SUBMISSION OF INFORMATION COLLECTION UNDER THE
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
DATE OF REQUEST: August 30, 2016
SUB AGENCY (I/C): HHS/AHRQ
TITLE: : Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division
GENERIC CLEARANCE UNDER OMB#: 0925-0179 EXP. DATE: 11/30/2017
	The mission of the EPC
	program is to create reports that improve healthcare by supporting
	evidence-based decision making by patients, providers, and
	policymakers.  To ensure that our reports are used, we invite
	nominations from professional organizations that create guidelines
	or other private or public sector organizations that need a
	systematic review of the evidence on some medical question in order
	to improve medical care.  In order to improve how we work with these
	nominators and to improve the utility of the final report, we would
	like to interview a representative of each nominator (most likely
	whoever worked as liaison with us during the project) about their
	experience and the usefulness of the final report once the project
	is completed. This information will be used to increase the
	efficiency and impact of our program. 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: 404 hours.
BURDEN THIS REQUEST: 20 hours.
FEDERAL COST: The estimated annual cost to the Federal government is $1,200_____.
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?
_____ WEB SITE
___x_ TELEPHONE INTERVIEW
_____ MAIL RESPONSE
_____ IN PERSON INTERVIEW
_____ OTHER: ___________________________________
CONTACT INFORMATION:
NAME: _Erwin Brown______________________________
TELEPHONE NUMBER: 301.427.1652________________
EMAIL ADDRESS: [email protected]________________
| 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 | Windows User | 
| File Modified | 2016-08-31 | 
| File Created | 2016-08-30 |