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Usability Testing Protocol
Updating and Expanding the AHRQ Quality Indicators Toolkit for Hospitals
OMB: 0935-0164
IC ID: 192332
OMB.report
HHS/AHRQ
OMB 0935-0164
ICR 201408-0935-001
IC 192332
( )
Documents and Forms
Document Name
Document Type
Form Old - Form #3
Usability Testing Protocol
Form and Instruction
Old - Form #3 Old - Usability Testing Protocol
Attachment F -- Usability testing protocol 05-19-10.doc
Form and Instruction
Form - 3 Toolkit usability protocol (includes informed consent st
Attachment D --Toolkit usability protocol.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Usability Testing Protocol
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Old - Form #3
Old - Usability Testing Protocol
Attachment F -- Usability testing protocol 05-19-10.doc
Yes
Yes
Paper Only
Form and Instruction
Form - 3
Toolkit usability protocol (includes informed consent statement)
Attachment D --Toolkit usability protocol.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
6
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
24
0
24
0
0
0
Annual IC Time Burden (Hours)
24
0
24
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.