The CIO’s first step should be to evaluate the survey results to understand what is actually driving the decline and how credible and actionable the findings are. In IT service management and leadership practice, survey outcomes are an initial signal—not a diagnosis. The CIO should review response rates, sampling (which departments responded), trends by service line, and segmentation (e.g., clinical vs. administrative users, inpatient vs. ambulatory). They should also analyze which dimensions dropped (incident response time, communication, downtime experience, training, EHR support, project delivery) and whether the decline correlates with recent events such as system outages, major upgrades, staffing changes, or backlog increases. This assessment establishes a fact base and prevents premature actions that may miss the real issues.

A follow-up survey (B) may be useful later, but only after determining what gaps already exist in the data and what additional detail is needed. Convening an all-staff meeting (C) is also premature without a clear problem statement; it risks turning into speculation rather than focused improvement planning. Hiring an external consultant (D) can be appropriate for complex or persistent issues, but it is not the first move when internal data has not yet been analyzed.