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  5. safety in CBOC workplace.
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Exit Survey
 
 
Hello:
We are conducting a survey of personnel in Community Based Outpatient Clinics (CBOCs) associated with the VA in order to monitor and address physical safety issues in your work environment. This survey will take 5-10 minutes of your time. All surveys will be confidential
Please note the following:

• This information will not be used for research
• It is an anonymous survey; no personal information is requested
• Skip any questions you prefer not to answer
• Please report any current or acute safety concerns through appropriate channels; this survey is for gathering general information with the goal of putting systems in place to provide a safe work environment. We are not able use it to address immediate or threatening problems.
Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
 
How safe (ie, physical safety) do you feel within your working environment today? I feel
 
1. Very safe
 
2. Pretty safe
 
3. At some risk
 
4. At high risk
 
5. I don’t know
 
 
 
Comments/Suggestions:
   
 
 
 
[If you are working in the same clinic as you were 2 years ago] Compared to 2 years ago, at work I feel:
 
1. Safer
 
2. Equally safe
 
3. Less safe
 
4. I don’t know
 
5. I am not working in the same workplace
 
 
 
If you feel safer than you did 2 years ago, please list the reason(s):
   
 
 
 
If you feel less safe than you did 2 years ago, please list the reason(s):
 
 
 
 
Are panic buttons available and working in your facility
 
1. Yes
 
2. No
 
3. I don’t know
 
 
 
7. If yes, to the above question; are the panic buttons easily accessible to call for help
 
1. Yes
 
2. No
 
3. I don’t know
 
 
 
When veterans become agitated or threatening, what do you see as the main reasons (Example long waiting times, etc )?
 
_______________________________________________
 
_______________________________________________
 
_______________________________________________
 
 
 
Is there enough staff/personnel to attend to an agitated person?
 
1. Always
 
2. Sometimes
 
3. Rarely
 
4. Never
 
5. I don’t know