Pilot Study of Proposed Medical Office Surveys on Patient Safety

ICR 200703-0935-001

OMB: 0935-0131

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2007-07-03
Supporting Statement B
0000-00-00
Supplementary Document
0000-00-00
Supporting Statement A
0000-00-00
IC Document Collections
ICR Details
0935-0131 200703-0935-001
Historical Active
HHS/AHRQ
Pilot Study of Proposed Medical Office Surveys on Patient Safety
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/05/2007
Retrieve Notice of Action (NOA) 03/07/2007
This ICR is approved consistent with the memo of 6/28/07. Absent a large scale validation study, AHRQ will use caution in making claims about the validity of results derived from this instrument.
  Inventory as of this Action Requested Previously Approved
07/31/2010 36 Months From Approved
1,638 0 0
410 0 0
0 0 0

This activity is an expansion and refinement of AHRQs Hospital Survey on Patient Safety Culture (HSOPSC) which was developed and released to the public for use in November 2004. Two new surveys are proposed to assess patient safety culture in outpatient medical office settings: One for clinicians (physicians, physician assistants, and nurse practitioners who diagnose, prescribe for, and treat patients) and one for medical office staff (all other non-clinician staff). The proposed new surveys will be based on the HSOPSC but also contain new and revised items as well as dimensions that are more applicable to the outpatient medical office setting. The two proposed surveys will contain some items that are the same and some item that are unique to each survey. The instruments will be pilot tested with clinicians and staff working in 97 outpatient medical offices. The data collected will be analyzed to determine the psychometric properties of each surveys items and dimensions and provide information for the revision and shortening of the final surveys based on an assessment of their reliability and construct validity. The final surveys will be made publicly available to enable outpatient medical offices to assess patient safety culture from the perspectives of their clinicians and staff. The surveys can be used by outpatient medical offices to identify areas for patient safety culture improvement.

None
None

Not associated with rulemaking

  71 FR 70778 12/06/2006
72 FR 6244 02/09/2007
Yes

1
IC Title Form No. Form Name
Pilot Study of Proposed Medical Office Surveys on Patient Safety

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,638 0 0 1,638 0 0
Annual Time Burden (Hours) 410 0 0 410 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New information collection.

$525,000
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/07/2007


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