Environmental Scan for Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families

Questionnaire and Data Collection Testing, Evaluation, and Research for the Agency for Healthcare Research and Quality

OMB: 0935-0124

IC ID: 219183

Documents and Forms

Document Name Document Type
Form 3 Environmental Scan for Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families Form and Instruction
2 Attachment B: Key Informant Interview Guide- In-person Attachment B Interview Guides_InPerson20151113docx.docx Form and Instruction
4 Attachment D: Interview Guide for Case Study Development Attachment D Interview Guides_Case Study_In Person 20151113docx.docx Form and Instruction
6 Attachment F: Interview Guide for Patients/Family Member Attachment F PatientsFamilyInterview Guide_In_Person 20151113.docx Form and Instruction
8 Attachment H: Interview Guide for Primary Care Practice Attachment H Interview Guide PCP StaffPhysicians_Telephone 20151113.docx Form and Instruction
1 Attachment A: Key Informant Interview Guide- Telephone Attachment A Interview Guides_Telephone 20151113docx.docx Form and Instruction
3 Attachment C: Interview Guide for Case Study Development Attachment C Interview Guides_Telephone 20151113docx.docx Form and Instruction
5 Attachment E: Interview Guide for Patients/Family Member Attachment E PatientsFamilyInterview Guide_Telephone 20151113.docx Form and Instruction
7 Attachment G: Interview Guide for Primary Care Practice Attachment G Interview Guide PCP StaffPhysicians_Telephone 20151113.docx Form and Instruction
TO3 OMB Cover Letter 20151030 Draft.doc Cover Letter IC Document
Clearance Form 20151120.docx Supporting Statement IC Document