SUBMISSION OF INFORMATION COLLECTION UNDER THE
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
DATE OF REQUEST: October 4, 2017
SUB AGENCY (I/C): HHS/AHRQ
TITLE: : Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division
GENERIC CLEARANCE UNDER OMB#: 0925-0179 EXP. DATE: XX/XX/20XX
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 are used, we invite
nominations from professional organizations that create guidelines
or other private or public sector organizations that need a
systematic review of the evidence on some medical question in order
to improve medical care. In order to improve how we work with these
nominators and to improve the utility of the final report, we would
like to interview a representative of each nominator (most likely
whoever worked as liaison with us during the project) about their
experience and the usefulness of the final report once the project
is completed. This information will be used to increase the
efficiency and impact of our program. 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: 0 hours.
BURDEN THIS REQUEST: 20 hours.
FEDERAL COST: The estimated annual cost to the Federal government is $1,200_____.
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?
_____ WEB SITE
___x_ TELEPHONE INTERVIEW
_____ MAIL RESPONSE
_____ IN PERSON INTERVIEW
_____ OTHER: ___________________________________
CONTACT INFORMATION:
NAME: _Erwin Brown______________________________
TELEPHONE NUMBER: 301.427.1652________________
EMAIL ADDRESS: [email protected]________________
| File Type | application/msword |
| File Title | Generic Clearance Form - 04/28/2008 |
| Subject | Generic Clearance Form - 04/28/2008 |
| Author | OD/USER |
| Last Modified By | SYSTEM |
| File Modified | 2017-11-07 |
| File Created | 2017-11-07 |