Step 1 - Preparation

This section provides guidance on building your case for undertaking the safety culture measurement and gaining health service support to establish your project team. It is important to determine a realistic timeline prior to undertaking a culture survey.

As a guide, plan for:

  • four weeks from the beginning of the project and pre survey communication
  • six-10 weeks for survey completion, analysis and reporting

Note: This timeline may be shorter if previous culture surveys have been done and may be longer if the size of the facility / organisation is large and a large response rate is wanted.

Careful planning will ensure smooth running of the survey and follow up activities. When selecting the best time to conduct the survey, consideration needs to be given to potential barriers to engagement.

The following principles should be considered when deciding when to run the survey:

  • Avoid periods when other staff surveys are running (e.g. the People Matter Survey).
  • Avoid busy periods (accreditation, budget time and the Christmas break when many staff are on leave).
  • Avoid periods when a change of staff or staff rotation occurs, and periods when new interns are taken in.

All improvement requires change. However, change is not always welcomed or accepted by individuals or teams, even when it is improvement focused. Improvement projects can often struggle to gain momentum if there is considerable resistance from those who will be impacted most by changes.

If there is an overall lack of enthusiasm and a resistance for involvement, it is vital this is addressed before proceeding further with the safety culture survey.

Resources available to support pre implementation planning

It is strongly recommended that you engage with your Clinical Governance Unit to seek support for and during your culture survey measurement if they aren't already involved. Your Clinical Governance Unit will be able to link you with local quality improvement experts and executive support for the survey.

You may also choose to reach out to colleagues in other health services to find out how they approached this work, including their successes and learnings.

It is essential to gain leadership support from within your health service as culture surveys require an investment of time, resources and commitment at every stage of the process.

The project sponsor is someone who can provide support and guidance to you during the survey implementation and following improvement project. They can help with ensuring appropriate resources are provided and help remove barriers when needed.

Ideally, your project sponsor is someone in a senior position. Ideally you should communicate closely with the project sponsor and provide regular updates.

Your project sponsor will be able to provide guidance on where the governance for safety culture will sit within your health service. This will ensure there is operational responsibility for the survey and a channel to report back on how the survey completion is progressing. For example:

  • At unit/ward level: Integrate survey / project results reporting with existing ward meetings
  • At Facility: Integrate review of outcomes with existing Health Care Quality & Safety Committee reporting.
  • At Local Health District: Oversight of outcomes through committees such as the peak Healthcare Quality & Safety Committee.

The project team should be interdisciplinary and include the right people, with the right experiences, expertise, and interest in contributing, for example:

  • Team leader
  • Quality improvement advisor/expert
  • People from all areas of the organisation the survey target, including junior and senior staff, Allied Health Staff, Administrative staff.

The team leader role is essential, and they will organise and lead the team meetings, ensure delegation of responsibilities and be the 'voice' for the safety culture project.

It is important to communicate the purpose of undertaking the culture survey and the outcomes that the findings will bring about by engaging relevant stakeholders and creating awareness through engagement activities.

What is a Stakeholder Engagement Plan?

A Stakeholder Engagement Plan is a way to communicate with project stakeholders (clinicians/non-clinical staff on the ward/unit, hospital executives etc) to achieve their support for the survey. It specifies the frequency and type of communications and communication activities that will help communicate, build and maintain stakeholder engagement with completing the survey at all levels.

Examples of engagement activities

Each of your stakeholder groups will have unique characteristics, needs and motivations. Some ideas include:

  • Utilising hospital wide communication channels, such as a newsletter, intranet etc.
  • Using local nursing and medical champions to advocate and support clinicians undertaking the survey
  • Creating a display board on the wards with information and data about the survey response rates
  • Setting a standing agenda item at regular meetings
  • Using double staffing time or staff meeting to provide short, regular updates
  • Creating posters and computer screensavers
  • Holding a survey launch
  • Distributing information to general practitioner Visiting Medical Officers (in rural and regional areas)

Resources available to support communication of the safety culture survey