Hospital Survey on Patient Safety Culture Data Submission

Participation Requirements

• Hospitals must be located in the United States or in a U.S. territory.
• Each hospital must have minimum of 10 responses.

• Data Use Agreement: Each hospital is required to submit a signed Data Use Agreement. Please sign and return a copy of your DUA via:
  • The DUA Submission Portal
  • Email DatabasesOnSafetyCulture@westat.com, or
  • Fax 1-888-852-8277
  • Hospital Survey on Patient Safety Culture Data Use Agreement (PDF, 135 KB, PDF HELP)
• Hospital Questionnaire(s) Administered: Users will need to upload a copy of the actual questionnaire(s) administered. If you used a copy of the Spanish questionnaire, please upload this questionnaire as well. We will review the submitted questionnaire(s) and users will receive an approved/not approved email within 3 business days.
  
  NOTE: Your questionnaire will not be approved if
  • You made changes to any of the questionnaire item text and/or response options.
  • You reordered questionnaire items A1−G1.
  • You added new questions between items A1 and G1 and did not add new questions at the end of the questionnaire after Section G, before the demographic questions in Section H.
• Hospital Site Information: Users can upload hospital site information in one of two ways, one at a time on the Data Submission Web site or all at once in an Excel spreadsheet.
  • Hospital Site-Level Specifications (PDF, 178 KB, PDF HELP)
  • Sample Hospital Site Information Data File (XLSX, 13 KB)
• Hospital Data: Users will need to upload their Hospital survey data, conforming to the Hospital Data Specifications.
  • Hospital Survey Data Specifications (PDF, 258 KB, PDF HELP)
  • Sample Hospital Survey Data File (XLSX, 13 KB)