Chapter 2. Getting Started

Community Pharmacy Survey User's Guide

Before you begin, you need to understand the basic tasks involved in the collection of survey data and decide who will manage the project. This chapter is designed to guide you through the planning and decisionmaking stages of your project.

Determine Available Resources and Project Scope

Two of the most important elements of an effective project are a clear budget to determine the scope of your data collection effort and a realistic schedule. Think about your available resources:

  • How much money and resources are available to conduct this project?
  • Who within the pharmacy, pharmacy chain, or health care system is available to work on this project?
  • When do we need to have the survey results completed and available?
  • Do we have the technical capabilities to conduct this project in the pharmacy, or do we need to consider using an outside company or vendor for some or all of the tasks?

You should read this user's guide before deciding on a budget and the project's scope, because it outlines the tasks that need to be accomplished. Each task has interrelated cost and scheduling implications. Use the following guidelines to determine your budget and plan:

  • Consider all project tasks and whether the tasks will be performed in-house (by the pharmacy or the chain/system headquarters, or both) or by an outside company or vendor.
  • Develop initial budget and scheduling estimates and revise as needed given your available resources, existing deadlines, and project implementation decisions.
  • Include a cushion for unexpected expenses and account for tasks that may take longer than expected.

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Decide on Your Data Collection Method

The decision to use a paper survey, a Web survey (either via the Internet or through your pharmacy Intranet), or mixed mode should be based on several important factors. Most single pharmacy sites will find that response rates are higher with paper surveys and that the logistics of paper surveys will be manageable. But to help you decide which data collection method is appropriate for your community pharmacy (or pharmacies), we discuss five factors you should consider:

  1. Response rates. Response rates are important because low rates may limit your ability to generalize results to your entire pharmacy. When response rates are low, there is a danger that the large number of staff who did not respond to the survey would have answered very differently from those who did respond. Generally, the higher the response rate, the more confident you can be that you have an adequate representation of staff views.

    Consider the following response rate findings when deciding how to administer your survey:

    • Published research shows that, generally, paper surveys have higher response rates than Web surveys (Dillman, et al., 2009; Lozar Manfreda, et al., 2008; Shih and Fan, 2008).
    • The AHRQ Hospital Survey on Patient Safety Culture 2012 User Comparative Database Report (Sorra, Famolaro, et al., 2012a) finds that response rates are higher with paper surveys (61 percent) compared with Web only (51 percent) and mixed mode using Web and paper (49 percent).
    • The AHRQ Medical Office Survey on Patient Safety Culture 2012 User Comparative Database Report (Sorra, Famolaro, et al., 2012b) finds that response rates are highest for mixed-mode data collection (87 percent), followed by paper (80 percent) and Web (66 percent). However, only 2 percent of the medical offices used a mixed-mode approach, so those response results are probably not typical.
  2. Your pharmacy's experience with employee surveys. You should also consider the following factors when thinking about the possible use of Web surveys:
    • Limited staff access to computers or email. If your pharmacy has a limited number of computers or limited access to the Internet, you will not be able to send staff email notifications containing hyperlinks to the survey. Those limitations may cause response rates to suffer. Staff may also be concerned about the privacy of their responses if they share computers and they may decide not to take the survey.
    • Individual differences in computer skills and experience completing Web surveys. Some staff may not be computer savvy, particularly in taking Web surveys. They may not respond to the survey if this is their only means of completing it.
    • Pharmacy experience with conducting Web surveys. If you currently survey pharmacy staff online and achieve high response rates, you may prefer administering a Web survey. If you have conducted successful Web surveys, but some pharmacy staff do not have access to computers, you may want to use a mix of both Web and paper.
  3. Logistics. In single community pharmacies, the logistical burden of managing and administering paper surveys may be quite modest. If you plan to survey multiple pharmacies, however, there are advantages with Web surveys:
    • There are no surveys or cover letters to print, survey packets to assemble, postage and mailing envelopes to arrange for, or completed paper surveys to manage.
    • The responses are automatically entered into a database, so the need for separate data entry is eliminated.
    • The task of data cleaning is reduced because of programmed validation checks.
  4. Costs and your pharmacy resources. Another major factor to consider, of course, is cost. Although the costs of a Web survey may seem lower because there are no printing, postage, or data entry expenses, do not overlook the labor costs associated with Web survey programming and testing or with hiring a vendor. At the same time, if your chain or health care system plans to survey a large number of pharmacies, a Web survey may be more cost effective than a paper survey.
  5. Survey preparation and testing time. Preparing a paper survey is relatively simple: Download the survey from the AHRQ Web site and format and print it (e.g., stapled single sheets, booklet, scannable booklet), proofread a sample copy, and produce the number of copies you need. If you are using a Web survey and plan to program it yourself, allow sufficient time and resources to:
    • Ensure that the Web survey meets acceptable standards for functionality, usability, and log-in passwords and allows respondents to save their responses and return later to finish the survey;
    • Format the survey appropriately to reduce respondent error;
    • Put security safeguards in place for protecting the data; and
    • Test it thoroughly to ensure that the resulting dataset has captured the data correctly.

In Chapter 4, we review best practices in Web survey design and testing. If you plan to use a vendor to conduct a Web survey, you will need to test the survey. When deciding on a data collection method, carefully consider the pros and cons of each method and choose a method that seems to be cost effective, suited to your pharmacy, and likely to result in a successful response rate and data collection.

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Decide Whether To Use Survey Identifiers

You need to decide whether you will use individual survey identifiers and, if you are surveying multiple pharmacies, how you will identify responses from each pharmacy.

Individual Identifiers

Staff completing patient safety culture surveys are usually concerned about the confidentiality of their responses, so we recommend that you conduct an individually anonymous survey. This means you should not use identifiers to track individuals. Also, do not ask respondents to provide their names on completed survey forms. Understand that confidentiality concerns are even stronger in smaller pharmacies. You need to ensure that respondents feel comfortable reporting their true perceptions and confident that their answers cannot be traced back to them.

Community Pharmacy Identifiers

If you are surveying multiple community pharmacies, you will want to use pharmacy-level identifiers so that you can identify which surveys came from which pharmacy and produce feedback reports of results for each pharmacy. We offer a few ways of doing this for paper and Web surveys. Our suggestions vary depending on the number of pharmacies you are surveying and how respondents will return their surveys.

Paper Surveys

Vary survey color. If the number of pharmacies you are surveying is not too large, you can print the survey on different colored paper for each pharmacy.

Print a pharmacy identifier on the survey. You can print a pharmacy identifier on the surveys by giving each pharmacy a unique form number. For example, if you are surveying three community pharmacies, you would use Form 1, Form 2, and Form 3 to identify these pharmacies. Print the identifier on the survey (e.g., lower left corner of the back page). Be aware, however, that some staff members will be so concerned about the confidentiality of their responses that they might mark out the pharmacy identifier or form number.

Web Survey

You can include a pharmacy identifier as part of the password that is used to access the survey. The password would be linked to a particular pharmacy site. Alternatively, you can use a customized hyperlink for staff within a pharmacy site that differs across sites.

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Decide Whether To Use an Outside Vendor

You may want to use an outside company or vendor to handle some or all of your data collection, analysis, and report preparation. Hiring a vendor may be a good idea for several reasons:

  • Working with an outside vendor may help ensure neutrality and the credibility of results.
  • Staff may feel their responses will be more confidential when they are returned to an outside vendor.
  • Vendors typically have experienced staff to perform all the necessary activities and the facilities and equipment to handle the tasks. A professional and experienced firm may be able to provide your pharmacy with better quality results faster than if you were to complete the tasks yourself.

On the other hand, the use of a vendor may add too much expense to your project. If your community pharmacy is part of a chain or health care system, find out if the headquarters staff are capable of and interested in conducting a survey of your pharmacy and analyzing the data for you. Your pharmacy chain or system may even be interested in administering the survey companywide. Moreover, your pharmacy's staff may feel more comfortable about the confidentiality of their responses if surveys can be returned to a chain or system headquarters address.

If you plan to hire a vendor, the following guidelines may help you select the right one:

  • Look for a vendor with expertise in survey research.
  • Determine whether the vendor can handle all the project components. Some vendors will be able to handle your data analysis and feedback report needs; others will not.
  • Provide potential vendors with a clear written outline of work requirements. Make tasks, expectations, deadlines, and deliverables clear and specific. Then, ask each vendor to submit a short proposal describing the work they plan to complete, qualifications of their company and staff, and details regarding methods and costs.
  • Meet with the vendor to make sure you will be able to work well together.
  • After choosing a vendor, institute monitoring and problem-resolution procedures.

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Plan Your Project Schedule

Use the timeline in Figure 1 as a guideline in planning the tasks to be completed for a single pharmacy using a paper survey. Note the modifications we recommend if you plan to administer any surveys via the Web or are surveying multiple pharmacies.

For a single pharmacy, plan for about 5 weeks from the beginning of project planning to the end of data collection if you are conducting a paper-only survey (Figure 1). Add a few more weeks for data cleaning, analysis, and report preparation.

If you plan to administer a Web-only or mixed-mode survey, but have no experience and do not plan to use a vendor, add several weeks to the timeline in Figure 1 during the preparation and planning stage. That will allow time to design, program, and test the survey.

 

Figure 1. Task Timeline for Project Planning for a Single Community Pharmacy: Paper Survey

Task Timeline for Project Planning Preparation / Planning Week 1 Week 2 Week 3 Week 4 Week 5  
Getting Started - Ch. 2
Determine available resources and project scope          
Decide on your data collection method          
Decide whether to use survey identifiers to track response          
Decide whether to use an outside vendor (and select vendor)          
Plan your project schedule          
Form a project team          
Establish a point of contact in your pharmacy          
Survey Administration Decisions and Steps - Ch. 3
Decide how surveys will be distributed and returned          
Develop, print, and assemble survey materials          
Publicize and promote the survey     Image of large 2-way arrow.  
Distribute first survey           {Data
Collection
Track responses and calculate preliminary response rates       Image of small 2-way arrow.    
Distribute second survey          
Close out data collection            


If you plan to survey multiple pharmacies in your chain or system, you may need to make some or all of the following adjustments to the timeline:

  • Establish a pharmacy-level or chain/system-level point of contact as well as a point of contact in each pharmacy.
  • Allow more time for assembling survey materials (e.g., 2 weeks instead of 1 week).
  • Distribute a first reminder 1 week after distributing the first survey.
  • Distribute a second survey 2 weeks after the first reminder.
  • Distribute a second reminder 1 week after distributing the second survey.
  • Add a week or more to the data collection period.

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Form a Project Team

Whether you conduct the survey in-house or through an outside vendor, you will need to establish a project team responsible for planning and managing the project. Your team may consist of one or more individuals from your own pharmacy staff, chain or health care system headquarters staff, outsourced vendor staff, or a combination. Their responsibilities will include duties such as the following:

  • Planning and budgeting—Determining the scope of the project given available resources, planning project tasks, and monitoring the budget.
  • Establishing contact persons—Assigning a point of contact in the pharmacies to support survey administration, maintain open communication throughout the project, and provide assistance.
  • Preparing publicity materials—Creating flyers, posters, and email and Intranet messages to announce and promote the survey in the pharmacy.
  • Preparing paper survey materials—Printing surveys, preparing postage-paid return envelopes and labels, and assembling these components for your survey distribution.
  • Developing a Web survey instrument—Designing the instrument, programming the survey, and pretesting the instrument.
  • Distributing and receiving paper survey materials—Distributing surveys and reminder notices and handling receipt of completed surveys.
  • Tracking survey responses and calculating preliminary response rates—Monitoring survey returns and calculating preliminary response rates; if individual identification numbers are used on the surveys to track nonrespondents, identifying the nonrespondents who should receive followup materials.
  • Handling data entry, analysis, and report preparation—Reviewing survey data for respondent errors and data entry errors in electronic data files, conducting data analysis, and preparing a report of the results.
  • Distributing and discussing feedback results with staff—Disseminating results broadly to increase their usefulness.
  • Coordinating with and monitoring an outside vendor (optional)—Outlining the requirements of the project to solicit bids from outside vendors, selecting a vendor, coordinating tasks to be completed in-house versus by the vendor, and monitoring progress to ensure that the necessary work is completed and deadlines are met.

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Establish a Point of Contact

You will need to appoint someone from the pharmacy project team to serve as the point of contact (POC) for the survey (e.g., the pharmacy manager). We recommend including the POC's name, job title, and contact information in survey cover letters, invitation emails for Web surveys, reminder notices, and any promotional materials in case respondents have questions about the survey.

The pharmacy POC has several duties, including:

  • Promoting the survey.
  • Answering questions about survey items, instructions, or processes.
  • Responding to staff comments and concerns.
  • Helping to coordinate survey distribution and receipt of completed surveys if paper surveys are used.
  • Communicating with outside vendors, as needed.
  • Communicating with other POCs, as needed.

If you plan to administer the survey in multiple community pharmacies in your chain or health care system, you may want to designate a chain- or system-level POC in addition to a POC in each pharmacy participating in the survey. The contact information for this POC should also be included in the survey cover letter (or invitation email) and in any survey reminder notices.

In Chapter 3 we discuss data collection procedures for paper surveys. In Chapter 4 we discuss data collection procedures for Web-only surveys and mixed-mode surveys. We also review guidelines for designing and pretesting Web surveys. If you plan to conduct a mixed-mode survey, you should read both chapters. If you have not yet decided which data collection method to use, reading both chapters can be useful in helping you assess which method will be best for your pharmacy.

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Page last reviewed April 2014
Internet Citation: Chapter 2. Getting Started: Community Pharmacy Survey User's Guide. April 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/pharmacy/toolkit/pharmsopsuserguide2.html