Q01
メッセージ
すべてのテンプレートHealthcare & Clinical
Medical Office Patient Safety Culture Survey (AHRQ-Aligned)
Benchmarks how staff in your medical office perceive teamwork, communication, error reporting, and leadership support for safety, modeled on AHRQ's patient safety culture domains. An AI follow-up interview digs into the most recent near-miss or error staff witnessed and what stopped or helped them report it.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
全13問・約7分
Q02
選択式必須
What is your primary role in this office?
- Physician/Provider
- Nurse
- Medical Assistant
- Front desk/Administrative
- Practice manager/Supervisor
- Other clinical staff
Q03
マトリクス必須
How much do you agree with each statement about your office?
6行 × 5列
- Staff feel free to question the decisions of those with more authority
- When someone points out a mistake, it is not held against them
- We work together as an effective team to care for patients
- Staff are told about changes made based on reported errors
- We have enough staff to handle the workload
- ほか1件
列: Strongly disagree · Disagree · Neither agree nor disagree · Agree · Strongly agree
Q04
オピニオンスケール必須
Overall, how would you rate patient safety in this office?
スケール: 0 – 10
最小:Poor最大:Excellent
Q05
選択式必須
In the last 12 months, how many event or incident reports have you personally filed?
- None
- 1 to 2
- 3 to 5
- 6 to 10
- 11 or more
Q06
スライダーマトリクス必須
How comfortable are you doing each of the following?
4行（各行にスライダー1つ）
- Speaking up if you see something that could harm a patient
- Asking a colleague to double-check a decision you're unsure about
- Reporting a mistake even if no patient was harmed
- Telling a supervisor about a process that isn't working safely
スライダー 0〜10最小:Very uncomfortable最大:Very comfortable
Q07
ベスト・ワースト選択（MaxDiff）必須
Which of these, if improved, would do the most to make this office safer for patients?
- Clearer handoffs between shifts or providers
- More consistent staffing levels
- Faster follow-up on lab or test results
- Better communication between front desk and clinical staff
- More feedback after safety events are reported
- Clearer protocols for common procedures
- Reduced pressure to rush patient visits
各セットで最も良いもの・最も悪いものを選択最も良い:Would improve safety most最も悪い:Would improve safety least
Q08
選択式
In the last 12 months, how often has important patient information been lost during shift changes or handoffs?
- Never
- Rarely
- Sometimes
- Often
- Very often
Q09
AIインタビュー
Reconstruct the most recent near-miss or safety event this person witnessed or was involved in: what happened, whether it was reported, and what made reporting easy or hard. If they say they'd hesitate to report, probe specifically what they fear would happen and whether they've seen a colleague face consequences for speaking up.
Q10
自由回答（長文）
Is there anything about patient safety in this office that you think leadership should know but hasn't heard?
Q11
選択式
How many years have you worked in this specific office?
- Less than 1 year
- 1 to 5 years
- 6 to 10 years
- 11 to 20 years
- 21 years or more
- Prefer not to say
Q12
選択式
What is your typical weekly working hours in this office?
- Less than 20 hours
- 20 to 39 hours
- 40 hours or more
- Prefer not to say
Q13
メッセージ
Thank you for your candor. Responses are combined into an anonymous safety culture report shared with leadership to guide concrete improvements — no individual answers are attributed to you.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Includes a matrix and slider-matrix covering the core AHRQ teamwork, communication, and error-reporting domains, plus an opinion-scale overall safety rating and a max-diff to prioritize improvement areas
- Goes beyond static rating scales with an AI follow-up interview that reconstructs the most recent near-miss or error the respondent witnessed, probing what helped or blocked reporting it
- Captures role, tenure, and weekly hours alongside incident-report frequency and information-loss-during-handoff questions, giving context to segment results by staff type and exposure
- Closes with an open long-text question inviting candid suggestions for leadership, and ends in an auto-generated report — with transparent prompts so you can see exactly what the AI asked
SurveyMonkey
AHRQ Surveys On Patient Safety Culture™ (SOPS®) Medical Office SurveyA fielding-ready template that directly licenses/mirrors the official AHRQ SOPS Medical Office Survey instrument, which gives it strong face validity for benchmarking against the national dataset. It is a static questionnaire, so all follow-up depends on manual analysis after the fact. Good choice for teams that want an off-the-shelf, unmodified AHRQ instrument rather than a customized flow.
優れている点
- Based on the official, validated AHRQ SOPS Medical Office instrument
- Backed by SurveyMonkey's broad distribution and reporting infrastructure
- Familiar format for practices already benchmarking against AHRQ national data
物足りない点
- Static question set with no adaptive follow-up to probe individual near-miss stories
- No voice-based interview option or guided screen-share tasks
- No published per-response quality scoring or transparent prompt methodology
SurveySparrow
Patient Safety Culture Survey TemplateA conversational-style survey template aimed at healthcare teams that covers general patient safety culture themes. It reads as a standard question-and-answer template rather than one explicitly built around the full AHRQ domain structure. It's ready to field but relies on fixed questions rather than dynamic probing of specific incidents.
優れている点
- Conversational chat-style UI that can feel more approachable than a plain grid survey
- Positioned specifically for healthcare/patient safety use cases
- Ready to deploy without additional setup
物足りない点
- No adaptive AI interview to dig into a specific recent near-miss or error
- No voice AI interview or screen-share guided task option
- No automated quality scoring of individual responses or transparent AI prompt disclosure
よくあるご質問
「Medical Office Patient Safety Culture Survey (AHRQ-Aligned)」テンプレートにはどのような設問が含まれていますか？
すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Thanks for taking part in our patient safety culture check-in. Your honest input helps us find where communication or re…」・「What is your primary role in this office?」・「How much do you agree with each statement about your office?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか？
回答者は通常、13問を約7分で回答し終えます。
テンプレートは編集できますか？
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか？
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか？
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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