Evaluation of the Field Triage Decision Scheme: The National Trauma Triage Protocol

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Informed Consent.doc	Supplementary Document	Uploaded 2010-02-02	Available
OMB Part B_Oct.19.09(2).doc	Supporting Statement B	Uploaded 2009-12-10	Available
AttachmentE_NOVA System Security Plan.pdf	Supplementary Document	Uploaded 2009-12-10	Available
Attachment D. NCIPC Non Research Determination Form.pdf	Supplementary Document	Uploaded 2009-12-10	Available
AttachmentC_PrivacyActDetermination.doc	Supplementary Document	Uploaded 2009-12-10	Available
AttachmentB_60-dayFRN.pdf	Supplementary Document	Uploaded 2009-12-10	Available
ATTACHMENT A.Public Health Service Act.doc	Supplementary Document	Uploaded 2009-12-10	Available
AttachmentI_Emails.doc	Supplementary Document	Uploaded 2009-12-10	Available
OMB Part A_Dec 2009.doc	Supporting Statement A	Uploaded 2009-12-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
191678	EMP Professional Focus Groups	Other-Moderator's Guide for Focus Groups	New
191677	Screening and Recruitment for Focus Groups	Other-Screener/Recruitment	New
191676	EMS Professional Survey	Other-Survey	New

ICR Details

OMB Control No: 0920-0844	ICR Reference No: 200912-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Evaluation of the Field Triage Decision Scheme: The National Trauma Triage Protocol
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/03/2010
	Date Received in OIRA: 12/28/2009
Terms of Clearance: Approved consistent with revised documents uploaded on 2/2/2010.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2012	24 Months From Approved
Responses	1,596	0	0
Time Burden (Hours)	412	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Field Triage Decision Scheme: The National Trauma Triage Protocol educational initiative was developed to help emergency medical services (EMS) professionals (administrators, medical directors, trauma system leadership, and providers) learn about and implement the revised Field Triage Decision Scheme. The proposed data collection is an evaluation to assess the Field Triage Decision Scheme: The National Trauma Triage Protocol educational initiative's short-term impact on EMS professional's knowledge, use, and implementation of the Decision Scheme.

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Authorizing Statute(s): US Code: 42 USC 301 [241] Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 48079	09/21/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 236	12/10/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Screening and Recruitment for Focus Groups
EMP Professional Focus Groups
EMS Professional Survey

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ICR Summary of Burden

table that charts list of burden

	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	1,596	0	0	1,596	0	0
Annual Time Burden (Hours)	412	0	0	412	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new request for data collection.

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Annual Cost to Federal Government: $56,200

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/28/2009

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