Ambulatory Surgery Center Survey on Patient Safety Culture

AHRQ developed the Ambulatory Surgery Center Survey on Patient Safety Culture in response to interest from ambulatory surgery centers (ASCs) in assessing patient safety culture in their facilities. This survey is designed specifically for ASC staff and asks for their opinions about the culture of patient safety in their facility.

ASCs are facilities: (1) where patients have surgeries, procedures, and treatments and are not expected to need an inpatient stay, and (2) that have been certified and approved to participate in the Centers for Medicare & Medicaid Services' ASC program.

Ambulatory Surgery Center Toolkit

Survey Form

  • Ambulatory Surgery Center Survey—English (PDF, 303 KB; MS Word, 89 KB).
  • Ambulatory Surgery Center Survey—Spanish (PDF, 89 KB; MS Word, 57 KB).

Survey Composites and Items

Survey User's Guide

The User's Guide provides a general overview of the issues and major decisions involved in conducting a survey and reporting the results. The User's Guide includes information on getting started, selecting a sample, determining data collection methods, establishing data collection procedures, conducting a Web-based survey, preparing and analyzing data, and producing reports.

Additional Resources

The SOPS program offers resources to assist survey users, including an Action Planning Tool, Data Entry and Analysis Tool, resource lists, research reference lists, and frequently asked questions.

Webcasts, Presentations, and Announcements

Learn more about the AHRQ-sponsored webcasts, presentations, and announcements on the SOPS program.

Page last reviewed March 2019
Page originally created April 2015
Internet Citation: Ambulatory Surgery Center Survey on Patient Safety Culture. Content last reviewed March 2019. Agency for Healthcare Research and Quality, Rockville, MD.
Back To Top