Donor Survey Application

Health Resources and Services Administration

C.W. Bill Young Cell Transplantation Program (The Program)

Donor Satisfaction Survey

The Health Resources and Services Administration (HRSA) is requesting OMB approval to conduct a donor satisfaction survey under the HRSA generic clearance for customer satisfaction surveys (OMB No. 0915-0212) on behalf of its Contractor, the National Marrow Donor Program^® (NMDP). This survey helps fulfill the requirements of:

1. Executive Order 12862, “Setting Customer Service Standards,” which directs Agencies to continually reform their management practices and operations to provide service to the public that matches or exceeds the best service available in the private sector.

2. The March 3, 1998, White House Memorandum, “Conducting Conversations with America to Further Improve Customer Service,” which further directs Agencies to determine the kind and quality of service its customers want and their level of satisfaction with existing services.

HRSA provides support for a variety of activities meant to improve and encourage organ, tissue, bone marrow, and cord blood and circulating blood stem cell donations. Under the C.W. Bill Young Cell Transplantation Program, HRSA provides support to the NMDP to promote and increase donation.

The NMDP is a non-profit organization based in Minneapolis, Minnesota, that facilitates marrow or blood cell transplants for patients who do not have a matched donor in their family. The NMDP coordinates hematopoietic cell transplants by managing a worldwide network of affiliated organizations that work together to arrange transplants. Donors are provided a variety of services and information by the NMDP and its affiliated centers. Donor centers help potential donors learn about bone marrow donation and assist donors throughout the donation process.

The objective of this survey is to assess satisfaction and identify areas for improvement of services and information provided to volunteer donors by the NMDP and its network donor, collection and apheresis centers. HRSA has awarded a contract to the NMDP which requires that the “contractor must conduct surveys of donors and potential donors to determine the extent of satisfaction with these services and to identify ways in which the services can be improved.”

Product/activity to be assessed:

The survey will be used to determine the extent of satisfaction with service access, quality of information, educational materials and medical care and interpersonal/staff experience throughout the donation process.

Statement of objectives of the proposed customer satisfaction survey, including a brief analysis plan:

Survey responses will be used to assess volunteer donor satisfaction with support provided throughout the donation process. Specifically, the survey will provide information to help provide a description of:

• Overall Satisfaction. Responses to all the survey questions will indicate the extent to which volunteer donors are satisfied with the overall donation experience.

• Specific Satisfaction. Responses to individual survey questions will provide an indication of the extent to which volunteer donors are satisfied with specific aspects of the donation process, such as: accuracy of information provided by staff; clarity of educational materials; and, caring and appreciation demonstrated by staff.

The survey is very brief, consisting of 14 questions that use a Likert-type scale ranging from “strongly disagree” to “strongly agree” and 3 open-ended questions that allow respondents to provide their thoughts and opinions.

Survey findings regarding volunteer donor satisfaction will help to identify areas for improvement in services provided by network centers. Brief summaries based on survey findings will be prepared by the NMDP and communicated to network centers. The network centers and NMDP will use the information provided to identify areas of improvement for donors.

Overview of Methods to Collect the Information

1. Data Collection Method

1. Paper survey: The distribution of the survey will be tied to the routine “Thank You” mailing that takes place one month post-donation. Staff at the Coordinating Center coordinates this mailing monthly for all donors who completed donation in the previous month. The distribution of “Thank You” letters is managed in coordination with the local donor centers. The post-donation “Thank You” letter that will accompany the survey is included in this request as an attachment.

The donor will be sent a paper survey that includes information to access the on-line survey, if desired. The mailing will also include a postage-paid return envelope should the donor elect to complete the survey on paper. The survey will be made available in six languages (English, Spanish, Mandarin, Korean, Portuguese and Vietnamese). The introductory letter and survey will match the language of the Thank You letter distributed by the Coordinating Center. Translated surveys will be available both on-line as well as on paper.

2. Web Based survey: For ease of distribution and results reporting, the donor satisfaction assessment tool will be made available to donors through a the web on the NMDP’s public web site, www.marrow.org.

This survey is intended to be an ongoing tool to assess post-donation donor satisfaction with the services provided by donor centers.

2. Method for Identifying Potential Respondents

The satisfaction survey will be mailed to every domestic donor who has completed a collection (primary and secondary donation), approximately 2,000 donors. In fiscal year 2007 (October 1, 2006 through September 30, 2007), it is anticipated that 2,000 domestic donors will donate through the NMDP (166 per month).

3. Expected Response Rate and Plan for Follow-up of Non-Respondents

NMDP has consulted with Galen Switzer, Ph.D. of the University of Pittsburgh’s Center for Research in Healthcare, in order to estimate the anticipated response rate for such a survey. Dr. Switzer has extensive experience with NMDP’s donor base given his broad psychosocial research with this population. Dr. Switzer estimates a 70% response rate for this effort given his experience with comparable donor survey projects. Although survey responses are voluntary, NMDP expects that donors will be eager to communicate about their experiences given their high level of investment in the program as a result of their voluntary donation.

The following methods will be employed in order to enhance response rate:

1. Surveys will be mailed with a cover letter explaining the survey and encouraging participation.

2. Donors will be informed about the post-donation satisfaction survey at the time of their information session in advance of the donation.

3. A contact person and toll-free number are provided for further information or questions.

4. The survey instrument is very brief and easy to understand.

5. The survey will be available in six languages in order to remove potential barriers for donors without English proficiency.

6. The survey requires only 5-10 minutes to complete.

7. Potential respondents are expected to have interest in responding to the survey.

8. Donors will be provided the option of completing the survey via the internet or by mail (with enclosed postage paid envelope) for ease of return.

4. Expected Ability to Assess Non-Response Bias

This survey is being proposed as a customer satisfaction survey solely to follow up with donors for comment and opinion. The survey procedures are not designed for the purpose of drawing a representative sample or for purposes of making generalizations or estimates. The Coordinating Center organizes the monthly mailing for the Thank you letters. Since the survey does not collect names and addresses from the respondents, there is no information available to evaluate characteristics of donors that do not respond to the survey.

5. Methods Used to Protect Respondent Information

To protect the responses of donors completing this survey, names and other identifying information will not be collected. No attempt will be made to identify respondents by name after the survey is mailed. At no time will HRSA receive any personal identifying information on respondents.

There are no plans for publication of the survey results. Analysis of the data will consist of examining distributions of the scaled responses for summaries and averages. Narrative comments will be compiled. Summary results will be reviewed regularly to identify areas for improvement.

6. Annual Response Burden Estimate

The NMDP pilot tested this survey in order to estimate the time burden it would require of donors in order to complete. Based on the nine donor surveys administered during this pilot, the average time it has taken to complete the survey with the donors is 8.5 minutes. The estimated annual response burden is as follows:

	Number of Respondents	Number of Responses per Respondent	Total Responses	Hours per Response	Total Burden Hours	Wage Rate	Total Hour Cost
Donor Satisfaction Survey	2,000	1	2,000	.14	280	$15	$4,200

The information collection burden is based on an estimate of the average time required for participants in a pre-test to complete each form. A nominal hourly rate of $15 is used because it is expected that individuals and households responding to this survey are doing so voluntarily during leisure hours without the need to refer to records.

There are no capital or start-up costs for respondents of the survey instruments. Surveys are submitted either via postage paid envelope or via the internet. There are no operation or maintenance costs to survey respondents.

The contact for the survey is Bernadette Anton, Manager of Donor Advocacy, National Marrow Donor Program, National Coordinating Center, 3001 Broadway Street NE, Suite 500, Minneapolis, MN 55413, 612-362-3468 or [email protected]. The NMDP Research Department will review and assist as necessary for any data analysis.

Methods used to develop and test the questions:

For assistance in the development of a useful survey tool, patient satisfaction survey literature was reviewed for content and format ideas. Questions were developed to address the areas of service access, service quality, interpersonal/staff experience, including donor experience with the donor center and the apheresis/collection center as well as any relevant services provided directly by the NMDP (i.e.; donor education). The survey was limited to 14 questions with three open ended questions at the end as recommended by industry experts. Attention was given to providing an easy-to-read survey at an accessible reading level that would require a minimal time investment for the donor. The readability of the survey was assessed using the Flesch-Kincaid assessment tool. The final survey is at a 9^th grade reading level. The Flesch reading ease score for the document is 51. A copy of the survey instrument is included as an attachment.

Questions were reviewed for content and clarity by a working group that included representation from the NMDP Coordinating Center, network donor centers, collection centers and apheresis centers. The survey was pre-tested among nine donors from two network donor centers via telephone to assess the level of understanding and the length of time required for survey completion. Survey questions were read to the donor verbatim. Lack of clarifying questions from the donor, and donor responses indicated an understanding of the questions. Several of the donors that were contacted expressed appreciation that NMDP was contacting them about their experience. Average time to complete the survey with the donor was 8.5 minutes.