Ahrq Cahps Ahrq Cahps

American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Surveys

AHRQ CAHPS Questionnaire_Template FINAL.xls

Previously Cleared ICs from prior Generic ICR

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

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

File Typeapplication/vnd.ms-excel
File TitleQuestionnaire Production Guidelines_Template
AuthorProfessional Services
Last Modified Bybjinnohara
File Modified2009-07-08
File Created2001-08-03

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