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First State Orthopaedics, a large specialty medical group with multiple physician offices and an ambulatory surgical center, wanted to improve safety within their organization by gaining a better understanding of their patient safety culture. First State decided to do an assessment so they could determine how staff perceived safety within their organization and make an informed choice as to how they could move their organization forward on the safety journey.


ECRI Institute Patient Safety Organization (PSO) encouraged First State to participate in our fully automated version of the AHRQ Culture of Safety Survey. The specialty group gave ECRI the list of people who needed to participate and ECRI handled all of the arrangements to secure participation.

After the survey was completed and analyzed, ECRI Institute PSO delivered a comprehensive report to First State senior leadership. The report identified the domains of safety culture where the organization performed best and where they had opportunities for improvement. The Report also compared First State results to national benchmarks. After leadership review, First State held focus groups with key front-line staff to gain more insight into the areas identified.


ECRI Institute PSO worked with the organization to develop an action plan focusing on the poorest performing areas. ECRI provided resources from both ECRI Institute PSO and external sources to help First State accomplish the actions required.

Based on the survey findings, First State discovered that although the staff had intervened and made changes to prevent or avoid system issues, they still weren’t communicating these issues to leadership. First State was concerned that their safety surveillance systems were not working and wanted to prevent these issues from happening repeatedly. In essence, First State wanted to become a learning organization.

The action plan included implementing a formal reporting process, which ECRI Institute PSO helped First State develop, including the forms required to put the process into action. ECRI Institute PSO received these reports and compiled the information to help First State put the analyses into action.

After seeing the changes that were made based on the assessment process and learnings, the specialty group felt empowered about their ability to improve their safety culture. First State decided to follow this effort with ECRI Institute’s Physician Practice Assessment to continue learning and improving their organization.


Learn more about ECRI Institute PSO membership.