FSR 264 HHS AHRQ CAHPS questionnaire

---

Overview

Current Model Qsts
Current Custom Qsts

---

Sheet 1: Current Model Qsts

Model Instance Name:
AHRQ CAHPS
MID:
Date:	6/25/2009
AHRQ CAHPS
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction (1=Poor, 10=Excellent)		Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1	Please rate the accuracy of information on this site.	21	What is your overall satisfaction with this site?	24	How likely are you to return to this site?
2	Please rate the quality of information on this site.	22	How well does this site meet your expectations?		Recommend (1=Not Very Likely, 10=Very Likely)
3	Please rate the freshness of content on this site.	23	How does this site compare to your idea of an ideal website?	25	How likely are you to recommend this site to someone else?
	Functionality (1=Poor, 10=Excellent, Don't Know)				Primary Resource (1=Not Very Likely, 10=Very Likely)
4	Please rate the usefulness of the features provided on this site.			26	How likely are you to use this site as your primary resource?
5	Please rate the convenience of the features on this site.
6	Please rate the variety of features on this site.
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
7	Please rate the visual appeal of this site.
8	Please rate the balance of graphics and text on this site.
9	Please rate the readability of the pages on this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
10	Please rate how well the site is organized.
11	Please rate the options available for navigating this site.
12	Please rate how well the site layout helps you find what you are looking for.
13	Please rate the number of clicks to get where you want on this site.
	Search (1=Poor, 10=Excellent, Don't Know)
14	Please rate the relevance of search results on this site.
15	Please rate the organization of search results on this site.
16	Please rate how well the search results help you decide what to select.
17	Please rate how well the search feature helps you to narrow the results to find what you want.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
18	Please rate how quickly pages load on this site.
19	Please rate the consistency of speed from page to page on this site.
20	Please rate the ability to load pages without getting error messages on this site.

---

Sheet 2: Current Custom Qsts

Model Instance Name:			red & strike-through: DELETE
AHRQ CAHPS			underlined & italicized: RE-ORDER
MID:			pink: ADDITION
Date: 6/25/09			blue + -->: REWORDING
AHRQ CAHPS CUSTOM QUESTION LIST
QID (Group ID)	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
		What is your primary purpose for visiting this site? To learn about:	CAHPS Survey Instrument		Checkbox, one-up vertical	M	Y
			Download All or Part of Survey Kits
			CAHPS Database--Get Information
			CAHPS Database--Data Submission
			CAHPS Database--Research Files
			Quality Improvement--Get Information
			Quality Improvement--CAHPS Improvement Guide
			Reporting CAHPS Scores--Get Information
			Reporting CAHPS Scores--Report Card Compendium
			The CAHPS Connection Newsletter
			News and Events
			Other (Please Specify)	A
	A	Other purpose for visiting			Text area, no char limit		N
		What is your main purpose for using information or products on this site?			Text area, no char limit		N
		Did you find the information you were looking for on the site?	Yes		Radio button, one-up vertical	S	Y
			No (Please specify)	A
	A	Information not found			Text area, no char limit		N
		How did you learn about this site?	AHRQ (Web Site, Newsletter, Event)		Checkbox, one-up vertical	M	Y
			CAHPS User Network (Newsletter, E-mail, HelpLine, Event)
			CAHPS Database (E-mail, HelpLine, Event)
			Search Engine
			Another Web Site
			Publication
			Colleague
			Trade Association
			Professional Organization
			Meeting/Conference/Webcast
			Other (Please Specify)
		What type of organization do you represent?	Health Plan		Radio button, one-up vertical	S	Y
			Clinician & Group Practice
			Hospital
			Nursing Home
			Vendor/Consultant
			State Government
			Federal Government
			Quality Improvement Organization
			Researcher
			Health Care Coalition
			Health System
			Consumer Group
			Consumer
			Other (Please Specify)	A
	A	Other organization			Text area, no char limit		N
		How did you access this site?	From AHRQ Main Site		Checkbox, one-up vertical	M	Y
			Web Search
			Link from Another Site
			Bookmarks or Favorites List
			Typed in URL Address
			Electronic Communication (Newsletter, E-mail, etc.)
			Other (Please Specify)	A
	A	Other access			Text area, no char limit		N
		Do you like the overall layout of the site?	Yes		Radio button, one-up vertical	S	Y
			No (Please specify)	A
	A	What do you not like about the overall layout of the site?			Text area, no char limit		N
		How could this Web site be improved? (Please be specific, i.e., navigation, future products, specific new topic content).			Text area, no char limit		N
		Did you encounter any technical difficulties while navigating the site?	Yes (Please specify)	A	Radio button, one-up vertical	S	Y
			No
	A	What technical difficulties did you encounter while navigating?			Text area, no char limit		N