Guided by our Safe and Reliable Healthcare SocioTechnical Framework© we measure culture & engagement using electronic surveys.                We’ll help you with:


your staff & physicians to the appropriate work settings


scheduling, running, supporting execution & monitoring response rates


senior clinical expert presenting results and insights

Action Planning

keep track of your debriefing process and document your action plans

Instruments we administer: The Integrated SCORE Survey, AHRQ SOPS


SCORE highlights

  • Highest scientific validity measures of any survey in the field

  • Integrated survey reduces cost and survey fatigue

  • Replaces incomplete views into performance and resulting departmental silos, with the sharp insights into the drivers of high reliability, psychological safety and learning

  • The field’s highest quality benchmark index with results indexed at the unit level

  • SCORE survey platform provides diagnostic and actionable insights and automated reports

  • Full Leapfrog accreditation enables maximum grade scoring

  • Approved for use in prestigious Magnet Accreditation for Nursing Excellence



SCORE is an integrated survey of Safety, Communication, Organizational Reliability, Physician & Employee Burnout and Engagement, and provides in depth and actionable insights into organizational clinical and operational performance and risk. SCORE is administered to create detailed unit-level indicators, critical in today’s industry where performance-based reimbursement incentives are challenging economic survival.  

We developed SCORE in 2014, in partnership with Professor Bryan Sexton of The Duke Patient Safety Center, to address the fragmented approaches to culture analysis and improvement using traditionally siloed data on culture, engagement and burnout. SCORE is an advance over its predecessors (the SAQ and AHRQ SOPS surveys, developed respectively in 1994 and 2002) in that it incorporates profound new insights about the precursors of operational excellence. S&R’s founders were instrumental in establishing the SAQ in healthcare, played major roles in the development of the AHRQ HSOPS survey, and extensively used both instruments. Their experience has been applied to SCORE and made it the most robust survey instrument available in the industry today.

Using experienced S&R staff and automated response rate tracking, hospitals achieve very high survey response rates. In addition, the survey has the largest burnout benchmark index available in the industry.

For more information on SCORE or our national collaborative with Duke to link culture with value, please click here.