envelope. If you want staff to return their surveys by mail, rather than returning them to the pharmacy POC or dropping them in a special box in the pharmacy, include a preaddressed postage-paid envelope to make it easy for respondents to return their surveys.
- Second survey. To promote a higher response, distribute a second survey to everyone in your pharmacy (it has to go to everyone if you are conducting an individually anonymous survey because you do not know who responded). Include a cover letter in the second survey packet thanking those who have already
responded and reminding others to complete the second survey. If you used individual identifiers on your surveys (although not recommended), you can distribute second surveys only to nonrespondents. We recommend the following timeline for distributing second paper surveys:
- Single small- or medium-sized pharmacies: Distribute the second survey 1 week after the first survey.
- Multiple or very large pharmacies: Distribute the second survey 2 weeks after distributing the first survey. If response rates remain low, distribute a reminder 1 week after distributing the second survey.
- Calculate preliminary response rates. Calculate a preliminary response rate at least once a week to track your response progress. To calculate preliminary response rates during data collection,
divide the number of returned surveys (numerator) by the number of eligible staff who received the survey (denominator).
Response rate = Number of surveys returned/Number of eligible staff who received a survey
If any staff members end their employment during data collection, they are still considered eligible and should be included in the denominator even if they did not complete and return the survey.
Note: At the end of data collection, you will need to adjust your preliminary response rate to reflect decisions made about whether a survey is complete or incomplete, or possibly ineligible. Chapter 5 discusses how to calculate the final official response rate for your pharmacy.
- Close out data collection. Keep in mind that your goal is to achieve a high response rate. If your response rate is still too low after distributing the second survey, add another week to the data collection period.
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Develop and Assemble Survey Materials
Estimate the number of surveys you need to print, and assemble the following materials for your paper survey data collection.
Number of Surveys To Print
We suggest the following printing guidelines:
- If you are conducting an anonymous survey and plan to send second surveys to everyone, print at least twice the number of surveys as staff in your sample. Include a few extra surveys in case some staff misplace theirs.
- If you are tracking responses and will send second surveys only to nonrespondents, you may print fewer surveys overall. For example, if you are administering the survey to 20 staff and your pharmacy typically experiences a 40 percent response to the first survey packet, print 20 first surveys and 12 second surveys (20 staff x 60% nonrespondents = 12), for a total of 32 printed surveys. Then add a few extra surveys in case some staff misplace theirs.
Pharmacy/Chain/System Point-of-Contact Letter and Instructions
Send a letter to the POCs describing the purposes of the survey and explaining their role in the survey effort. The letter should be on letterhead, signed by a senior executive. We also recommend that you provide the POCs with a data collection protocol that describes their tasks, along with a proposed timeline. Appendix A presents a sample data collection protocol.
Your publicity materials can help legitimize the survey effort and increase your response rate by including some or all of the following types of information:
- Endorsements of the survey from your pharmacy leaders.
- Clear statements about the purpose of the survey, which is to assess staff attitudes and opinions about patient safety in their pharmacy.
- Description of how the collected data will be used to identify ways to improve patient and medication safety.
- Assurances that only summary (aggregated) data will be reported, thus keeping individual responses confidential.
- Introductions to the survey vendor, if you have chosen to use a vendor.
- Contact information for the designated POC in the pharmacy.
Cover Letter in First Survey Packet
The cover letter that is included in the first survey packet should be on official pharmacy letterhead and signed by a senior pharmacy leader or executive. The cover letter should address the following points:
- Why the pharmacy is conducting the survey and how survey responses will be used.
- How much time is needed to complete the survey.
- Assurances that the survey is voluntary and can be completed during work time.
- Assurance of individual anonymity (if no individual identifiers are used) or confidentiality of response (if individual identifiers are used).
- How to return completed surveys.
- Incentives for survey participation (optional).
- Contact information for the pharmacy POC (and chain/system-level POC, if applicable).
In the cover letter or on the paper survey form, ask staff to complete the survey within 7 days, but do not print an actual deadline date on the letter or survey. Sometimes data collection schedules get delayed and you do not want to reprint letters or surveys because they are outdated. In addition, sometimes people will not complete a survey if they notice that it is beyond the deadline date.
Sample Cover Letter Text for Paper Survey
The enclosed survey is part of our pharmacy’s efforts to better address patient and medication safety. All staff in the pharmacy are being asked to complete this survey. Your participation is voluntary, but we encourage you to complete the survey to help us improve the way we do things in this pharmacy. It will take about 10 to 15 minutes to complete, and your individual responses will be kept anonymous [say confidential if you are using respondent identifiers]. Only group statistics, not individual responses, will be prepared and reported.
Please complete your survey WITHIN THE NEXT 7 DAYS. When you have completed your survey, please [provide return instructions for paper surveys]. [Optional incentive text: In appreciation for participation, staff who complete and return their surveys will receive (describe incentive).]
Please contact [POC name and job position] if you have any questions [provide phone number and email address]. Thank you in advance for your participation in this important effort.
Cover Letter in Second Paper Survey Packet
The contents of the second survey cover letter should be similar to the first cover letter but should have
a different beginning. If you conduct an anonymous survey, you will have to distribute second surveys to everyone, so you might say: “About X days ago a copy of the Pharmacy Survey on Patient Safety was distributed to you and other staff at your pharmacy. If you have already returned a completed survey, thank you very much and please disregard this second survey packet.”
If you use individual identifiers, you can send the second survey to nonrespondents only, so you might begin as follows: “About X days ago a copy of the Pharmacy Survey on Patient Safety was distributed to you and other staff at your pharmacy. Because we have not yet received a completed survey from you, we are enclosing a second copy of the survey (if you recently returned your survey, thank you and please disregard this second survey).”
Followup Reminder Notices
If needed to improve response, distribute reminder notices after the second survey administration. The notices, which can be on a half-page of cardstock, should ask staff to please complete and return their surveys and should include a thank you to those who have done so already. If you use individual identifiers to track responses, you can distribute the reminders to nonrespondents only.
Labels and Envelopes for Paper Survey Packets
Outer envelope labels with names are a good idea even if the survey itself is completed anonymously to ensure that every staff member receives a survey. Self-addressed return labels should be used on return envelopes. Labels may also be used to place pharmacy identifiers on the surveys.
Use a slightly larger outer envelope to keep from bending or folding the survey or return envelope contained in the survey packet. Use your estimate of the number of surveys to print to estimate the numbers of outer and
return envelopes you will need.
Postage for Returning Paper Surveys
If staff will return their surveys by mail, weigh the survey and the return envelope to ensure that you have adequate postage on the envelopes. When calculating the total cost of postage, be sure to base the amount on your estimated number of any initial and followup surveys that need to be mailed.
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