Cover Letter

SUBMISSION OF INFORMATION COLLECTION UNDER THE

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

DATE OF REQUEST: August 30, 2016

SUB AGENCY (I/C): HHS/AHRQ

TITLE: Stakeholder Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Program

Practice Center (EPC) Division

GENERIC CLEARANCE UNDER OMB#: 0925-0179 EXP. DATE: 11/30/2017

ABSTRACT:

The mission of the EPC program is to create reports that improve healthcare by supporting evidence-based decision making by patients, providers, and policymakers. To ensure that our reports answer the questions that are important to these stakeholders and to facilitate dissemination of our reports, we notify stakeholders at several key points during the systematic review development process. When we are beginning a systematic review, we identify stakeholders who may be interested in the topic. We then notify them via email to let them know we have started working on a topic, when there are opportunities for public comment, and when the review is complete. We want to learn more about their experiences receiving these updates and how we can improve their experiences.

Respondents will be invited to take a brief survey via email. The survey will not collect or store any personally identifiable information from the respondent; it will only collect the name of the systematic review, the organization the respondent is from, and the survey responses.

Organizations that download MONAHRQ and generate reports to help improve health care are referred to as “Host Users.” The Future of MONAHRQ Survey 2014 will be accessible to current and prospective Host Users. Examples of Host Users include: state agencies, public health departments, hospital associations, hospital systems, and individual hospitals, multi-stakeholder alliances and coalitions, Quality Improvement Organizations (QIOs), and health plans.

TOTAL ANNUAL BURDEN APPROVED: 3,383 Hours Per year

BURDEN USED TO DATE: 404 hours.

BURDEN THIS REQUEST: 100 hours.

FEDERAL COST: The estimated annual cost to the Federal government is $5,500_____.

IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ______ NO _____x_ N/A

OBLIGATION TO RESPOND:

___x___ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

______ MANDATORY

HOW WILL THIS SURVEY BE OFFERED?

___x_ WEB SITE

____ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

_____ IN PERSON INTERVIEW

_____ OTHER: ___________________________________

CONTACT INFORMATION:

NAME: _Erwin Brown______________________________

TELEPHONE NUMBER: 301.427.1652________________

EMAIL ADDRESS: [email protected]________________