In 2014, the Andrews Institute Ambulatory Surgery Center in Gulf Breeze, Florida, conducted its first annual safety culture survey. It asked the employees to rank the ASC’s performance in areas including safety priority within the facility, safety as part of the ASC’s ongoing agenda, accountability, issues corrected, teamwork and training.

The results, says Barbara Holder, RN, the ASC’s quality improvement, safety and infection control officer, were eye-opening. “Our employees rated us at 82.5 percent, which is the equivalent of a B- in my book. We really strive for excellence in our facility. When you work with world-renowned surgeons bringing in athletes from around the globe, that is not an acceptable grade. It told me we had some serious work to do.”