Improving Response Rates on the AHRQ Surveys on Patient Safety Culture
Joe Hughes, Director of Quality Care Management at Riverside Walter Reed Hospital
Rebecca Caschette, Administrator of Safety and Quality at Memorial Healthcare System
Theresa Famolaro, Surveys on Patient Safety Culture Database Manager, Westat
Audio podcast available at http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/sopspodcasts.html.
Theresa Famolaro: Welcome to Improving your Response Rates on the AHRQ Hospital Survey on Patient Safety Culture Podcast sponsored by the Agency for Healthcare Research and Quality. This podcast will provide you with information on tips and tools to increase your survey response rates in your hospital. I'm Theresa Famolaro from Westat and I manage the databases for the AHRQ Surveys on Patient Safety Culture. I'm here today with Rebecca Caschette, the Administrator of Safety and Quality at Memorial Healthcare System in Hollywood, Florida, and Joe Hughes, the Director of Quality Care Management at Riverside Walter Reed Hospital in Gloucester, Virginia.
Thank you, Rebecca and Joe, for being here today. Rebecca, you had three hospitals in your system increase survey response rates by at least 29 percent. Joe, your hospital increased by 37 percent. One of the things you both mentioned was that leadership was critical in increasing your response rate. Rebecca, can you tell us a little bit more about the importance of leadership?
Rebecca Caschette: Well, honestly, the first year that we took it, our rates were dismal. But we realized that leadership was going to be key to hospital participation. And our executive team is totally committed to our culture. We don't think for one minute that we're going to get safer and improve our quality if we don't change our culture and we also know that we have to focus on that because culture eats strategy for lunch.
Theresa Famolaro: So leadership also had a major influence on culture. Can you tell us a little bit more about your leadership activities?
Rebecca Caschette: Well, a few years ago myself and a couple of my colleagues were fortunate enough to attend a year-long HRET Patient Safety Leadership Fellowship, and during that fellowship they stressed how important it was to focus on the culture of the hospital, clinical outcomes, and quality. So we went back and presented to health system executives and administrators and let them know about the response rate and in turn they realized the importance of, you know, improving our results.
Theresa Famolaro: You educated your leaders and the survey became more important in improving patient safety and quality. Joe, what did your leadership do to encourage support of the survey?
Joe Hughes: Well, prior to the survey campaign, our leadership team made daily rounds on each of the units throughout the hospital. With the exception of Sundays, this is a daily process that we do throughout the hospital. The leadership team is made up of hospital directors and nurse managers from each of the units. In addition, it includes our CEO and our service line chief ,who is also a hospitalist. During our most recent survey administration for the HSOPS, the leadership team promoted the survey to staff on each of these units and departments and mentioned it daily on their walk-arounds.
In addition, an initial announcement about the survey came from the CEO and the announcement included "Spring Into Safety" as our slogan and theme. And this enabled staff to become more familiar with the culture of the response rates.
Theresa Famolaro: So leadership plays a big part in hospital participation. Survey administration methods also affect hospital response rates. Rebecca, did you administer your survey by paper or Web? And how do you think mode affected your response rates?
Rebecca Caschette: We had always done the electronic via a Zoomerang and we chose to do this because we use Zoomerang surveys for a lot of things with our organization. We took the icon to take the survey. It was placed on our main Web page for everyone to see. We made it super large. And computers are readily accessible to all of our units, including environmental services. All employees that don't regularly use a computer are directed by one of their managers to use a computer.
And our hospital administrators send out Email invitations and weekly reminders for the survey. And the Email invitation contains a letter of support from each hospital system executive. During the survey administration, my assistant sent out response reports containing the number of completes, not only for each administrator's respective hospitals, but for all the hospitals in the system, so that all of the hospital administrators can see how other hospitals are doing. And this provoked quite a competitive spirit among the hospitals to achieve the higher response rates.
Theresa Famolaro: It's interesting that you mentioned competition as a way to increase your response rates. How often did you send out those response reports and who got those reports?
Rebecca Caschette: We sent the reports out every single week. Every Monday morning we send the reports out and they get back with their staff and let them know. We send it to the executive of each hospital and then they let all their department leaders know how they're doing in comparison to everybody else.
Theresa Famolaro: Joe, I understand that you used incentives to boost response rates. Can you tell us about the incentives that you used?
Joe Hughes: Sure. For the most recent survey administration, we conducted a raffle and this was announced during National Hospital Week, whereas the hospital raffled three baskets as incentives to participate in the SOPS survey. These baskets consisted of goodies and we had three different themes. One was for a movie night, a game night, and a car wash. Participants of the SOPS survey took this survey on the Web and then via the honor system reported their survey completion to the unit manager, who then in turn gave them a raffle ticket for the entry for the baskets for completing the survey.
The managers on the units kept track of who requested a raffle ticket and then followed up with employees who did not receive a ticket. So those that did not receive a raffle ticket did not take the survey.
Theresa Famolaro: So how did the incentives affect employee participation?
Joe Hughes: Well, given the poor participation from the last survey, these incentives really did help. Our staff is competitive, not only between departments, but even within the same departments between different shifts. We had an ice cream social and the activities during National Hospital Week created a lot of interest.
Theresa Famolaro: How much did your incentives cost and how did you fund the incentives?
Joe Hughes: The budget for the incentives came from our Employee Activity Fund, and also we took donations during National Hospital Week. We had several department directors that were interested in donating, so all that was taken up as collections for donations was used to help fund this. The costs were very minimal.
Theresa Famolaro: Thank you, Rebecca and Joe, for sharing your strategies to improve survey response rates. I think the advice you have offered is really helpful to other users. Although we focused on hospitals in today's podcast, these same tips about improving your response rates can be used when administering the Nursing Home Survey on Patient Safety Culture.
To find out more about increasing your response rates, please read our response rate tip sheet located on the same Web page as this podcast. If you need any help or assistance on any of the AHRQ Surveys on Patient Safety Culture, please feel free to Email us at firstname.lastname@example.org [email@example.com] or call the help line at 1-888-324-9790.
We thank you for joining us and we look forward to bringing you more stories and experiences from users of the Surveys on Patient Safety Culture. Thank you.