Instructions for submitting data via Performance Improvement Measurement System
Service Utilization by Type of Organization Requesting Service and Outcomes for Reporting Period
Provide the total number of individual clients/departments requesting TRC services and hours of client contact service provided, including preparation time.
Total number of new/first time |
Total number of repeat clients (those who received service in the past – prior to the current reporting period – who are returning for more/other services) |
Total number of hours of technical assistance provided including preparation time |
Method Query for Reporting Period
Indicate the method of contact for technical assistance request for this reporting period.
Conference/Meeting or other In-Person Contact |
Phone |
Referral from Another TRC |
Social Media (Twitter, Facebook, LinkedIn, etc.) |
TRC Initiated |
Website |
Other |
Types of Services Provided by TRC during the Reporting Period
Provide the topic of query from the selection below:
General Information |
Clinical Service Program Development/Operations |
Equipment and Technology Assessment/Selection |
Financial (Reimbursement, Business Models, Grants) |
Policy |
Other |
Types of Services Provided by TRC during the Reporting Period
Identify by categories provided the means chosen for training, education and outreach.
Training/Education and Outreach |
Events |
Organize/Host Conference or Training Event (# of Events, Total Direct Service Hours, Total # of Participants) |
Presentation at Conferences/Meetings/Webinars (# of Presentations, Total Direct Service Hours, Total # of Participants) |
Other |
Communications/Promotional Activities |
Exhibits (# of hours, # of contacts) |
Newsletter (# of newsletters, # of subscribers) |
Web Site (# unique visitors, # of pages viewed by visitors) |
Research Publications (# of publications) |
General Media (# interviews/articles) |
Social Media |
Facebook (# of page likes, # of posts) |
Twitter (# of followers, # of tweets) |
LinkedIn (# of followers, # of posts) |
Other |
Technical Assistance/Consultation |
Method Used to Respond to Queries |
Email (# responses) |
Phone (# responses) |
Videoconference (# responses) |
In Person Visit (# responses) |
Group Collaboration/Planning (# responses) |
Client Satisfaction Survey Results |
The following 4 questions come from the standardized Client Satisfaction Questionnaire – CSQ-8 and ratings are on a 4 point scale) |
How would you rate the quality of service you received – Excellent, Good, Fair, Poor (# respondents, average rating) |
If a colleague were in need of similar help, would you recommend our program to him or her – No, definitely not, No, I don’t think so, Yes, I think so, Yes definitely (# respondents, average rating) |
In an overall, general sense, how satisfied are you with the services you have received – Very satisfied, Mostly satisfied, Indifferent or mildly dissatisfied, Quite dissatisfied (# respondents, average rating) |
If you were to seek help again, would you come back to our program – No, definitely not, No, I don’t think so, Yes, I think so, Yes, definitely (# respondents, average rating) |
Tools/Materials/Resources (# developed, # distributed) |
New telehealth sites or services developed |
Number of new telehealth sites established as a result of TRC TA |
Number of new telehealth services initiated as a result of TRC TA |
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Windows User |
| File Modified | 0000-00-00 |
| File Created | 2021-01-24 |