Attachment K: Clinical Outcomes Data for Surgical Services

The AHRQ Safety Program for Methicillin-Resistant Staphylococcus aureus (MRSA) Prevention

Documents and Forms

Document Name Document Type
Form 10 Attachment K: Clinical Outcomes Data for Surgical Services Form and Instruction
10 Attachment K: Clinical Outcomes Data for Surgical Servic Att K Clinical Outcomes Data for Surgical Services.docx Form and Instruction
10 Attachment K: Clinical Outcomes Data for Surgical Servic Att K Clinical Outcomes Data for Surgical Services.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Attachment K: Clinical Outcomes Data for Surgical Services	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10	Attachment K: Clinical Outcomes Data for Surgical Services	Att K Clinical Outcomes Data for Surgical Services.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50	30	20
Annual IC Time Burden (Hours)	50	40	10
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.