NASA Safety Culture Survey

This sample survey has variations based on:
   

PURPOSE:
This survey provides basic feedback to your center on the safety culture with the goal of preventing incidents from occurring.

FOR IMMEDIATE SAFETY CONCERNS:
1. Please contact your supervisor or Center Safety Representative.
2. Or, go to the NASA Safety Center web page, where you can select your home center for more specific information: http://www.nasa.gov/audience/safety/reporting/Safety_reporting.html

SURVEY INSTRUCTION:
1. Please read the short description of each component of safety culture (Reporting, Just, Flexible, Learning, and Engaged), then select the responses that most accurately match your perceptions.
2. Comment blocks are available for each question (400 words max. for each, and 600 words max. for the open-ended items at the end).
3. When you are done, click the Submit button. A "Thank You" note will let you know you have successfully completed the survey.
4. An individual must be free to respond without fear of reprisal, whether the fear is real or perceived. Without this, the data gathered may be inaccurate and of minimal use.
  • Data analysis will not include individual scores or identify individuals.
  • We welcome comments, and will keep them word for word, (inappropriate language may be modified or removed.)
7-Digit PIN:
Your AFFILIATION
Civil Service (CS)
Contractor
Military (DoD)
Tenant
Your DEPARTMENT
(Directorate)
Your OCCUPATION
Administrative Support
Aviation
Contracts/Procurement/ Finance
Education
Engineer
Human Resources
Institutional Services Support
Information Technology (IT)
Legal
Health & Medical
Protective Services & Emergency Management
Public Affairs
Safety & Mission Assurance
Scientist
Student (also intern and grantee)
Technician
I choose not to answer
Your LEVEL
Individual
Team Leader
Manager/Supervisor
Executive Leadership (Program Mgrs., SES's, etc.)
I choose not to answer
YEARS at your Center
0 - 5
6 - 10
11 - 15
16 - 19
20 - 25
26+
I choose not to answer
Reporting Culture:  We report our concerns.  Identification of hazards or safety concerns is encouraged, including a system that’s easy to use. The reporting system maintains anonymity and is separate from the disciplinary processes. Useful feedback based on reporting is quick and insightful. An atmosphere of trust exists between managers and workers, with employees knowing important information will be voiced, heard, and acted on appropriately.

Please rate your Immediate work area with respect to its Reporting Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Department with respect to its Reporting Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Center with respect to its Reporting Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate the Agency with respect to its Reporting Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400


Just Culture: We have a sense of fairness.  Balances the need for discipline when warranted, with rewards when earned. People are held accountable for deliberate violations of rules and recognized for outstanding performance. There’s a clear understanding of acceptable and unacceptable behaviors. There’s a sense of fairness about how business is conducted, where people aren’t punished for reporting and aren’t afraid of reprisal if they do.

Please rate your Immediate work area with respect to its Just Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Department with respect to its Just Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Center with respect to its Just Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate the Agency with respect to its Just Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400


Flexible Culture: We change to meet new demands.  The organization effectively balances and adapts to changing demands while managing complex technologies and maintaining productivity. A healthy flexible culture uses safety data to make meaningful changes when there’s a concerning trend or issue.

Please rate your Immediate work area with respect to its Flexible Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Department with respect to its Flexible Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Center with respect to its Flexible Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate the Agency with respect to its Flexible Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400


Learning Culture: We learn from our successes and mistakes.  Collecting, assessing, and sharing from experience is a priority. Information is available to everyone from novice to expert. In a learning culture members value and commit to proactively “learning from our mistakes,” both formally and informally.

Please rate your Immediate work area with respect to its Learning Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Department with respect to its Learning Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Center with respect to its Learning Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate the Agency with respect to its Learning Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400


Engaged Culture: Everyone does their part.  All members regardless of status or occupation are involved and actively participate in safely accomplishing the mission. The key is to have leaders and employees who demonstrate they value safety by “walking the talk.”

Please rate your Immediate work area with respect to its Engaged Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Department with respect to its Engaged Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate your Center with respect to its Engaged Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400
Please rate the Agency with respect to its Engaged Culture.

Very Dissatisfied

Dissatisfied

Slightly Dissatisfied

Slightly Satisfied

Satisfied

Very Satisfied

Don't Know
Characters remaining: 400


General

Please specify the characteristic of safety culture that you feel is the most significant.

Reporting Culture

Just Culture

Flexible Culture

Learning Culture

Engaged Culture

N/A

Don't Know
Characters remaining: 400