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Request for Approval under the “Fast Track Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0704-0553)

T ITLE OF INFORMATION COLLECTION: Enterprise Blood Management System – Donor Post Implementation Review

PURPOSE: The purpose of this survey is to capture end user satisfaction of the Enterprise Blood Management System – Donor formerly known as BDMS and complete the Post Implementation Review.

The post implementation review (PIR) will report the degree to which doctrine, organization, training, materiel, leadership and education, personnel, facilities, and policy changes have achieved the established measures of effectiveness for the desired capability; evaluate systems to ensure positive return on investment and decide whether continuation, modification, or termination of the systems is necessary to meet mission requirements; and document lessons learned from the PIR.

The purpose of this PIR plan is to support the EBM-D, Full Deployment (FD) in accordance with the Interim DoD Instruction 5000.02, Enclosure 11, and the Defense Acquisition Guidebook (DAG). The outcome of the PIR will be a report that will determine whether the delivered product meets the business need and how shortfalls may be mitigated

DESCRIPTION OF RESPONDENTS: The respondents will be EBMS-D end users (Active Duty Military, Civilian and Contractors) familiar with the EBMS-D system and the DOD’s processes for collecting and manufacturing blood components.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Frank Harold Bradt

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ X ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ X ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals	400	15 Mins	100
Totals	400	15 Min	100

FEDERAL COST: There is no cost to the Federal government.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

Attached is the PIR Plan for EBMS-D.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ X ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X ] No

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