Composites and Items

Pharmacy Survey User's Guide

In this document, the items in the Pharmacy Survey on Patient Safety Culture are grouped according to the safety culture composites they are intended to measure. The item’s survey location is shown to the left of each item. Negatively worded items are indicated. Reliability statistics (Cronbach’s alpha) based on the pilot test data from 60 pharmacies and 496 staff are provided for the composites.

1. 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?

A1. This pharmacy is well organized.
A5. This pharmacy is free of clutter.
A7. The physical layout of this pharmacy supports good workflow.

Reliability of this composite—Cronbach’s alpha (3 items) = .76

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2. 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?

A2. Staff treat each other with respect.
A4. Staff in this pharmacy clearly understand their roles and responsibilities.
A9. Staff work together as an effective team.

Reliability of this composite—Cronbach’s alpha (3 items) = .85

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3. Staff Training and 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?

A3. Technicians in this pharmacy receive the training they need to do their jobs.
A6. Staff in this pharmacy have the skills they need to do their jobs well.
A8. Staff who are new to this pharmacy receive adequate orientation.
A10. Staff get enough training from this pharmacy.

Reliability of this composite—Cronbach’s alpha (4 items) = .89

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4. Communication Openness

(Never, Rarely, Sometimes, Most of the Time, Always, Does Not Apply or Don’t Know)

How often do the following statements apply to this pharmacy?

B1. Staff ideas and suggestions are valued in this pharmacy.
B5. Staff feel comfortable asking questions when they are unsure about something.
B10. It is easy for staff to speak up to their supervisor/ manager about patient safety concerns in this pharmacy.

Reliability of this composite—Cronbach’s alpha (3 items) = .79

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5. Patient Counseling

(Never, Rarely, Sometimes, Most of the Time, Always, Does Not Apply or Don’t Know)

How often do the following statements apply to this pharmacy?

B2. We encourage patients to talk to pharmacists about their medications.
B7. Our pharmacists spend enough time talking to patients about how to use their medications.
B11. Our pharmacists tell patients important information about their new prescriptions.

Reliability of this composite—Cronbach’s alpha (3 items) = .74

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6. Staffing, Work Pressure, and Pace

(Never, Rarely, Sometimes, Most of the Time, Always, Does Not Apply or Don’t Know)

How often do the following statements apply to this pharmacy?

B3. Staff take adequate breaks during their shifts.
B9. We feel rushed when processing prescriptions. (negatively worded)
B12. We have enough staff to handle the workload.

B16. Interruptions/distractions in this pharmacy (from phone calls, faxes, customers, etc.) make it difficult for staff to work accurately. (negatively worded)

Reliability of this composite—Cronbach’s alpha (4 items) = .68

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7. Communication About Prescriptions Across Shifts

(Never, Rarely, Sometimes, Most of the Time, Always, Does Not Apply or Don’t Know)

How often do the following statements apply to this pharmacy?

B4. We have clear expectations about exchanging important prescription information across shifts.
B6. We have standard procedures for communicating prescription information across shifts.
B14. The status of problematic prescriptions is well communicated across shifts.

Reliability of this composite—Cronbach’s alpha (3 items) = .85

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8. Communication About Mistakes

(Never, Rarely, Sometimes, Most of the Time, Always, Does Not Apply or Don’t Know)

How often do the following statements apply to this pharmacy?

B8. Staff in this pharmacy discuss mistakes.
B13. When patient safety issues occur in this pharmacy, staff discuss them.
B15. In this pharmacy, we talk about ways to prevent mistakes from happening again.

Reliability of this composite—Cronbach’s alpha (3 items) = .85

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9. 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?

C1. Staff are treated fairly when they make mistakes.
C4. This pharmacy helps staff learn from their mistakes rather than punishing them.
C7. We look at staff actions and the way we do things to understand why mistakes happen in this pharmacy.

C8. Staff feel like their mistakes are held against them. (negatively worded)

Reliability of this composite—Cronbach’s alpha (4 items) = .83

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10. 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?

C2. When a mistake happens, we try to figure out what problems in the work process led to the mistake.
C5. When the same mistake keeps happening, we change the way we do things.
C10. Mistakes have led to positive changes in this pharmacy.

Reliability of this composite—Cronbach’s alpha (3 items) = .76

Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composite scores.

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11. 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?

C3. This pharmacy places more emphasis on sales than on patient safety. (negatively worded)
C6. This pharmacy is good at preventing mistakes.
C9. The way we do things in this pharmacy reflects a strong focus on patient safety.

Reliability of this composite—Cronbach’s alpha (3 items) = .79

Note: Negatively worded questions should be reverse coded when calculating percent “positive” response, means, and composite scores.

Composite scores are not calculated for Documenting Mistakes and the Overall Rating.

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Documenting Mistakes

(Never Documented, Rarely Documented, Sometimes Documented, Most of the Time Documented, Always Documented, Does Not Apply or Don’t Know)

In this pharmacy, how often are the following types of mistakes documented (in writing OR tracked electronically)?

D1. When a mistake reaches the patient and could cause harm but does not, how often is it documented?
D2. When a mistake reaches the patient but has no potential to harm the patient, how often is it documented?
D3. When a mistake that could have harmed the patient is corrected BEFORE the medication leaves the pharmacy, how often is it documented?

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Overall Rating 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.

(Poor, Fair, Good, Very Good, Excellent)

E1. How do you rate this pharmacy on patient safety?

FOR TECHNICAL ASSISTANCE OR QUESTIONS ABOUT THE PHARMACY SURVEY ON PATIENT SAFETY CULTURE, PLEASE EMAIL SAFETYCULTURESURVEYS@AHRQ.HHS.GOV.

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Current as of March 2013
Internet Citation: Composites and Items: Pharmacy Survey User's Guide. March 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/pharmacy/toolkit/pharmsopsuserguideitems.html