2017 Safety Market Survey Question Title * 1. How concerned are you about the changes resulting from CMS' and The Joint Commission's adoption of the 2012 Life Safety Code? Very concerned Concerned Somewhat concerned Not concerned Question Title * 2. In what ways has the issue changed your facility's protocols or procedures? Question Title * 3. How well do you feel your facility is prepared to comply with the newly adopted 2012 Life Safety Code? Very prepared Prepared Somewhat prepared Not prepared Question Title * 4. How concerned are you about complying with OSHA and CAP standards for laboratory safety? Very concerned Concerned Somewhat concerned Not concerned Question Title * 5. What are your biggest challenges when it comes to laboratory safety compliance with OSHA and CAP standards? Question Title * 6. Are you prepared to comply with CMS' new Emergency Preparedness rule? Very prepared Prepared Somewhat prepared Not prepared Question Title * 7. What are your biggest challenges when it comes to emergency preparedness? Question Title * 8. How successful has your facility been in creating a Culture of Safety? Very successful Somewhat successful Not successful Question Title * 9. What are your biggest challenges when it comes to creating a Culture of Safety? Question Title * 10. How likely are you to purchase a book on the following topics? (Not likely/Somewhat likely/Likely/Very likely) Very likely Likely Somewhat likely Not likely Compliance with the 2012 Life Safety Code® Compliance with the 2012 Life Safety Code® Very likely Compliance with the 2012 Life Safety Code® Likely Compliance with the 2012 Life Safety Code® Somewhat likely Compliance with the 2012 Life Safety Code® Not likely Infection control/healthcare-associated infections (HAI) Infection control/healthcare-associated infections (HAI) Very likely Infection control/healthcare-associated infections (HAI) Likely Infection control/healthcare-associated infections (HAI) Somewhat likely Infection control/healthcare-associated infections (HAI) Not likely Proposed EPA hazardous waste rule changes Proposed EPA hazardous waste rule changes Very likely Proposed EPA hazardous waste rule changes Likely Proposed EPA hazardous waste rule changes Somewhat likely Proposed EPA hazardous waste rule changes Not likely The new CMS emergency preparedness rule The new CMS emergency preparedness rule Very likely The new CMS emergency preparedness rule Likely The new CMS emergency preparedness rule Somewhat likely The new CMS emergency preparedness rule Not likely OSHA-CAP standards crosswalk OSHA-CAP standards crosswalk Very likely OSHA-CAP standards crosswalk Likely OSHA-CAP standards crosswalk Somewhat likely OSHA-CAP standards crosswalk Not likely Building a Culture of Safety Building a Culture of Safety Very likely Building a Culture of Safety Likely Building a Culture of Safety Somewhat likely Building a Culture of Safety Not likely Question Title * 11. Are there any other topics about which you’d like to receive training and information in 2017? Question Title * 12. What is your biggest priority this year? Question Title * 13. Which of the following best describe your job function? Administrator Trainer/Educator Purchaser Physician/Nurse Safety Coordinator/Officer Consultant Infection Preventionist Facilities director Plant operations director Security Director Hospital fire marshal Director of Engineering Survey coordinator Occupational safety and health officer Emergency management coordinator Vice president of operations Other (please specify) Question Title * 14. What best describes your work facility? Acute care hospital Critical access hospital Inpatient rehabilitation hospital Long-term acute care hospital Psychiatric/behavioral health hospital Healthcare system corporate office Home health agency Skilled nursing facility Ambulatory surgery center Physician office Urgent care facility Billing agency Consultant Other (please specify) Question Title * 15. Would you be interested in participating in the following with HCPro? A focus group with HCPro and 2-4 of your peers A 30-minute one-on-one phone call with an HCPro editor to discuss your job and most pressing challenges No thanks Question Title * 16. Please provide your contact information for a chance to win a $50 gift certificate towards HCPro Safety products. Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Done