Attachment F_Informed_Consent

Attachment F: Informed Consent

IMPAQ/RAND Synthesis of AHRQ-Funded HAI Projects: FY2007–2010

Informed Consent Statement

We’d like to let you know how the information you share will be recorded and used:

With your permission, we would like to audio-record the interview for research purposes only. All recordings will be transcribed, and the audio-recordings will be destroyed at the end of the study. If you prefer not to be audio-taped, we will only document the interview with manual notes.

Your responses will be kept confidential to the extent permitted by law, including AHRQ’s confidentiality statute, 42 USC 299c-3(c). That law requires that information collected for research conducted or supported by AHRQ that identifies individuals or establishments be used only for the purpose for which it was supplied unless you consent to the use of the information for another purpose

We will only produce summary information from our collective set of interviews and your identity and that of your organization will not be shared with anyone outside of the research team and AHRQ except with your permission or as required by law. 

We will destroy all information that identifies you after the end of the study.

We also want to emphasize that your participation in the interview is completely voluntary.  Your participation or nonparticipation will not be reported to anyone.  You are free to stop the interview at any time and to decline to discuss any particular topic that we raise.

Questions or Concerns

If you have any questions about this study, you may contact the project leads:

David Baker, PhD (Project Director)

IMPAQ International

10420 Little Patuxent Parkway, Suite 300

443-539-9773, [email protected]

Katherine Kahn, MD (Principal Investigator)

RAND Corporation

1776 Main Street
Santa Monica, CA 90401-3208 

393-0411, ext. 7706, [email protected]

If you have any questions or concerns about your rights as a research participant, you may contact RAND’s Human Subjects Protection Committee at 310-393-0411, ext. 6369.