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SOPS Frequently Asked Questions (FAQs)

These frequently asked questions address issues related to the AHRQ Surveys on Patient Safety Culture™ (SOPS®) for hospitals, medical offices, nursing homes, community pharmacies, and ambulatory surgery centers, as well as the Health Information Technology Patient Safety Supplemental Item Set, the Diagnostic Safety Supplemental Item Set, the Workplace Safety Supplemental Item Sets for hospitals and nursing homes, and the Value and Efficiency Supplemental Item Sets for hospitals and medical offices.

Contents

General Questions

  1. Why should a healthcare organization conduct a safety culture survey?
  2. There are other organizational culture and safety culture surveys; why should an organization use one of the AHRQ Surveys on Patient Safety Culture?
  3. How often should an organization administer the AHRQ Surveys on Patient Safety Culture?
  4. Are there web versions of the surveys?
  5. What is a composite measure or a dimension?
  6. Can I use the AHRQ Surveys on Patient Safety Culture outside the United States?
  7. Do I have permission to use the surveys?
  8. Can international facilities participate in the Surveys on Patient Safety Culture Databases?
  9. Can I translate the AHRQ Surveys on Patient Safety Culture?
  10. How should the AHRQ Surveys on Patient Safety Culture be referenced?
  11. Can I modify the AHRQ Surveys on Patient Safety Culture or do I need to use them as is?
  12. What supplemental item sets are available for the Surveys on Patient Safety Culture?
  13. Where should the supplemental item sets be added?
  14. Are Spanish versions of the AHRQ Surveys on Patient Safety Culture available?
  15. Is it possible for me to obtain the research datasets from the SOPS Databases?
  16. How can I improve my survey results?
  17. How can I improve my response rate?
  18. How can I stay up to date on safety culture news?
  19. Whom can I contact if I have further questions?

Questions Specific to the SOPS Hospital Survey Version 2.0 (HSOPS 2.0)

  1. Why did AHRQ develop Version 2.0 of the SOPS Hospital Survey (HSOPS 2.0)?
  2. What is different about the new SOPS Hospital Survey 2.0 (HSOPS 2.0) compared with the original SOPS Hospital Survey 1.0 (HSOPS 1.0)?
  3. How long is the SOPS Hospital Survey 2.0 (HSOPS 2.0)?
  4. How many completed surveys are needed to submit to the SOPS Hospital Database?
  5. What areas of patient safety culture are assessed on the SOPS Hospital Survey 2.0 (HSOPS 2.0)?
  6. How was the SOPS Hospital Survey 2.0 (HSOPS 2.0) developed and tested?
  7. How can hospitals transition from the SOPS Hospital Survey 1.0 (HSOPS 1.0) to the new SOPS Hospital Survey 2.0 (HSOPS 2.0)? Can hospitals compare scores on HSOPS 2.0 against scores from a previous administration of HSOPS 1.0?
  8. How can hospitals conduct a simultaneous administration of SOPS Hospital Survey 1.0 (HSOPS 1.0) and SOPS Hospital Survey 2.0 (HSOPS 2.0) to compare scores?
  9. Are the current SOPS Hospital Survey resource materials—including the Survey User’s Guide, Data Entry and Analysis Tool, and Action Planning Tool—still relevant or are there new versions of these resources for the SOPS Hospital Survey 2.0 (HSOPS 2.0)?
  10. Will AHRQ continue to support the SOPS Hospital Survey 1.0 (HSOPS 1.0)? If so, for how long?
  11. Several survey items from the SOPS Hospital Survey 1.0 (HSOPS 1.0) were dropped from HSOPS 2.0 but my organization finds these items useful. Can I still use any of the survey items from HSOPS 1.0?
  12. Can I compare my SOPS Hospital Survey 2.0 (HSOPS 2.0) results against other hospitals?
  13. What supplemental item sets are available for the SOPS Hospital Survey Version 2.0?
  14. Can I compare my SOPS Health IT Patient Safety Supplemental Item Set results against other hospitals?
  15. Can I compare my SOPS Workplace Safety Supplemental Item Set results against other hospitals?
  16. Can I compare my SOPS Value and Efficiency Supplemental Item Set results against other hospitals?

Questions Specific to the SOPS Hospital Survey Version 1.0 (HSOPS 1.0)

  1. What areas of patient safety culture do the survey questions cover on the SOPS Hospital Survey Version 1.0 (HSOPS 1.0)?
  2. How long is the SOPS Hospital Survey 1.0 (HSOPS 1.0)?
  3. How many completed surveys are needed to submit to the SOPS Hospital Database?
  4. Will AHRQ continue to support the SOPS Hospital Survey 1.0 (HSOPS 1.0)? If so, for how long?
  5. Can I compare my SOPS Hospital Survey results against other hospitals?

Questions Specific to the SOPS Medical Office Survey

  1. What areas of patient safety culture do the survey questions cover on the SOPS Medical Office Survey?
  2. How long is the SOPS Medical Office Survey?
  3. What is considered a medical office?
  4. Can any size medical office conduct the SOPS Medical Office Survey?
  5. Does it matter what specialty or specialties my medical office covers?
  6. How many completed surveys are needed to submit to the SOPS Medical Office Database?
  7. Can I compare my SOPS Medical Office Survey results against other medical offices?
  8. What supplemental items are available for the SOPS Medical Office Survey?
  9. Can I compare my medical office's SOPS Value and Efficiency Supplemental Item Set results against other medical offices?
  10. Can I compare my medical office's SOPS Diagnostic Safety Supplemental Item Set results against other medical offices?

Questions Specific to the SOPS Nursing Home Survey

  1. What areas of patient safety culture do the survey questions cover on the SOPS Nursing Home Survey?
  2. How long is the SOPS Nursing Home Survey?
  3. Does the SOPS Nursing Home Survey apply to assisted living facilities, community care facilities, or independent living facilities?
  4. How many completed surveys are needed to submit to the SOPS Nursing Home Database?
  5. Can I compare my SOPS Nursing Home Survey results against other nursing homes?
  6. What supplemental item sets are available for the SOPS Nursing Home Survey?
  7. Can I compare my nursing home's SOPS Workplace Safety Supplemental Item Set results against other nursing homes?

Questions Specific to the SOPS Community Pharmacy Survey

  1. What areas of patient safety culture do the survey questions cover on the SOPS Community Pharmacy Survey?
  2. How long is the SOPS Community Pharmacy Survey?
  3. What is considered a community pharmacy?
  4. How many completed surveys are needed to submit to the SOPS Community Pharmacy Database?
  5. Is the SOPS Community Pharmacy Survey applicable to a hospital pharmacy setting that does both inpatient and retail pharmacy business?
  6. Can I compare my SOPS Community Pharmacy Survey results against other community pharmacies?

Questions Specific to the SOPS Ambulatory Surgery Center Survey

  1. What areas of patient safety culture do the survey questions cover on the SOPS Ambulatory Surgery Center Survey?
  2. How long is the SOPS Ambulatory Surgery Center Survey?
  3. What is considered an ambulatory surgery center (ASC)?
  4. Is the SOPS Ambulatory Surgery Center Survey applicable to hospital outpatient departments?
  5. Can I compare my SOPS Ambulatory Surgery Center Survey results against other ASCs?

General Questions

Question 1: Why should a healthcare organization conduct a safety culture survey?

Answer: Safety culture surveys are useful for measuring organizational conditions that can lead to adverse events and patient harm in healthcare organizations. Organizations that want to assess their existing culture of patient safety should consider conducting a safety culture survey. Safety culture surveys can be used to:

  • Raise staff awareness about patient safety.
  • Assess the current status of patient safety culture.
  • Identify strengths and areas for patient safety culture improvement.
  • Examine trends in patient safety culture change over time.
  • Evaluate the cultural impact of patient safety initiatives and interventions.

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Question 2: There are other organizational culture and safety culture surveys; why should an organization use one of the AHRQ Surveys on Patient Safety Culture?

Answer: The AHRQ Surveys on Patient Safety Culture have several advantages. They are:

  1. Free—available to the public. The surveys were developed by AHRQ and are available free of charge.
  2. An organizationwide instrument. The surveys were designed to be administered to all types of staff, including clinical and nonclinical staff in hospitals, nursing homes, medical offices, community pharmacies, and ambulatory surgery centers. They can be used to assess individual units or departments or can be administered organizationwide.
  3. Reliable and valid. The survey development process was careful and rigorous, based on a review of the existing research and other culture surveys. More important, the survey items have demonstrated reliability and validity (for more details, refer to the survey Toolkit materials available on the AHRQ SOPS website).
  4. Comprehensive and specific. The surveys cover several areas of patient safety culture, providing a level of detail that helps organizations identify specific areas of strength and areas for improvement. In addition, there are supplemental item sets users may add to assess content in areas not included in the core questionnaire (e.g., Health Information Technology Patient Safety Supplemental Item Set and Value and Efficiency Supplemental Item Sets).
  5. Easy to use. Each survey has accompanying resource materials:
    • Survey Forms.
    • Survey Items and Composite Measures.
    • A Survey User's Guide: Gives step-by-step instructions on how to select a sample, administer the survey and obtain high response rates, and how to analyze and report results.
    • Data Entry and Analysis Tool: A data entry and analysis tool that works with Microsoft® Excel and makes it easy to input your individual-level data from the survey. The tool then automatically creates tables and graphs to display your survey results. To request the tool for any of the SOPS surveys or supplemental item sets, send an email.
  6. Repositories of data. AHRQ established the SOPS Databases as central repositories for survey data from each of the SOPS surveys. Healthcare organizations that administer one of the AHRQ patient safety culture surveys can voluntarily submit their data to the appropriate database and compare their survey results with the Database.

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Question 3: How often should an organization administer the AHRQ Surveys on Patient Safety Culture?

Answer: On average, hospitals that have submitted to the Hospital Survey on Patient Safety Culture Database more than once readminister the survey every 24 months. Although we do not provide any set recommendations regarding when to readminister the survey, we do caution against administering the survey less than 6 months apart. This would apply as well to the medical office, nursing home, community pharmacy, and ambulatory surgery center settings.

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Question 4: Are there web versions of the surveys?

Answer: AHRQ does not currently have a web survey available for any of the AHRQ Surveys on Patient Safety Culture. Thus, survey users must program their own web surveys or hire a vendor. For guidance on how to administer a web survey, please see the respective Survey User’s Guide located on the AHRQ website.

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Question 5: What is a composite measure or a dimension?

Answer: The Surveys on Patient Safety Culture survey items are grouped into areas of patient safety culture that they are intended to measure. These areas are referred to as composite measures or dimensions. The terms composite measure and dimension are used interchangeably to refer to this grouping of survey items that measure the same patient safety culture area.

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Question 6: Can I use the AHRQ Surveys on Patient Safety Culture outside the United States?

Answer: Please contact the Surveys on Patient Safety Culture team to request AHRQ’s permission to translate and/or use the surveys internationally. For more information about international use of the Surveys on Patient Safety Culture, visit the AHRQ SOPS website.

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Question 7: Do I have permission to use the surveys?

Answer: The AHRQ Surveys on Patient Safety Culture for hospitals, nursing homes, medical offices, community pharmacies, and ambulatory surgery centers and all of their related materials are free and available for public use. You may locate and download them from the AHRQ SOPS website.

More information about using the AHRQ Surveys on Patient Safety Culture.

For permission to use the surveys outside the United States, contact the Surveys on Patient Safety Culture team.

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Question 8: Can international facilities participate in the Surveys on Patient Safety Culture Databases?

Answer: Unfortunately, while any facility is free to use the survey, the AHRQ Surveys on Patient Safety Culture Databases are currently accepting data only from U.S. facilities. However, we would like to know more about what your plans are or what you have done with the survey in your country. Please contact the Surveys on Patient Safety Culture team to share information about your use of the Surveys on Patient Safety Culture.

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Question 9: Can I translate the AHRQ Surveys on Patient Safety Culture?

Answer: Spanish versions are available for all of the AHRQ Surveys on Patient Safety Culture and supplemental item sets: Hospital, Medical Office, Nursing Home, Community Pharmacy, Ambulatory Surgery Center, Diagnostic Safety Supplemental Item Set, Health IT Patient Safety Supplemental Item Set, Value and Efficiency Supplemental Item Sets for hospitals and medical offices, and Workplace Safety Supplemental Item Sets for hospitals and nursing homes. The Spanish translations are designed for U.S. Spanish-speaking respondents from different countries. A number of translations in other languages have already been developed by international users who have agreed to share their contact information. For more information on translating the surveys, contact the Surveys on Patient Safety Culture team to request AHRQ's permission to translate and/or use the surveys internationally.

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Question 10: How should the AHRQ Surveys on Patient Safety Culture be referenced?

Answer: When using any of the SOPS surveys, reference the full name “Surveys on Patient Safety Culture™ (SOPS®)" with the trademark symbol ™ to indicate trademark pending for "Surveys on Patient Safety Culture" and the registered trademark symbol for "SOPS." In the text of written documents (journal articles, press coverage, etc.), spell out the name the first time it appears, followed by SOPS in parentheses: "Surveys on Patient Safety Culture™ (SOPS®) program." Indicate that this is a program of the Agency for Healthcare Research and Quality.

If you are administering a patient safety culture survey that is based on a SOPS survey or uses items from a SOPS survey, refer to the guidelines on modifying and naming SOPS surveys in Using the AHRQ Surveys on Patient Safety Culture.

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Question 11: Can I modify the AHRQ Surveys on Patient Safety Culture or do I need to use them as is?

Answer: Any changes made to modify the survey may affect the reliability and overall validity of the survey and may make comparisons with other facilities difficult. To maintain comparability and consistency across SOPS surveys, AHRQ offers the following guidelines regarding the impact of changes to a SOPS survey:

  • Changing the core survey: The SOPS surveys should be administered in their entirety without modifications or deletions to the core survey items. If any of the following changes are made, then the survey data will not be accepted into any of the SOPS Databases and your survey results will not be comparable with other organizations in the SOPS Databases: (1) changing the wording of items or response options, (2) changing the order of items or response options, (3) deleting one or more items, and (4) adding supplemental or custom questions among the core items within a SOPS survey. 
  • Modifying work areas or staff positions: Your facility may wish to modify the responses to these background questions so that they reflect the names of work units and staff position titles used within your facility. Modifications to the work areas and staff positions are acceptable; however, if your facility plans to submit to any of the SOPS Databases, it must recode the modified units/work areas or staff positions so they crosswalk back to the original survey’s units/work areas or staff positions.
  • Adding items: Facilities may use the supplemental item sets developed under the SOPS program or items from other surveys for your own purposes, including open-ended questions. Any supplemental item sets or additional items from other surveys must be added to the end of the SOPS surveys, just before the Background Questions section. When inserting supplemental item sets, remember to include the appropriate subheadings for each supplemental item set.

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Question 12: What supplemental item sets are available for the Surveys on Patient Safety Culture?

Answer: AHRQ has developed supplemental item sets that can be added to the Hospital and Medical Office SOPS to assess content in areas not covered by the core questions. These supplemental item sets are optional. Currently, there are supplemental item sets for Health IT Patient Safety for Hospitals, Workplace Safety for Hospitals, Value and Efficiency for Hospitals and Medical Offices, and Diagnostic Safety for Medical Offices.

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Question 13: Where should the supplemental item sets be added?

Answer: Any supplemental item sets must be added to the end of the SOPS Hospital or Medical Office Survey, just before the Background Questions section. Be sure to include the definitions of terms and subheadings.

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Question 14: Are Spanish versions of the AHRQ Surveys on Patient Safety Culture available?

Answer: All of the SOPS surveys and supplemental item sets are available in Spanish:

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Question 15:  Is it possible for me to obtain the research datasets from the SOPS Databases?

Answer: AHRQ has established a process whereby researchers can request de-identified data files from the SOPS Databases. Those interested in obtaining the data must submit a completed Research Abstract Form and signed Data Release Agreement.

For the SOPS Hospital Database only, hospital-identifiable data files may be made available that include data that contain hospital identifiers, such as hospital name, address, and Medicare Provider ID. Valid purposes for using the hospital-identifiable data do not include the use of the data for public reporting, or for proprietary, commercial, or competitive purposes involving the participating organizations; or to determine the rights, benefits, or privileges of organizations participating in the Database. Researchers interested in obtaining hospital-identifiable data must submit a completed Hospital-Identifiable Research Abstract Form and Confidentiality Agreement.

More information and the forms.

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Question 16: How can I improve my survey results?

Answer: SOPS resource lists are available and contain references to websites that provide practical resources to improve patient safety culture and patient safety. The lists are not exhaustive but are meant to offer initial guidance for those looking for information on patient safety initiatives. Resource lists have been developed for the hospital, medical office, nursing home, community pharmacy, and ambulatory surgery center surveys, the Health IT Patient Safety Supplemental Item Set for hospitals, Workplace Safety Supplemental Item Set for hospitals, the Workplace Safety Supplemental Item Set for nursing homes, the Value and Efficiency Supplemental Item Set for hospitals and medical offices, and the Diagnostic Safety Supplemental Item Set for medical offices. In addition, the Action Planning Tool helps healthcare organizations develop an action plan for improving patient safety culture in their facilities.

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Question 17: How can I improve my response rate?

Answer: There are many ways to increase your survey response rate, but it will require effort and careful planning. Here are some strategies to consider:

  1. Engage leadership.
  2. Publicize the survey.
  3. Use survey best practices.
  4. Create a competitive spirit.
  5. Provide survey incentives.

An audio podcast and tip sheet on improving response rates is available.

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Question 18: How can I stay up to date on safety culture survey news?

Answer: You may register for Email updates from the AHRQ website. On the AHRQ website, you can find this at the top of the page as an icon labeled "Email Updates." Choose from the following Surveys on Patient Safety Culture Email subscription lists:

  • Hospital Survey.
  • Medical Office Survey.
  • Nursing Home Survey.
  • Community Pharmacy Survey.
  • Ambulatory Surgery Center Survey.

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Question 19: Whom can I contact if I have further questions?

Answer: If you have questions about the Surveys on Patient Safety Culture, please email SOPS Technical Assistance.

If you have questions or need assistance with the SOPS Databases, please email SOPS Databases Technical Assistance.

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Questions Specific to the SOPS Hospital Survey Version 2.0 (HSOPS 2.0)

Question 20: Why did AHRQ develop Version 2.0 of the SOPS Hospital Survey (HSOPS 2.0)?

Answer: AHRQ originally released the SOPS Hospital Survey in 2004 and it has been widely adopted in the United States and internationally. Over the years, users and stakeholders provided AHRQ with feedback about suggested changes to the survey. User feedback included:

  • Rewording complex survey items and survey items difficult to translate;
  • Adding a "Does not apply or Don't know"” (NA/DK) response option;
  • Shifting to a "Just Culture" framework to assess Response to Error;
  • Revising the staff positions and units/work areas; and
  • Determining if the number of negatively worded items could be reduced.

Using this feedback, AHRQ developed and pilot tested a new version of the survey, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019.

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Question 21. What is different about the new SOPS Hospital Survey 2.0 (HSOPS 2.0) compared with the original SOPS Hospital Survey 1.0 (HSOPS 1.0)?

Answer: HSOPS 2.0 assesses many of the same areas of patient safety culture as HSOPS 1.0, but substantial changes were made to the survey. The final HSOPS 2.0 has 40 survey items compared with 51 survey items in HSOPS 1.0. The names of some composite measures (a group of 2 to 4 survey items that assess the same area of patient safety culture) were changed to align with changes to the content assessed in the measures. Five HSOPS 1.0 survey items were kept in HSOPS 2.0 unchanged, but the following changes were made to the remaining items:

  • 21 HSOPS 1.0 survey items were dropped;
  • 25 HSOPS 1.0 survey items were reworded or response options were changed; and
  • 10 new survey items were added to HSOPS 2.0.

HSOPS 2.0 now includes a "Does not apply/Don't know" response option. Similar to HSOPS 1.0, HSOPS 2.0 still includes a mix of positively and negatively worded survey items. For more information about differences between HSOPS 1.0 and HSOPS 2.0 and how to transition to the new 2.0 survey, review the document Transitioning to the SOPS Hospital Survey Version 2.0: What's Different and What To Expect (PDF, 776 KB).

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Question 22. How long is the SOPS Hospital Survey 2.0 (HSOPS 2.0)?

Answer: HSOPS 2.0 has a total of 40 survey items (compared with 51 survey items in HSOPS 1.0) and it takes approximately 10-15 minutes to complete. Most of the survey items use Strongly Disagree/Strongly Agree or Never/Always response options. The survey also includes a “Does not apply or Don’t know” response option. A section for open-ended comments is at the end of the survey.

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Question 23: How many completed surveys are needed to submit to the SOPS Hospital Database?

Answer: A single hospital location needs at least 10 completed surveys to submit to the SOPS Hospital Database.

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Question 24: What areas of patient safety culture are assessed on the SOPS Hospital Survey 2.0 (HSOPS 2.0)?

Answer: HSOPS 2.0 has 10 composite measures (a group of 2 to 4 survey items that assess the same area of patient safety culture):

  1. Communication About Error (3 items)
  2. Communication Openness (4 items)
  3. Handoffs and Information Exchange (3 items)
  4. Hospital Management Support for Patient Safety (3 items)
  5. Organizational Learning—Continuous Improvement (3 items)
  6. Reporting Patient Safety Events (2 items)
  7. Response to Error (4 items)
  8. Staffing and Work Pace (4 items)
  9. Supervisor, Manager, or Clinical Leader Support for Patient Safety (3 items)
  10. Teamwork (3 items)

HSOPS 2.0 also includes:

  1. One survey item that asks respondents how many patient safety events they have reported.
  2. One survey item that asks respondents to provide an overall rating on patient safety for their unit/work area.
  3. Four survey items that ask respondents to provide their background characteristics (staff position, unit/work area, hospital tenure, unit/work area tenure, work hours, and whether they have direct interaction with patients).

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Question 25. How was the SOPS Hospital Survey 2.0 (HSOPS 2.0) developed and tested?

Answer: The survey development team reviewed the literature on patient safety in hospitals, interviewed hospital experts and researchers, identified appropriate survey topics, and drafted survey items for review by the SOPS Technical Expert Panel. The draft survey was cognitively tested with hospital providers and staff to ensure that the questions were easy to understand and answer and that the items were relevant.

An initial pilot test was conducted with 44 hospitals in 2017, but after further analysis and input from the SOPS Technical Expert Panel, additional revisions were made to the survey. A second pilot test was conducted in 2019 on the revised HSOPS 2.0 in 25 hospitals. The 2019 pilot data were analyzed to examine the survey’s psychometric properties (reliability, factor structure, etc.), with the goal of shortening the survey by including only the best items. The final SOPS Hospital Survey 2.0 is therefore the product of extensive development and testing, demonstrates good psychometric properties, and is a reliable instrument to assess patient safety culture in hospitals.

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Question 26: How can hospitals transition from the SOPS Hospital Survey 1.0 (HSOPS 1.0) to the new SOPS Hospital Survey 2.0 (HSOPS 2.0)? Can hospitals compare scores on HSOPS 2.0 against scores from a previous administration of HSOPS 1.0?

Answer: Many hospitals trend their patient safety culture scores to determine whether their patient safety culture improves over time. Given the substantial changes made in HSOPS 2.0, it is not possible to trend scores from a previous administration of HSOPS 1.0 to a current administration of HSOPS 2.0. If the two surveys are administered at different times, it is not possible to determine the extent to which differences in scores are due to changes in HSOPS 2.0 or due to actual changes in patient safety culture over time.

Hospitals have three options for transitioning from HSOPS 1.0 to HSOPS 2.0.

  • Option 1:  Administer HSOPS 2.0—with no trending of previous HSOPS 1.0 scores;
  • Option 2: Administer HSOPS 1.0 One More Time—to trend previous HSOPS 1.0 scores and then later administer HSOPS 2.0 to establish a new baseline on HSOPS 2.0; or
  • Option 3: Conduct Simultaneous Administration of HSOPS 1.0 and HSOPS 2.0—to trend previous HSOPS 1.0 scores and establish a new baseline on HSOPS 2.0 at the same time. This option involves administering HSOPS 1.0 and HSOPS 2.0 at the same time (simultaneous administration), with half of the providers and staff receiving HSOPS 1.0 and the other half receiving HSOPS 2.0. This option is only feasible for larger hospitals (with at least 1,000 providers and staff), because a large number of providers and staff are needed to produce reliable and accurate measurements on both surveys at the same time. Smaller hospitals should use Option 1 or 2.

Only Option 3 (simultaneous administration) enables hospitals to trend their current HSOPS 1.0 scores to previous HSOPS 1.0 scores, while establishing a new baseline on HSOPS 2.0. In future years, only HSOPS 2.0 would need to be administered to trend HSOPS 2.0 scores over time. Option 3 enables hospitals to directly compare their HSOPS 1.0 and HSOPS 2.0 scores because the comparison is done when both surveys are administered simultaneously. When both surveys are administered simultaneously, differences in scores can be attributed to changes that were made in HSOPS 2.0 rather than changes in patient safety culture over time.

Figure 1: Option 3: Conduct Simultaneous Administration of HSOPS 1.0 and HSOPS 2.0 (Only Larger Hospitals With 1,000+ Providers and Staff)

Previous survey administration—HSOPS 1.0. No Trending of HSOPS 1.0—Do Not Compare HSOPS 1.0 with HSOPS 2.0. Next survey administration—HSOPS 2.0. Trending of HSOPS 2.0 to 2nd survey administration—HSOPS 2.0.

For more information about these options and what changes your hospital can expect in scores due to changes in the survey instrument, review the document Transitioning to the SOPS Hospital Survey Version 2.0: What’s Different and What To Expect (PDF, 776 KB).

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Question 27. How can hospitals conduct a simultaneous administration of SOPS Hospital Survey 1.0 (HSOPS 1.0) and SOPS Hospital Survey 2.0 (HSOPS 2.0) to compare scores?

Answer: A simultaneous administration involves administering HSOPS 1.0 and HSOPS 2.0 at the same time, with half of the providers and staff receiving HSOPS 1.0 and the other half receiving HSOPS 2.0. This option is only feasible for larger hospitals (with at least 1,000 providers and staff), because a large number of providers and staff are needed to produce reliable and accurate measurements on both surveys at the same time.

With simultaneous administration, staff are randomly assigned by units/work areas, and then by staff positions within units/work areas, to receive either HSOPS 1.0 or HSOPS 2.0; half receive HSOPS 1.0 and the other half receive HSOPS 2.0. The benefit of a simultaneous administration is that it enables hospitals to continue to trend against previous HSOPS 1.0 scores, while establishing a new baseline on HSOPS 2.0 at the same time. In future years, only HSOPS 2.0 would need to be administered for trending.

In addition, this option allows hospitals to compare their scores on the two survey versions, because differences in scores are likely due to changes in the HSOPS 2.0 survey rather than differences in patient safety culture. Comparing scores on the two survey versions helps hospitals understand how changes in the HSOPS 2.0 survey affect their scores.

For specific guidance, review Appendix B: How To Conduct Simultaneous Administration of HSOPS 1.0 and HSOPS 2.0 and Compare Scores, which is an appendix for the document Transitioning to the SOPS Hospital Survey Version 2.0: What’s Different and What To Expect (PDF, 776 KB).

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Question 28: Are the current SOPS Hospital Survey resource materials—including the Survey User’s Guide, Data Entry and Analysis Tool, and Action Planning Tool—still relevant or are there new versions of these resources for the SOPS Hospital Survey 2.0 (HSOPS 2.0)?

Answer: To accompany HSOPS 2.0, there are new Version 2.0 resource materials, including a new Survey User’s Guide and Data Entry and Analysis Tool. However, no changes were needed to the Action Planning Tool, which was designed for users of all of the SOPS Surveys, regardless of the healthcare setting or survey version.

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Question 29. Will AHRQ continue to support the SOPS Hospital Survey 1.0 (HSOPS 1.0)? If so, for how long?

Answer: The SOPS Hospital Survey 1.0 is still available on the AHRQ website, but the use of HSOPS 2.0 is encouraged. Note that the SOPS Hospital Database will only accept data from HSOPS 2.0.

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Question 30. Several survey items from the SOPS Hospital Survey 1.0 (HSOPS 1.0) were dropped from HSOPS 2.0 but my organization finds these items useful. Can I still use any of the survey items from HSOPS 1.0?

Answer: Yes, you can still use any HSOPS 1.0 survey items that may have been dropped from HSOPS 2.0, but put the items at the end of the Version 2.0 survey before the background questions, along with any other supplemental item sets you want to include.

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Question 31: Can I compare my SOPS Hospital Survey 2.0 (HSOPS 2.0) results against other hospitals?

Answer: AHRQ established the SOPS Hospital Database as a central repository for survey data from the SOPS Hospital Survey 2.0. AHRQ has produced database reports, which aggregate data from over 100 hospitals that have voluntarily submitted their data to the Database. The Database serves as an important resource for patient safety culture improvement.

Information about eligibility requirements, registration procedures, and benefits of participating in the Database is available.

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Question 32: What supplemental item sets are available for the SOPS Hospital Survey 2.0?

Answer: AHRQ has developed supplemental item sets that can be added to the SOPS Hospital Survey 2.0 to assess content in areas not covered by the core questions. These supplemental item sets are optional. Currently, there are supplemental item sets for Health Information Technology, Workplace Safety, and Value and Efficiency.

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Question 33: Can I compare my SOPS Health IT Patient Safety Supplemental Item Set results against other hospitals?

Answer: Hospitals can refer to the Pilot Study Results from the 2017 AHRQ SOPS Health IT Patient Safety Supplemental Item Set for Hospitals, which are based on data from more than 9,000 staff in 44 hospitals that participated in a pilot test of the supplemental item set in 2017.

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Question 34: Can I compare my SOPS Workplace Safety Supplemental Item Set results against other hospitals?

Answer: Hospitals can refer to the 2022 Updated Results for the AHRQ SOPS Workplace Safety Supplemental Items for Hospitals, which are based on data from more than 11,000 staff in 40 hospitals.

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Question 35: Can I compare my SOPS Value and Efficiency Supplemental Item Set results against other hospitals?

Answer: Hospitals can refer to the Results From the 2014 Pilot Study of the AHRQ SOPS Value and Efficiency Supplemental Item Set for the Hospital Survey, which are based on data from more than 4,000 staff in 47 hospitals that participated in a pilot test of the items in early 2014.

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Questions Specific to the SOPS Hospital Survey Version 1.0 (HSOPS 1.0)

Question 36: What areas of patient safety culture do the survey questions cover on the SOPS Hospital Survey 1.0 (HSOPS 1.0)?

Answer: The SOPS Hospital Survey 1.0 (HSOPS 1.0) includes a total of 51 items. There are 42 items grouped into 12 composite measures.

The composite measures in the hospital survey are:

  1. Communication Openness.
  2. Feedback & Communication About Error.
  3. Frequency of Events Reported.
  4. Hospital Handoffs & Transitions.
  5. Hospital Management Support for Patient Safety.
  6. Nonpunitive Response to Error.
  7. Organizational Learning-Continuous Improvement.
  8. Overall Perceptions of Safety.
  9. Staffing.
  10. Supervisor/Manager Expectations & Actions Promoting Patient Safety.
  11. Teamwork Across Hospital Units.
  12. Teamwork Within Units.

In addition, the hospital survey includes:

  1. One item that asks respondents to provide an overall grade on patient safety for their hospital.
  2. One item measuring the number of events the respondent has reported over the past 12 months.
  3. Seven items about respondent background characteristics.

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Question 37: How long is the SOPS Hospital Survey 1.0 (HSOPS 1.0)?

Answer: HSOPS 1.0 has a total of 51 items and it takes approximately 10 minutes to complete. Most of the items use Agree/Disagree or Never/Always response categories, so they are easy to answer. There is room for written comments at the end of the survey.

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Question 38: How many completed surveys are needed to submit to the SOPS Hospital Database?

Answer: A single hospital location needs at least 10 completed surveys to submit to the SOPS Hospital Database.

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Question 39: Will AHRQ continue to support the SOPS Hospital Survey 1.0 (HSOPS 1.0)? If so, for how long?

Answer: The SOPS Hospital Survey 1.0 is still available on the AHRQ website, but the use of HSOPS 2.0 is encouraged. Note that the SOPS Hospital Database will no longer accept data from HSOPS 1.0 in June 2022.

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Question 40: Can I compare my SOPS Hospital Survey 1.0 results against other hospitals?

Answer: AHRQ established the SOPS Hospital Database as a central repository for survey data from the SOPS Hospital Survey. AHRQ has produced database reports, which aggregate data from hundreds of hospitals that have voluntarily submitted their data to the Database. The Database serves as an important resource for patient safety culture improvement.

Information about eligibility requirements, registration procedures, and benefits of participating in the Database is available.

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Questions Specific to the SOPS Medical Office Survey

Question 41: What areas of patient safety culture do the survey questions cover on the SOPS Medical Office Survey?

Answer: The SOPS Medical Office Survey includes a total of 58 items. There are 38 items measuring 10 composites.

The composite measures in the medical office survey are:

  1. Communication About Error.
  2. Communication Openness.
  3. Office Processes and Standardization.
  4. Organizational Learning.
  5. Overall Perceptions of Patient Safety and Quality.
  6. Owner/Managing Partner/Leadership Support for Patient Safety
  7. Patient Care Tracking/Followup.
  8. Staff Training.
  9. Teamwork.
  10. Work Pressure and Pace.

In addition, the medical office survey includes:

  1. Nine items measuring patient safety and quality issues.
  2. Five items about information exchange with other settings.
  3. One screener question.
  4. Six overall rating questions.
  5. Three items about respondent background characteristics.

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Question 42: How long is the SOPS Medical Office Survey?

Answer: The SOPS Medical Office Survey has a total of 58 items and it takes approximately 10 to 15 minutes to complete. Most of the items use response categories such as Daily/Not in the Past 12 Months, Agree/Disagree, or Never/Always, so they are easy to answer. There is room for written comments at the end of the survey.

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Question 43: What is considered a medical office?

Answer: The survey was designed to measure the culture of patient safety in medical offices with the following characteristics:

  • A medical office should be an outpatient facility in a specific location. A medical practice or health care system may have multiple medical offices in different locations, but each unique location would be considered a separate medical office for survey administration and feedback.
  • A medical office could be located in a building containing multiple medical offices, but each office in the building would be considered a separate medical office for the purposes of the survey.
  • Providers in a single medical office should share some or all administrative staff, such as receptionists and schedulers, and share some or all clinical support staff.

These characteristics are essential because the survey asks respondents about patient safety and quality issues for a specific medical office location. The survey can be administered to multiple medical offices within a practice, healthcare system, or building, but each medical office would have to be identified as a separate office rather than being surveyed as one entity.

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Question 44: Can any size medical office conduct the SOPS Medical Office Survey?

Answer: In small offices with a solo practitioner or two-providers, rather than administering the survey, it can be used as a tool to initiate open dialog or discussion about patient safety and quality issues among providers and staff. In health systems or multisite practices, the survey may be administered in smaller offices if the responses are aggregated and only reported at the larger practice or system level. Aggregating the responses would help maintain the confidential nature of individual responses in small offices.

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Question 45: Does it matter what specialty or specialties my medical office covers?

Answer: The survey was designed to be appropriate for any specialty. Your office may provide primary care services only, other specialty care services only, or a mix of primary and specialty care services.

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Question 46: How many completed surveys are needed to submit to the SOPS Medical Office Database?

Answer: A single medical office location needs at least five completed surveys to submit to the SOPS Medical Office Database.

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Question 47: Can I compare my SOPS Medical Office Survey results against other medical offices?

Answer: AHRQ established the SOPS Medical Office Database as a central repository for survey data from the SOPS Medical Office Survey. AHRQ has produced database reports, which aggregate data from hundreds of medical offices that have voluntarily submitted their data to the Database. The Database serves as an important resource for patient safety culture improvement.

Information about eligibility requirements, registration procedures, and benefits of participating in the Database is available.

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Question 48: What supplemental item sets are available for the SOPS Medical Office Survey?

Answer: AHRQ has developed supplemental item sets that can be added to the SOPS Medical Office Survey to assess content in areas not covered by the core questions. These supplemental item sets are optional. Currently, there are supplemental item sets for Diagnostic Safety and Value and Efficiency.

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Question 49: Can I compare my medical office’s SOPS Value and Efficiency Supplemental Item Set results against other medical offices?

Answer: Medical offices can refer to the Results From the 2014 Pilot Study of the AHRQ Value and Efficiency Supplemental Item Set for the Medical Office SOPS Survey, which are based on data from more than 1,400 providers and staff in 96 medical offices that participated in a pilot test of the items in early 2014.

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Question 50: Can I compare my medical office’s SOPS Diagnostic Safety Supplemental Item Set results against other medical offices?

Answer: Medical offices can refer to the 2022 Results for the AHRQ SOPS® Diagnostic Safety Supplemental Item Set for Medical Offices (1.4 MB), which are based on data from more than 1,100 providers and staff in 100 medical offices.

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Questions Specific to the SOPS Nursing Home Survey

Question 51: What areas of patient safety culture do the survey questions cover on the SOPS Nursing Home Survey?

Answer: The SOPS Nursing Home Survey includes a total of 51 items emphasizing resident safety issues. It includes 42 survey items grouped into 12 composite measures.

The composite measures in the nursing home survey are:

  1. Communication Openness.
  2. Compliance With Procedures.
  3. Feedback and Communication About Incidents.
  4. Handoffs.
  5. Management Support for Resident Safety.
  6. Nonpunitive Response to Mistakes.
  7. Organizational Learning.
  8. Overall Perceptions of Resident Safety.
  9. Staffing.
  10. Supervisor Expectations and Actions Promoting Resident Safety.
  11. Teamwork.
  12. Training and Skills.

In addition, the nursing home survey includes:

  1. Two overall rating questions.
  2. Seven items about respondent background characteristics.

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Question 52: How long is the SOPS Nursing Home Survey?

Answer: The SOPS Nursing Home Survey has a total of 51 items and it takes approximately 10 to 15 minutes to complete. Most of the items use Agree/Disagree or Never/Always response categories, so they are easy to answer. There is room for written comments at the end of the survey.

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Question 53: Does the SOPS Nursing Home Survey apply to assisted living facilities, community care facilities, or independent living facilities?

Answer: A nursing home is a facility or a special contained area of a facility that has only licensed nursing home beds and is not an assisted living, community care, or independent living facility. The survey was designed to measure resident safety culture in a nursing home facility or in a special contained area of a facility (e.g., a hospital) that includes only licensed nursing home beds, so it is important to understand the type of nursing home facility that the survey was designed for:

  • It was not designed for use in assisted living facilities, community care facilities, or independent living facilities.
  • If a nursing home is located on a large campus or facility that has a mix of nursing home and other long-term care programs (such as independent living, assisted living, and rehabilitation services), survey only the facilities or areas with nursing home beds. Exclude staff who work only in areas with independent living, assisted living, or rehabilitation beds.

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Question 54: How many completed surveys are needed to submit to the SOPS Nursing Home Database?

Answer: A single nursing home location needs at least 10 completed surveys to submit to the SOPS Nursing Home Database.

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Question 55: Can I compare my SOPS Nursing Home Survey results against other nursing homes?

Answer: AHRQ established the SOPS Nursing Home Database as a central repository for survey data from the Nursing Home SOPS. AHRQ has produced database reports, which aggregate data from hundreds of nursing homes that have voluntarily submitted their data to the Database. The Database serves as an important resource for patient safety culture improvement.

Information about eligibility requirements, registration procedures, and benefits of participating in the database is available.

Question 56: What supplemental item sets are available for the SOPS Nursing Home Survey?

Answer: AHRQ has developed a supplemental item set that can be added to the SOPS Nursing Home Survey to assess content in areas not covered by the core questions. This supplemental item set is optional. Currently, there is a supplemental item set for Workplace Safety.

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Question 57: Can I compare my nursing home's SOPS Workplace Safety Supplemental Item Set results against other nursing homes?

Answer: Nursing homes can refer to the Pilot Study Results from the 2022 AHRQ SOPS Workplace Safety Supplemental Item Set for Nursing Homes (PDF, 996 KB), which are based on data from more than 2,500 staff in 48 nursing homes that participated in a pilot test of the items in 2022.

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Questions Specific to the SOPS Community Pharmacy Survey

Question 58: What areas of patient safety culture do the survey questions cover on the SOPS Community Pharmacy Survey?

Answer: The SOPS Community Pharmacy Survey includes a total of 43 items. There are 36 items grouped into 11 composite measures.

The composite measures in the community pharmacy survey are:

  1. Communication About Mistakes.
  2. Communication About Prescriptions Across Shifts.
  3. Communication Openness.
  4. Organizational Learning—Continuous Improvement.
  5. Overall Perceptions of Patient Safety.
  6. Patient Counseling.
  7. Physical Space and Environment.
  8. Response to Mistakes.
  9. Staff Training and Skills.
  10. Staffing, Work Pressure, and Pace.
  11. Teamwork.

In addition, the community pharmacy survey includes:

  1. Three items about documenting mistakes.
  2. One overall rating question.
  3. Three items about respondent background characteristics.

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Question 59: How long is the SOPS Community Pharmacy Survey?

Answer: The SOPS Community Pharmacy Survey has a total of 43 items and it takes approximately 10 minutes to complete. Most of the items use Agree/Disagree or Never/Always response categories so it is easy to answer. There is room for written comments at the end of the survey.

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Question 60: What is considered a community pharmacy?

Answer: The survey was designed to measure the culture of patient safety in community pharmacies in a single location. This includes pharmacies such as:

  • Independent pharmacies.
  • Supermarket pharmacies.
  • Mass merchants/discount retailer pharmacies.
  • Chain drugstores (local, regional, national).
  • Integrated health system pharmacies (non-hospital unit based).

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Question 61: How many completed surveys are needed to submit to the SOPS Community Pharmacy Database?

Answer: A single pharmacy location needs at least five completed surveys to submit to the SOPS Community Pharmacy Database.

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Question 62: Is the SOPS Community Pharmacy Survey applicable to a hospital pharmacy setting that does both inpatient and retail pharmacy business?

Answer: The survey was designed for community pharmacies. You may decide, however, that it is appropriate to administer it in other types of pharmacies, such as pharmacies in an integrated health care system or a hospital, or pharmacies that supply medications only to hospices or nursing homes. Alternatively, it may be that the Hospital Survey best suits the needs of hospital-based pharmacies. We recommend that you closely review the content of both surveys before deciding.

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Question 63: Can I compare my SOPS Community Pharmacy Survey results against other community pharmacies?

Answer: AHRQ established the SOPS Community Pharmacy Database as a central repository for survey data from the SOPS Community Pharmacy Survey. AHRQ has produced a database report, which aggregates data from dozens of community pharmacies that have voluntarily submitted their data to the Database. The Database serves as an important resource for patient safety culture improvement.

Information about eligibility requirements, registration procedures, and benefits of participating in the database is available.

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Questions Specific to the SOPS Ambulatory Surgery Center Survey

Question 64: What areas of patient safety culture do the survey questions cover on the SOPS Ambulatory Surgery Center Survey?

Answer: The SOPS Ambulatory Surgery Center Survey includes a total of 35 items. There are 27 items grouped into 8 composite measures.

The composite measures in the ambulatory surgery center survey are:

  1. Communication About Patient Information.
  2. Communication Openness.
  3. Staffing, Work Pressure, and Pace.
  4. Teamwork.
  5. Staff Training.
  6. Organizational Learning—Continuous Improvement.
  7. Response to Mistakes.
  8. Management Support for Patient Safety.

In addition, the ambulatory surgery center survey includes:

  1. One item measuring how often ASCs document near-misses.
  2. One item asking respondents to provide an overall rating on patient safety for their ASC.
  3. One screener item asking whether the respondent is in the room during surgeries, procedures, or treatments and three subsequent items measuring how often doctors and staff communicate before and after surgeries.
  4. Three items about communication before and after surgery.
  5. Two items about respondent background characteristics.

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Question 65: How long is the SOPS Ambulatory Surgery Center Survey?

Answer: The survey has a total of 35 items and it takes approximately 15 minutes to complete. Most of the items use Agree/Disagree or Never/Always response categories so it is easy to answer. There is room for written comments at the end of the survey.

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Question 66: What is considered an ambulatory surgery center (ASC)?

Answer: Ambulatory Surgery Centers (ASCs) are facilities that have been certified and approved to participate in the Centers for Medicare & Medicaid Services’ ASC program. ASCs provide surgical services to patients who are not expected to need an inpatient stay following surgery. ASCs can be freestanding or affiliated with a hospital or large medical center.

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Question 67: Is the SOPS Ambulatory Surgery Center Survey applicable to hospital outpatient departments? 

Answer: The survey was designed for ASCs, which are facilities that have been certified and approved to participate in the Centers for Medicare & Medicaid Services' ASC program. However, an ASC can be affiliated with a hospital and the SOPS Hospital Survey may best suit the needs of hospital outpatient departments. We recommend that you closely review the content of both surveys before deciding.

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Question 68: Can I compare my SOPS Ambulatory Surgery Center Survey results against other ASCs?

Answer: AHRQ established the SOPS Ambulatory Surgery Center Database as a central repository for survey data from the SOPS Ambulatory Surgery Center Survey. AHRQ has produced a database report, which aggregates data from hundreds of ASCs that have voluntarily submitted their data to the Database. The Database serves as an important resource for patient safety culture improvement.

Information about eligibility requirements, registration procedures, and benefits of participating in the Database is available.

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Page last reviewed February 2023
Page originally created April 2010

Internet Citation: SOPS Frequently Asked Questions (FAQs). Content last reviewed February 2023. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/sops/about/faq.html

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