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Federal forms, ICRs, and supporting documents

Information Collection

Pilot test and bridge study

IC 218086 under ICR 201508-0935-001 · OMB 0935-0230.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Pilot test and bridge study
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 Crosswalk Between the Original AHRQ Hospital Survey on Patient Safety Culture and Draft Version 2.0 Attachment A - Crosswalk of Hospital Survey on Patient Saafety 9-2-15.docx Yes Yes Fillable Fileable
Form and Instruction 4 Draft Health IT Patient Safety Attachment B - Draft Health IT and Patient Safety Supplemental Items and Composites 9-2-15 (3).docx Yes Yes Fillable Fileable

Health Health Care Services

 

9,188 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   90 %

  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 9,188 0 9,188 0 0 0
Annual IC Time Burden (Hours) 2,297 0 2,297 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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