SUBMISSION OF INFORMATION COLLECTION UNDER THE
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
DATE OF REQUEST: July 11, 2014
SUB AGENCY (I/C): HHS/AHRQ
TITLE: Future of MONAHRQ® Survey 2014: Current and Potential Host Users
GENERIC CLEARANCE UNDER OMB#: 0925-0179 EXP. DATE: 107/31/2014
My Own Network powered by AHRQ—is innovative, free, website-generating software from the Agency for Healthcare Research and Quality (AHRQ). The purpose of the survey is to gather input on current and potential uses for MONAHRQ. We plan to use this feedback to help identify the most useful ways to improve MONAHRQ, such as adding new features. Respondents will be asked to describe their current level of involvement with MONAHRQ, satisfaction with the functions it offers, and offer suggestions for potential new features and uses for MONAHRQ.
Organizations that download MONAHRQ and generate reports to help improve health care are referred to as “Host Users.” The Future of MONAHRQ Survey 2014 will be accessible to current and prospective Host Users. Examples of Host Users include: state agencies, public health departments, hospital associations, hospital systems, and individual hospitals, multi-stakeholder alliances and coalitions, Quality Improvement Organizations (QIOs), and health plans.
TOTAL ANNUAL BURDEN APPROVED: 3,383 Hours Per year
BURDEN USED TO DATE: 346 hours.
BURDEN THIS REQUEST: 551 hours.
FEDERAL COST: The estimated annual cost to the Federal government is $3,800.00_____.
IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?
______YES ______ NO _____x_ N/A
OBLIGATION TO RESPOND:
___x___ VOLUNTARY
______ REQUIRED TO OBTAIN OR RETAIN BENEFITS
______ MANDATORY
HOW WILL THIS SURVEY BE OFFERED?
__x___ WEB SITE
_____ TELEPHONE INTERVIEW
_____ MAIL RESPONSE
_____ IN PERSON INTERVIEW
_____ OTHER: ___________________________________
CONTACT INFORMATION:
NAME: _Erwin Brown______________________________
TELEPHONE NUMBER: 301.427.1652________________
EMAIL ADDRESS: _ebrown@ahrq.gov________________
| File Type | application/msword |
| File Title | Generic Clearance Form - 04/28/2008 |
| Subject | Generic Clearance Form - 04/28/2008 |
| Author | OD/USER |
| Last Modified By | erwin.brown |
| File Modified | 2014-07-30 |
| File Created | 2014-07-09 |