Clearance Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0935-0179)

TITLE OF INFORMATION COLLECTION: Voluntary Customer Satisfaction Survey of AHRQ PSNet and AHRQ WebM&M Users

PURPOSE:

The purpose of this request is to conduct a voluntary customer satisfaction survey of the AHRQ Patient Safety Network (PSNet) and AHRQ WebM&M sites to invite feedback from our audience on how the sites are being used as a resource on patient safety, along with the extent to which they are meeting the needs of their users. A secondary objective is to use the results to consider future enhancements to the sites. To achieve this goal, a short Web-based survey will be available on the sites for readers to complete voluntarily during a 4-week period in 2014. (The survey instrument was previously developed, validated, and administered. It has been updated slightly in 2014 to account for some new features of the sites.) The main differences in the earlier submissions include the combination of both survey questions into one form, enumerated sections and questions, placement of open-ended questions following each website’s respective sections, and the inclusion of a skip pattern.

When on the AHRQ PSNet website, the respondent shall complete a set of questions for AHRQ PSNet. Then, survey respondents will be asked if they have visited AHRQ WebM&M before. If they have not visited AHRQ WebM&M before, the respondent can click “No” and will be directed to a set of questions about Visitor Demographics. If the respondent has visited the other website, he or she can click “Yes” and will be directed to the set of questions for the AHRQ WebM&M website, followed by Visitor Demographic questions.

When on the AHRQ WebM&M website, the respondent shall complete a set of questions for AHRQ WebM&M. Then, survey respondents will be asked if they have visited AHRQ PSNet before. If they have not visited AHRQ PSNet before, the respondent can click “No” and will be directed to a set of questions about Visitor Demographics. If the respondent has visited the other website, he or she can click “Yes” and will be directed to the set of questions for the AHRQ PSNet website, followed by Visitor Demographic questions.

AHRQ PSNet is a popular patient safety site that offers weekly updates on patient safety literature, reports, news, tools, and meetings, and a vast set of carefully annotated links to important research and other information on patient safety. Supported by a robust taxonomy and web architecture, AHRQ PSNet provides powerful searching and browsing capability, as well as the ability for diverse users to customize the site around their interests (My PSNet). AHRQ PSNet can be accessed via the Internet at http://psnet.ahrq.gov.

AHRQ WebM&M (Morbidity and Mortality Rounds on the Web) is an online journal on patient safety and quality. This site features expert analysis of medical errors reported anonymously by our readers, interactive learning modules on patient safety ("Spotlight Cases"), Perspectives on Safety, Interviews and podcasts, and CME. AHRQ WebM&M can be accessed via the Internet at http://webmm.ahrq.gov.

DESCRIPTION OF RESPONDENTS:

Respondents will be a sample of visitors to the AHRQ PSNet and AHRQ WebM&M sites during the survey period, and may include health care providers, allied health professionals, educators, and trainees, along with non-clinician hospital, quality, and safety professionals.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [x] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:__ Erin Hartman

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [x] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants?
[ ] Yes [x] No

Category of Respondent: (the options here are Public Sector or Private Sector, or both)

Both

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
AHRQ PSNet and AHRQ WebM&M site visitors	1000	10 minutes	167
Totals	1000	n/a	167

FEDERAL COST: The estimated annual cost to the Federal government is __$11,343.15__________

A Health Scientist Administrator (GS-12, Step 1) is providing oversight, and devotes approximately 15% FTE to this project. At an annual salary of $75,621 (Annual salary based on 2014 OPM Pay Schedule for Washington/DC area: http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2014/DCB.pdf), this adds $11,343.15 to the annualized estimate and total estimate, because this task shall occur once throughout the remainder of the contract during its final year. The total cost is estimated to be $11,343.15 to the Federal Government. There will be no additional cost to the Federal Government under the contract at this time. The work conducted by AHRQ’s contractor, UCSF, is already accounted.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [x] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

All visitors to the AHRQ PSNet and AHRQ WebM&M sites during the survey period will be eligible to participate in the survey. The AHRQ PSNet site has, on average, 36,000 visitor sessions per month and the AHRQ WebM&M site has 18,000 on average. Using the relatively conservative assumption of a 2% response rate, we would expect roughly 1,000 responses over a one-month period. We propose to solicit all visitors to both sites during a 4-week period with the goal of obtaining up to approximately 1,000 responses.

During the 4-week administration, participant recruitment will occur as follows. The first approach will be to include a button/link on the home pages (http://psnet.ahrq.gov and http://webmm.ahrq.gov) that says, “Take our survey.” Clicking on the button will open the electronic survey instrument in a new window. The second approach will be a link to the survey in our e-mail newsletters to registered users. Third, during the survey period, visitors to the home page will encounter a “pop-up-type” window requesting their participation in the survey. Users may choose to accept or decline. Declining will close the window; accepting will open a new window with survey.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[x] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [x] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Attachment A: Survey Instrument