Document
Hospital Leader - Follow-Up Survey
ICR 202308-0920-003 · OMB 0920-1415 · Object 134184200.
Form
Approved OMB
No. 0920-xxxx
Exp.
Date: xx/xx/20xx
HOSPITAL LEADER SURVEY QUESTIONS ON WORKING CONDITIONS AND MENTAL HEALTH
You are invited to participate in an online questionnaire conducted by JPA Health on behalf of the National Institute for Occupational Safety and Health (NIOSH), to better understand hospital practices that promote staff mental health.
Completing the voluntary questionnaire should take about 10 minutes. You may refuse to take part or exit the questionnaire at any time. You can skip any question you do not wish to answer.
There are no direct benefits to questionnaire participation. Risks to participation are minimal, with the main foreseeable risk being breach of confidentiality. Although this questionnaire does ask you to indicate the functional area in which you work (e.g., business operations, clinical operations, human resources, etc.), it does not collect information on your name, email address, or IP address.
Responses will be collected and stored in a secure, electronic format on the REDCap survey system. JPA’s research partner Education Development Center (EDC) will analyze all data on NIOSH’s secured network.
JPA/EDC will report all results in aggregate. No one at your workplace will be able to identify you or your answers based on your position, and no one will know whether or not you participated in the study. Information collected as part of this study will not be used or distributed for other research studies.
If you have questions at any time about this assessment, you may contact JPA Senior Vice President Christina Zurla at czurla@jpa.com or 202-870-5487; and/or EDC Principal Research Scientist Kim Dash, PhD, MPH, at KDash@edc.org or 617.618.2425.
Please select your choice below. You may print a copy of this consent form for your records. Clicking on the “Agree” button indicates that:
You have read the above information
You voluntarily agree to participate
You have reached the age of majority (18 in most states)
O Agree
O Disagree
Public
reporting
burden
of
this collection
of
information is
estimated
to
average
10
minutes
per
response,
including
the
time
for
reviewing
instructions,
searching
existing data
sources,
gathering
and
maintaining
the
data
needed,
and
completing and reviewing the
collection
of
information.
An
agency
may
not
conduct
or
sponsor,
and
a
person
is
not
required
to
respond to
a
collection
of
information unless
it
displays a
currently
valid
OMB
control number.
Send
comments
regarding
this
burden
estimate
or
any
other
aspect
of
this
collection
of
information,
including
suggestions
for
reducing
this
burden
to
-
CDC/ATSDR
Reports
Clearance
Officer;
1600
Clifton Road
NE,
MS D-74,
Atlanta,
Georgia
30333
ATTN:
PRA
(0920-xxxx).
Position
SCREENING QUESTION: Which of the following best describes the setting where you currently work? Select one. If you work in more than one setting, pick the setting where you spend the most time.
Hospital
Health care system or hospital network
Outpatient clinic
Long-term care facility
Clinical lab
Hospice
Home care
Other (please specify):
[If response is something other than hospital, then respondent will be thanked for their time and exited from the survey.]
Which best describes the area of your senior leadership (i.e., executive) role in your hospital?
Business operations (finance, marketing)
Clinical operations (clinical directors, chief clinical officers)
Human Resources/Wellness
Information/Informatics
Nursing
Patient care
Other:
I do not hold a senior leadership role [Respondent will be thanked for their time and exited from the survey.]
How long have you served in this role at your hospital (in years)? (number)
Perceptions of Job-Related Distress or Burnout
Mental health includes your emotional, psychological, and social well-being. If affects how you think, feel, and act. It also helps determine how you handle stress, relate to others, and make healthy choices. On a scale of 1 – 10, how much does your job affect your mental health? 1 = strongly believe that my job does NOT affect my mental health; 10 = strongly believe that my job DOES affect my mental health
-
1
2
3
4
5
6
7
8
9
10
Burnout can affect your mental health. Staff who experience burnout often feel drained and exhausted by their jobs, find their jobs more stressful and frustrating, and struggle to focus on and complete work tasks Thinking about the hospital where you work, what percent of staff (e.g., nurses, physicians, technicians) would you say have experienced burnout in the past 12 months?
None
A few (between 1% than 19%)
Some (between 20% and 39%)
About half (between 40% and 59%)
Most (between 60% and 79%)
Nearly all (80% or more)
In your opinion, how likely are the following to contribute to burnout among staff at your hospital?
1 = Extremely Unlikely 3 = Unlikely 5 = Likely 7 = Extremely Likely
-
1
2
3
4
5
6
7
Long work hours
Staff shortages
High patient caseloads
Too many bureaucratic tasks (e.g., electronic health record documentation)
Limited paid time off
Few onsite mental health or support services
Contact with patients who have COVID-19
Limited participation in decision-making
Low control over one’s area or work
Inflexible working hours
Practices to Reduce Job-Related Distress or Burnout
Which of the following does your hospital currently provide?
-
Yes
No
Don’t know
Limits on overtime
Adequate staff to handle patient caseload
Limits or restrictions on clinician caseload
Health informatics approaches (e.g., speech recognition) to electronic health record interaction
Sufficient paid time off
Onsite mental health services
Onsite health services
Onsite wellness services
Enough personal protective equipment (PPE) on your unit
Sufficient COVID-19 testing for staff
Sufficient COVID-19 testing for patients
Opportunities for staff to participate in decision-making
Staff control over their work
Flexible working hours
Onsite childcare
If respondent answers yes to 7f, 7g, or 7h, then, ask: Which of the following mental health, health, and wellness services does your hospital currently provide to staff? Select all that apply.
-
Yes
No
Don’t know
Employee assistance program (EAP)
Group or individual counseling
Exercise classes (e.g., yoga, tai chi, Zumba)
Guided meditation sessions
Stress management skills workshops
Onsite health clinic
Onsite fitness facility
Other: (open field)
Knowledge, Attitudes, and Practices Related to Mental Health Services
If staff at your hospital accessed mental health services how likely is it that they would experience the following? 1 = Extremely Unlikely 3 = Unlikely 5 = Likely 7 = Extremely Likely
-
1
2
3
4
5
6
7
Lose opportunities for promotion or advancement?
Face harassment or ridicule?
Feel shame or embarrassment?
Continue working alongside the rest of their colleagues?
Be permitted to see patients?
Lose benefits for self or family?
Jeopardize future employment opportunities?
In your opinion, if your hospital wants its staff to obtain professional services for mental health concerns how important is it that . . .
-
Not at all important
Somewhat important
Moderately important
Very important
Treatment and other mental health supports are offered onsite?
Treatment and other mental health supports are offered offsite?
Programs and services are available during evenings and weekends (as well as weekdays)?
Treatments and services provided have been proven effective?
Senior leaders encourage staff to seek help and support them when they do so?
Appointments are easy to get and available without delays?
Treatment is offered privately via the Internet, or phone?
Counseling and other supports are available to family members of staff?
Treatment and services are offered at low or no cost?
During the past 3 months, how often have you heard the following at your hospital:
-
Never
A few times a year or less
Once a month or less
A few times a month
Once a week
A few times a week
Every day
Colleagues (i.e., healthcare executives) talking publicly about getting help for their own mental health concerns?
Colleagues encouraging staff experiencing mental health concerns to seek help?
Staff talking publicly about getting help for their own mental health concerns?
Staff encouraging other staff with mental health concerns to seek help?
During the past 3 months, how often have staff at your hospital:
-
Never
A few times a year or less
Once a month or less
A few times a month
Once a week
A few times a week
Every day
Had enough time to complete all their work tasks.
Influenced the amount of work assigned to them.
Influenced what they do at work.
Decided when to take a break.
Had the option of learning new things through their work.
During the past 3 months, how often have you and other senior leaders at your hospital . . .
-
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Dedicated the right amount of resources to support staff mental health.
Put in place effective strategies to support staff mental health.
Expected staff to participate in self-care activities to manage their mental health.
Promoted policies and practices that improve staff working conditions.
Included staff in decision making about mental health efforts.
Informed staff ahead of time about important decisions, changes, or plans for the future.
Please indicate the extent to which you agree or disagree with the following statements.
-
At this hospital . . .
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Staff mental health is not a problem.
Senior leaders are aware of how organizational policies and practices affect staff mental health.
Policies and practices that support staff mental health are too complex to implement well.
Senior leaders are satisfied with the current policies and practices that affect working conditions.
We do not have the resources to support additional mental health services for staff.
Campaign Awareness
Are you aware of the [name of customizable toolkit for healthcare executives]?
Yes
No
If respondent answers NO to question 15, then they will be thanked and exited from the survey.
16. If yes, where did you learn about the [toolkit]?
Coworker
Hospital leadership
Family member
Radio
Print news
NIOSH website
Online
Social media ad
17. Did you use the [name of customizable toolkit for healthcare executives] in the past 12 months?
Yes
No
Campaign Promotion
18. a. Did you share [campaign] materials with other hospital leaders?
Yes
No
b. If yes, with how many?
1 – 3
4 – 6
7 – 9
10 or more
19. a. Did you talk about the campaign with other hospital leaders?
Yes
No
b. If yes, with how many?
1 – 3
4 – 6
7 – 9
10 or more
Campaign Engagement/Knowledge
20. Did the [campaign] provide guidance on . . .
-
Yes
No
Don’t Know
How to help staff who may be experiencing mental health concerns?
How hospital leaders can promote better working conditions for staff?
Policies and practices that hospital leaders can implement to support staff mental health?
Behavioral Intent and Change
21. Did the [campaign] help you . . .
-
Yes
No
Identify workplace policies and practices that support staff mental health?
Identify ways to improve working conditions at your hospital?
Take one or more concrete steps toward implementing changes to policies and practices that support staff mental health?
d. Take one or more concrete steps toward modifying working conditions at your hospital that affect staff mental health?
e. Implement one or more changes to policies and practices that support staff mental health?
Modify one or more working conditions at your hospital that affect staff mental health?
Hospital Characteristics
22. Which best describes your hospital based on the way it is funded?
23. How many beds are in your hospital?
24. Where is your hospital currently located?
Urban (serves a community of 50,000 or more people)
Suburban (serves a community of more than 2,500, but fewer than 50,000 people)
Rural (serves a community of 2,500 or fewer people)
Multiple settings (serves urban, suburban, and/or rural populations)
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Hospital Leader - Follow-Up Survey |
| Author | Novicki, Emily (CDC/NIOSH/OD/ODDM) |
| File Modified | 0000-00-00 |
| File Created | 2023-08-18 |