Supporting Statement

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number:0935-0179)

TITLE OF INFORMATION COLLECTION:

Administration of “Use of Agency for Healthcare Research and Quality (AHRQ) Tools to Measure Aspects of Patient Safety” Questionnaire to AHRQ SOPS® Listserv Subscribers

PURPOSE:

The AHRQ Surveys on Patient Safety Culture™ (SOPS®) program is composed of a set of surveys designed to ask healthcare providers and other staff in hospitals, medical offices, nursing homes, community pharmacies, and ambulatory surgery centers about their perceptions of their organizational culture’s support for patient safety. AHRQ is seeking input via a brief questionnaire of multiple constituencies that are connected to, or engaged with, the SOPS program to assess their awareness of AHRQ tools that assess safer patient environment in healthcare settings. Specifically, AHRQ would like to learn whether these constituencies recognize and/or are familiar with AHRQ SOPS surveys about patient safety culture, compared to knowledge of other similar products.

The AHRQ SOPS surveys are all created using a similar development process to ensure overall quality and rigor for the varied set of SOPS surveys, which include the following five (5) surveys:

• Hospital Survey: In 2004, AHRQ released the SOPS Hospital Survey for providers and other staff to assess patient safety culture in their hospitals. Since then, hundreds of hospitals across the United States have implemented the survey. In 2019, AHRQ released a new version, the SOPS Hospital Survey 2.0.

• Medical Office Survey: This survey was designed specifically for outpatient medical office providers and other staff and asks for their opinions about the culture of patient safety in their medical offices.

• Nursing Home Survey: This survey is designed specifically for nursing home providers and other staff. It asks for their opinions about the culture of patient safety in their nursing home. The survey is not intended for use in assisted living facilities, community care facilities, or independent living facilities.

• Community Pharmacy Survey: This survey is designed specifically for community pharmacy providers and other staff and asks for their opinions about the culture of patient safety in their pharmacy.

• Ambulatory Surgery Center: This survey is designed specifically for ambulatory surgery center (ASC) staff, and asks for their opinions about the culture of patient safety in their facility. ASCs are facilities: (1) where patients have surgeries, procedures, and treatments and are not expected to need an inpatient stay, and (2) that have been certified and approved to participate in the Centers for Medicare & Medicaid Services' ASC program.

There are also other measurement tools developed by other organizations focusing on patient safety culture. AHRQ would like to have a better understanding of the level of use and awareness of these tools in addition to the SOPS® tools. This data collection activity presents an expeditious and non-invasive ways to help us understand whether the SOPS surveys are recognized and attributed to AHRQ by individuals concerned with patient safety culture assessment and measurement.

The five (5) AHRQ SOPS surveys listed above each have a listserv available for subscribed members to receive information about ongoing developments, announcements, etc., for each of the surveys. A brief seven (7) question questionnaire (Appendix A) will be administered to SOPS listserv subscribers to collect their input about patient safety culture measurement tools.

It is estimated that respondents will take approximately 8 minutes, on average, to complete the questionnaire. The information collected from listserv subscribers will be used to determine whether the AHRQ SOPS surveys are recognizable to individuals who are potential users of these tools.

DESCRIPTION OF RESPONDENTS:

Respondents will include all subscribers to the AHRQ SOPS listservs. While we do not track information about subscribers other than contact information, we expect that they include health care providers, clinical and non-clinical health care administrators, program or policy-makers, researchers, patients and advocates, among others. We expect that listserv subscribers are employed in a number of settings including university and academic settings, research organizations, clinical healthcare settings, government agencies, and healthcare associations. There exists no other comprehensive listing of users of patient safety culture measurement tools.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus Group [X] Other: Questionnaire

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: Caren Ginsberg

To assist review, please provide answers to the following question:

Personally Identifiable Information:

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

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

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

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

Category of Respondent: (the options here are Public Sector or Private Sector, or both)

Both.

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
All occupations/general population (code 00-000)	1,000	8 minutes	133hours
Totals	1,000		133 hours

FEDERAL COST: The estimated annual cost to the Federal government is $3,300

Grade	Number of Hours	Value
GS-14	60	3,000
GS-15	5	300
Total		3300.00

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

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Questionnaire respondents will comprise the entire population of listserv subscribers and be drawn from the collective set of five (5) SOPS listservs, resulting in a total de-duplicated count of 49,806 prospective respondents. The group of five (5) SOPS listservs listed below reflect duplicated enrollment counts because many subscribers are enrolled in one (1) or more SOPS listservs:

• Ambulatory Surgery Center (ASC) SOPS: 34,049

• Community Pharmacy SOPS: 34,498

• Hospital SOPS: 45,759

• Medical Office (MO) SOPS: 41,767

• Nursing Home (NH) SOPS: 41,335

• TOTAL SOPS LISTSERVS: 49,806

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

A GovDelivery email message will be sent to all unique subscribers to the collective set of five (5) SOPS listservs with an introduction to the purpose of the questionnaire, an invitation to participate and a link to the questionnaire, resulting in a total de-duplicated count of 49,806 listserv subscribers who will receive the GovDelivery message.

We will also send a series of follow up reminder emails to maximize response rates; we project that we will send a maximum of two (2) reminder email invitations to listserv subscribers. Note that no identifying information will be collected from subscribers to the SOPS listservs. Accordingly, these email invitations will be submitted to the entire population of listserv subscribers. Email invitations will include language advising listserv subscribers to please disregard the email invitation message if the subscriber has already completed the questionnaire.

Appendix A – Use of AHRQ Tools to Measure Aspects of Patient Safety Questionnaire