OxySafe Provider Survey 2021

Home oxygen fires are responsible for around 150^[i]deaths and around 1,200 burn injuries every year in the United States^[ii]. OxySafe is a small device that cuts off the flow of oxygen in the event of a fire in the tubing and can prevent patient death and limit injuries.

We would like to get your thoughts on the issue via this short survey. By completing the survey, you are contributing to improved home oxygen patient safety.

Thank you for your help!
Applied Home Healthcare Equipment

[i] BPR Medical (2019) The prevalence of home oxygen fires in the U.S.
[ii] National Fire Protection Association

Question Title

* 1. Which best describes your business?

An independent home oxygen provider

Part of a regional home oxygen provider

National home oxygen provider

Other (please specify)

Question Title

* 2. Have any of your patients experienced a home oxygen fire in the past?

Yes, a fatality / fatalities

Yes, an injury / injuries

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* 3. Would you install an OxySafe if these people specifically requested it?

	Yes	No
The patient	The patient Yes	The patient No
Respiratory Therapist	Respiratory Therapist Yes	Respiratory Therapist No
State Fire Marshal	State Fire Marshal Yes	State Fire Marshal No

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* 4. Who in your organization would make the decision on installing OxySafe for home oxygen patients?

General Manager

Clinical Lead

Patient Safety Manager

Sales Manager

Purchasing Manager

Someone else (please specify)

Question Title

* 5. How much influence would the following have on your decision to install firebreaks? Please rank 1-4 (1 = most influential / 4 = least influential)

	1	2	3	4
The costs were fully reimbursed	The costs were fully reimbursed 1	The costs were fully reimbursed 2	The costs were fully reimbursed 3	The costs were fully reimbursed 4
They added to my bottom line	They added to my bottom line 1	They added to my bottom line 2	They added to my bottom line 3	They added to my bottom line 4
They reduced my potential liability costs	They reduced my potential liability costs 1	They reduced my potential liability costs 2	They reduced my potential liability costs 3	They reduced my potential liability costs 4
They reduced the risk of harm to my patient	They reduced the risk of harm to my patient 1	They reduced the risk of harm to my patient 2	They reduced the risk of harm to my patient 3	They reduced the risk of harm to my patient 4

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* 6. If your business were responsible for the cost of OxySafe, at what price would the balance tip towards installing, rather than not installing OxySafe? Please note these costs are per patient for the intended life of the firebreak (four years).

Only at no cost

Less than $5

$5-$10

$15-$20

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* 7. What trade media do you read, watch and listen to?

HME News

HME Business

HomeCare Magazine

Provider Magazine

Another (please specify)

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* 8. Are you interested in any of the following?

	Yes	No
Joining a closed online group to discuss home oxygen safety?	Joining a closed online group to discuss home oxygen safety? Yes	Joining a closed online group to discuss home oxygen safety? No
Taking part in a follow up phone interview?	Taking part in a follow up phone interview? Yes	Taking part in a follow up phone interview? No
Learning more about home oxygen fire safety.	Learning more about home oxygen fire safety. Yes	Learning more about home oxygen fire safety. No

If so, what?

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* 9. Contact Info

Job Title

Email Address