15 Matched responses - Details

15 Matched responses - Details.docx

Survey of Eligible Users of the National Practitioner Databank

15 Matched responses - Details

OMB: 0915-0366

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OMB Number: 0915-0366; Expiration date: XX/XX/202X


Entities Survey: Module 15

Number of questions: 15


This module is relevant for only those participants who received a matched response, as indicated in Module 14.



Matched Responses in Query


Q 15.1. What type of information did your organization ever receive as a result of conducting an NPDB query (regardless of one-time or continuous query)? (Please select all that apply.)


State Licensure Action Report

Reinstatement / Restoration Report

DEA/Federal Licensure Action Report

Title IV Clinical Privileges Action Report

Health Plan Action Report

Exclusion/Debarment Action Report

Professional Society Action Report

Peer Review Organization Action Report

Accreditation Action Report

Government Administrative Action Report

Criminal Conviction Report

Deferred Conviction or Pre­-Trial Diversion Report

Nolo Contendere (No Contest) Plea Report

Civil Judgment Report

Injunction Report

Medical Malpractice Payment Report

Other (Please Explain) ________


Survey Page Break


Q 15.2. How often do your query results from the NPDB provide you with new information about practitioners that you did not obtain through other sources, including the practitioner’s application?


All the Time

Most of the Time

More than Half the Time

About Half the Time

Less than Half the Time

Rarely

Never

Not Applicable

Other (Please Explain) _________


If participants respond, “never” or “not applicable” or “other” above, skip the next question.


Q 15.3. What kinds of reports has your organization received which contained new information that it had not obtained through other sources (e.g., employment application of practitioners, query response from the FSMB, response to requests for information from previous work sites, etc.)? (Please select all that apply.)


State Licensure Action Report

Reinstatement / Restoration Report

DEA/Federal Licensure Action Report

Title IV Clinical Privileges Action Report

Health Plan Action Report

Exclusion/Debarment Action Report

Professional Society Action Report

Peer Review Organization Action Report

Accreditation Action Report

Government Administrative Action Report

Criminal Conviction Report

Deferred Conviction or Pre­-Trial Diversion Report

Nolo Contendere (No Contest) Plea Report

Civil Judgment Report

Injunction Report

Medical Malpractice Payment Report

Other (Please Explain) _________



Q 15.4. What types of actions does your organization take when a query response contains adverse action reports, judgment or conviction reports, or medical malpractice payment reports on practitioners at your facility? (Please select all that apply.)


Initiate an Informal Investigation

Seek Additional Information

Conduct a Formal Peer Review

File Information for Scheduled Review

No Action Is Taken

Unknown

Not Applicable

Other (Please Explain) ________


Survey Page Break


Q 15.5. Which of the following decisions are affected by the information provided by the

NPDB? (Please select all that apply.)


Hiring of Staff

Firing of Staff

Credentialing

Monitoring

Proctoring

Granting Clinical Privileges

Licensing

Certification

Membership

Disciplinary Actions

Non­-Disciplinary Actions

Not Applicable

Other (Please Explain) _______


Q 15.6. Would your decisions (selected in the previous question) regarding practitioner(s) have been different if you had not received the NPDB response?


Yes

No

Other (Please Explain) _________


If the response is “yes”, continue to next question, otherwise skip the next question.


Q 15.7. What percent of your decisions regarding practitioners would have been different if you had not received the NPDB response?


Select a number: ___ [drop down menu of 0 to 100]


Survey Page Break


Q 15.8. For each type of report listed below, please rate its effect on your organizations decision to offer employment, credentialing, licensing, certification, or granting of clinical privileges if the practitioner had such a report in the NPDB. (Only one answer per row.)


Rating Scale

Neutral / Slightly Negative / Somewhat Negative / Moderately Negative / Extremely Negative


State Licensure Action Report

Reinstatement / Restoration Report

DEA/Federal Licensure Action Report

Title IV Clinical Privileges Action Report

Health Plan Action Report

Exclusion/Debarment Action Report

Professional Society Action Report

Peer Review Organization Action Report

Accreditation Action Report

Government Administrative Action Report

Criminal Conviction Report

Deferred Conviction or Pre­-Trial Diversion Report

Nolo Contendere (No Contest) Plea Report

Civil Judgment Report

Injunction Report

Medical Malpractice Payment Report

Other (Please Explain) __________


Survey Page Break


Q 15.9. How often does your organization contact the original reporters for additional information when it receives reports resulting from querying the NPDB?


All the Time

Most of the Time

More than Half the Time

About Half the Time

Less than Half the Time

Rarely

Never

Not Applicable

Other (Please Explain)


Survey Page Break


Q 15.10. How often does information from the NPDB lead to further investigation into additional sources of information?


All the Time

Most of the Time

More than Half the Time

About Half the Time

Less than Half the Time

Rarely

Never

Not Applicable

Other (Please Explain) ___________


Q 15.11. Information received from the NPDB makes my organization confident about the decisions it makes concerning practitioners.


Rating Scale

Completely Agree / Agree / Neither Agree or Disagree / Disagree / Completely Disagree


Survey Page Break


Q 15.12. About how many times in the last 3 years did you receive a response regarding a practitioner other than the one on whom you attempted to query in the NPDB (e.g., a “mismatch”)? Select a number below. If you have never received such responses to your queries, select zero.


Select a number: ___ [drop down menu of 0 to 10]


If the response is 0 (zero), skip the next question.


Q 15.13. The last time this happened, what action did you take? (Select all that apply.)


None

Inform the NPDB

Obtained additional identification information and re-queried

Other (please explain) ____________


Survey Page Break


Q 15.14. About how many times in the last 3 years did you receive a non-response to a query from the NPDB (e.g., you were expecting a report but there was no disclosure of any report)? Select a number below. If you have never received such responses to your queries, select zero.


Select a number: ___ [drop down menu of 0 to 10]


If the response is 0 (zero), skip the next question and end this module.


Q 15.15. What does your organization do in the event of a non-response to a query (e.g., you were expecting a report but there was no disclosure of any report)? (Select all that apply.)


Nothing

Inform the NPDB

Obtained additional identification information and re-query

Other (please explain) ____________



Piping Logic:


Survey will be directed to Module 16 next.


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