Agency for Healthcare Research and Quality's (AHRQ) Medical Office Survey on Patient Safety Culture (MOSOPS)

The MOSOPS is tailored to single specialty and/or primary care clinics with the following characteristics: an outpatient facility in one geographic location, shared administrative and clinical support staff among providers, at least three providers per location, and at least five respondents. The survey was designed specifically for the outpatient health care setting in order to question providers and staff about their views regarding the culture of patient safety and health care quality in their clinics. The MOSOPS includes thirty-eight items measuring ten composites of patient safety culture. Fourteen additional items measure other patient safety and quality issues and problems with exchanging information with other settings.

The complete MOSOPS survey User Guide can be viewed and downloaded at this link: MOSOP User Guide.pdf.

Adapting the MOSOPS to dental clinical and academic settings

To adapt the survey to the dental clinical and academic settings, only trivial changes were required, i.e., changing the word “medical” to “dental” and adding a category “students” in the background section, just as a medical specialist might adapt the survey to his or her specialty practice. We did not add or remove any items. Negatively worded items were reverse coded on the Likert scale so that high scores were indicative of positive responses. Additional questions were constructed to record demographic data and professional characteristics. All composite measures were calculated using the MOSOPS User Comparative Database Report.

Adapted Survey Questionnaire

The survey instrument that was used for this purpose can be viewed and downloaded here: Patient Safety Culture Survey Instrument.pdf.

Administering the survey

The survey was administered at three academic dental institutions. All institutions met the MOSOPS criteria described above. The dental clinical faculty, dental hygienists, dental students, and dental clinic staff (including dental assistants, nurses, front desk staff, business office staff, clinic managers, patient care coordinators, and dispensary staff) from each school were asked to participate. Each site
was responsible for administering the paper-based survey to a representative sample of full-time clinical faculty, predoctoral and postdoctoral students, dental hygienists, and other staff involved in patient care.

Methods for Statistical Analysis of the Results

Following the MOSOPS protocol, composite scores (reported as percentages and standard deviations) were calculated by grouping the thirty-eight individual questions into the ten, patient safety culture survey dimensions. The ten dimensions were:

Overall Perceptions of Patient Safety and Quality (Only answered by financial leadership)
Organizational Learning (Only answered by financial leadership)
Teamwork
Staff Training
Work Pressure and Pace
Office Processes and Standardization
Owner/Managing Partner/Leadership Support for Patient Safety (Only answered by non-leadership)
Communication About Error
Communication Openness
Patient Care Tracking/Follow-Up

Percent positive values were estimated by calculating the sum value of the total contributing items in accordance with the User Comparative Database. To assess whether there were significant improvements in the composite metrics over the two time periods, we conducted independent sample hypothesis tests. In order to assess any significant differences in the composite metrics by site, we conducted Fisher’s Exact test of association. In order to control the type 1 error rate, we employed the Benjamini-Hochberg false discovery rate method. All statistical analyses were conducted at the 0.05 significance level and performed using Stata Statistical Software release 13 for StataCorp LP (2013, College Station, TX).

[Adapted from: 'Open Wide: Looking into the Safety Culture of Dental School Clinics' by Rachel Ramoni, Muhammad F. Walji, Anamaria Tavares, Joel White, Oluwabunmi Tokede, RamVaderhobli, Elsbeth Kalenderian; Journal of Dental Education May 2014, 78 (5) 745-756]