SOPS Program Updates During the COVID-19 Pandemic

Given the current changes in healthcare delivery and the burden on healthcare facilities in meeting the challenges of the COVID-19 pandemic, the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS^®) Program is providing information to help healthcare organizations:

• Decide how to proceed with SOPS survey administration and database submission.
• Add supplemental items.
• Request technical assistance support.

In addition, we note the following schedule adjustments:

• Data submission to the SOPS Hospital Database will occur October 1-30.
• Data submission to the SOPS Nursing Home Database is postponed until further notice.

Administration of AHRQ SOPS Surveys During COVID-19

Whether and when to administer a SOPS survey. Rapid and unprecedented adaptations in healthcare delivery due to COVID-19 are having a tremendous impact on the healthcare workforce. Healthcare organizations that already administered one of the SOPS surveys before the onset of the COVID-19 pandemic will be able to submit their SOPS data during the next relevant data submission period. However, organizations that have not yet administered SOPS, or have postponed SOPS survey administration, may be trying to decide when to assess patient safety culture.

Healthcare organizations should consider a variety of factors when deciding to administer a SOPS survey during the COVID-19 pandemic, including the following:

1. Organizations may have other priorities at this time.
2. Significant numbers of healthcare staff may not be working and those who are working may not have the ability or desire to complete a survey, resulting in lower response rates.
3. Survey responses would likely be affected by COVID-related issues and concerns.

For organizations that want to wait to administer a SOPS survey, it is unclear when healthcare delivery processes and procedures will resume under a “new normal.” Other organizations may want to specifically assess the current impact of COVID-19 on patient safety culture to understand how culture has been affected and obtain feedback to inform future initiatives. However, survey instructions should be revised to acknowledge the challenges affecting providers and staff, asking them to focus on the culture during the COVID-19 timeframe, with the goal of better understanding the impact of COVID-19 on the organization’s patient safety culture.

Each organization will need to weigh these factors to determine when to assess patient safety culture:

For hospitals: Which survey version to administer. Hospitals that decide to administer the SOPS Hospital Survey will need to decide whether to administer Version 1.0, Version 2.0, or both Versions 1.0 and 2.0 (conducting a simultaneous administration in which half of the providers and staff receive Version 1.0 and the other half receive Version 2.0).

The SOPS Hospital Database will accept data from both Versions 1.0 and 2.0, so any of the options is acceptable. The main decision affecting which option to choose is whether an organization wants to trend its previous patient safety culture scores to its current scores, understanding that the COVID-19 pandemic is likely to affect the organization’s culture and scores.

For more information about the differences between the SOPS Hospital Survey Version 1.0 and 2.0 and to help with decisions about which version to administer, review Transitioning to the SOPS Hospital Survey Version 2.0: What’s Different and What To Expect, Part I: Main Report (PDF, 775 KB) and Appendixes (PDF, 624 KB).

Adding Custom or Supplemental Items to SOPS Surveys

While the current SOPS surveys do not have questions that specifically address the impact of COVID-19, supplemental items may be added to SOPS surveys as long as they are placed at the end of the core survey items immediately before the background questions. An organization might consider using or adapting existing SOPS supplemental items if they address topics it wants to assess at this time:

• Health Information Technology Patient Safety (for hospitals)—addresses five areas related to electronic health records (EHRs):
  1. EHR System Training.
  2. EHR System Support and Communication.
  3. EHR Patient Safety and Quality Issues.
  4. EHR and Workflow/Work Process.
  5. Overall EHR System Rating.
• Value and Efficiency (for hospitals and medical offices)—addresses six areas for hospitals and five for medical offices:
  1. Empowerment To Improve Efficiency.
  2. Efficiency and Waste Reduction.
  3. Patient Centeredness and Efficiency.
  4. Management Support for Improving Efficiency and Reducing Waste.
  5. Experience With Activities To Improve Efficiency.
  6. FOR HOSPITALS: Overall Ratings (patient centered, effective, timely, efficient).

New SOPS Supplemental Items Under Development.

• Workforce Safety. To address emerging needs, AHRQ is currently developing and testing supplemental items on workforce safety that might apply to multiple settings of care. AHRQ aims to pilot test these items in early 2021. Status updates will be provided via SOPS email updates—sign up instructions are under Technical Assistance below. 
• Diagnostic Safety. AHRQ is also developing supplemental questions on Diagnostic Safety for the Medical Office SOPS.

Organizations interested in helping to pretest these supplemental survey items should contact SOPS technical assistance.

2020 Data Submission Schedule Adjustments

In light of the COVID-19 pandemic, and to provide flexibility and as many options as possible, AHRQ has made adjustments to the schedule for data submission to the SOPS Databases. AHRQ will continue to monitor the situation and will update the timing of data submission as needed.

• SOPS Hospital Database: (Update as of 6/2/2020) Data submission will occur October 1–30, 2020.
• Accepting data from SOPS Hospital Survey (Versions 1.0 and 2.0), SOPS Health IT Patient Safety Supplemental Items, and SOPS Value and Efficiency Supplemental Items. 
• SOPS Nursing Home Database: (Update as of 6/2/2020) Data submission is postponed until further notice.

Technical Assistance

Contact AHRQ’s SOPS technical assistance team for questions or assistance:

• For questions about the surveys and general inquiries: SafetyCultureSurveys@westat.com, 1-888-324-9749.
• For database questions: DatabasesOnSafetyCulture@westat.com, 1-888-324-9790.

To sign up for SOPS email updates, news, and events, submit your email address and then select “Surveys on Patient Safety Culture” under Quality and Safety topics: https://public.govdelivery.com/accounts/USAHRQ/subscriber/new.