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1 - TAKE A SURVEY
2 - SURVEY INFORMATION
a) Survey Overview
b) AFCMRS Policy
c) Survey Instructions
d) Sample CC Access
e) Hierarchy View
f) Unit Survey History
g) Optional Items
3 - SAMPLE SURVEYS
a) OPS Survey
b) MX Survey
c) SUP Survey
d) HHQ Survey
e) MED PT Safety Survey
f) SW OPS
g) Driving Safety Survey
h) Mtr Veh Awareness Survey
i) NucMsn OPS Survey
j) NucMsn MX Survey
k) NucMsn PRAP SUP
l) NucMsn non-PRAP SUP
m) NucMsn MED
n) ISR OPS
o) ISR SUP
p) Test Agency Survey
q) MED OPS Survey
4 - SET-UP UNIT SURVEY
5 - SAMPLE CC ACCESS
6 - COMMANDER ACCESS
7 - SURVEY ADMIN
8 - CONSIDERATIONS
a) OPS Survey
b) MX Survey
c) SUP Survey
d) HHQ Survey
e) MED PT Safety Survey
f) SW OPS Survey
g) NucMsn OPS Survey
h) NucMsn MX Survey
i) NucMsn PRAP SUP
j) NucMsn non-PRAP SUP
k) Archived Surveys
OPS (2016)
MX (2016)
SUP (2016)
HHQ (2016)
NucMsn OPS (2016)
NucMsn MX (2016)
NucMsn PRAP SUP (2016)
MED PT Safety (2017)
9 - SUGGESTIONS
10 - HELP / FAQ
11 - LINKS
12 - CONTACT US
13 - HOME
Accessibility/Section 508
Report Control Symbol (RCS)
DD-USAF-2803
Expiration: 31 JAN 2028
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MED OPS Survey
Conducted on authority of:
SEAN M. CHOQUETTE, Maj Gen, USAF
USAF / USSF Chief of Safety
Commander, Air Force Safety Center
For questions regarding AFCMRS surveys, contact: AFSEC/SEH via email:
afsec.seh.hqafsecafcmrs@us.af.mil
INFORMED CONSENT
. This survey is voluntary, per Office of People Analytics guidance. This is your opportunity to anonymously provide concerns to your commander via write-in comments. Please be specific.
Do NOT discuss or comment on classified, operationally sensitive, or personally identifiable information.
PURPOSE
. This survey is designed to give members of the opportunity to provide anonymous feedback to your commander. This process helps leadership identify concerns and highlight areas where they might best focus their efforts. Demographic information will be used only to help your commander analyze results. Your responses are anonymous and aggregated. No results will be reported unless there are five or more members of a demographic group. This prevents the use of demographics to identify individual survey participants.
SURVEY INSTRUCTIONS:
Please use the scale below the survey item to rate your level of agreement with the statements.
Respondents may skip individual survey items that they do not want to answer. ALL demographics must be answered.
Once all survey items are completed, click on the Submit button at the bottom of the page.
A "Thank You" note will appear. You have then completed the survey.
Privacy Act Statement
Authority:
10 U.S.C. 9013, Secretary of the Air Force
Purpose:
To provide senior leadership insight on unit climate.
Routine Uses:
Feedback will be used to focus resources and effort to improve safety and mission effectiveness
Disclosure:
Providing information in this survey is voluntary. Survey results are reported only in a manner that does not identify an individual. However, comments that indicate intent to cause harm to self or others, commit criminal acts, or describe illegal behavior cannot be protected.
Please select one:
Military
Civilian
7-Digit PIN:
Grade/Rank
Cadet
E1-E4
E5-E6
E7-E8
E9
WO1-CWO5
O1-O3
O4-O5
O6 & above
Other
No response
Grade/Rank
GS-1 to GS-3
GS-4 to GS-8
GS-9 to GS-11
GS-12 & above
WG-8 & below
WG-9 to WG-11
WG-12 & above
WL-5 & below
WL-6 & above
WS-7 & below
WS-8 to WS-13
WS-14 & above
YA-1/2/3
YB-1/2/3
YC-1/2/3
YD-1/2/3
YE-1/2/3/4
YF-1/2/3
YG-2/3
YH-1/2/3
YI-1/2/3
YJ-1/2/3/4
YK-1/2/3
YL-1/2/3/4
YM-1/2
YN-1/2/3
YP-1
NAF
DR-I
DR-II
DR-III
DR-IV
DO-I
DO-II
DO-III
DO-IV
Other (Civilian)
No response
Your age
< 21
21-22
23-24
25-30
31-40
>40
No response
Your time in this unit
<1 month
1 to 3 months
4 to 6 months
7 to 12 months
13 to 24 months
2 to 5 years
6 to 10 years
11 to 20 years
> 20 years
No response
Your status
Military
Federal Civil Service
Civilian, Non-civil service
Resident
Temporary employee
Other
No response
Your military affiliation
Active Duty
Traditional Reservist
Individual Mobilization Augmentee (IMA)
Active Guard-Reserve (AGR)
Air Reserve Technician (ART)
Full-time Reserve Technician
N/A
No response
Your service
I am in the ANG
I am in the ARNG
I am in the USAF
I am in the USSF
I am in the US Army
I am in the USMC
I am in the USN
I am in the USCG
US Civilian
I am in another Service
No response
Your total number of operational tours
1
2 - 5
> 5
N/A
No response
Your primary position
Provider
Pharmacist
Nurse
Technician
Bioenvironmental
Public Health
Admin, Clinical
Admin, Non-clinical
Medical Support
Environmental Support (housekeeping)
Command
Other
No response
Your primary work area
Administration
Aeromedical Evacuation
Dental
Emergency
Family health
Flight medicine
ICU
Laboratory
Medical support
Medicine
Mental health
OB/GYN
Pediatrics
Pharmacy
Radiology
Rehabilitation
Surgery
Women's Health
N/A
Other
No response
Total years in career field
< 1
1-2
3-5
6-10
11-15
16-20
> 20
No response
ORGANIZATIONAL PROCESSES
The use of operating instructions is enforced in my organization
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Required written guidance is current in my organization
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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My organization has effective time-outs.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization are comfortable reporting all adverse incidents.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization incorporate risk management into daily activities.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Personnel must possess the appropriate skills to earn qualifications in my organization.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization know the standards of performance for which they are accountable.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Medical Readiness training is conducted as required in my organization.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members follow Situation, Background, Assessment, Recommendations (SBAR) when handing off high-risk patients.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Following all steps in written guidance is the best way to accomplish daily tasks.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization have huddles at least weekly.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization encourage use of helping resources when needed.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization have no fear of reprisal when submitting an event in Patient Safety Report (PSR).
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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All members of my organization have the authority to halt unsafe activities until the hazards/risks are addressed.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
Enter any comment here:
ORGANIZATIONAL CLIMATE
My organization has a reputation for high-quality performance.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Additional duties do not adversely affect my primary duties in my unit.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
Enter any comment here:
My duty day ends at a predictable time.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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My organization effectively communicates information.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization assist coworkers when workload is high.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Personal conflicts between team members are addressed effectively.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Feedback is delivered in a way that promotes positive behavior change.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Members of my organization share information that enables timely decision making.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
Enter any comment here:
LEADERSHIP/SUPERVISION
Individuals in my organization are comfortable communicating with their supervisor about personal issues.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
Enter any comment here:
Morale in my organization is high.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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RESOURCES
My unit has sufficient qualified personnel to execute
healthcare delivery mission
.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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My unit has sufficient qualified personnel to execute
medical readiness mission
.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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I am provided adequate materiel resources to accomplish my job.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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My current assignment allows me to practice my specialty to the full extent.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
Enter any comment here:
My unit manpower document reflects the correct personnel to perform organization's mission.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders model collaborative team behavior.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders share information with team leaders.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders in my organization care about my quality of life.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders view mistakes as learning opportunities.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders conduct leadership rounds on a regular basis.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders in my organization set a good example for following standards.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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Senior leaders in my organization react well to unexpected changes.
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
N/A
Don't Know
Characters remaining:
400
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STANDARD OPEN-ENDED RESPONSE ITEMS
Do NOT discuss or comment on classified, operationally sensitive, or personally identifiable information.
The next patient safety error will be caused by...
Characters remaining:
400
The most significant action(s) my organization can take to improve patient safety is(are)...
Characters remaining:
400
The most important thing Military Treatment Facilities (MTF) could do to improve the referral process is...
Characters remaining:
400
The MTF promotes patient safety reporting by...
Characters remaining:
400
What is my organization doing right and why?
Characters remaining:
400
Use this space to provide any concern that you would like to comment upon.
Characters remaining:
400
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