T ITLE OF NHLBI’s Health Information Center (HIC):
PURPOSE:
Executive Order 13571 charges agencies that serve the public to streamline service delivery and improve customer service. The National Heart, Lung, and Blood Institute (NHLBI) intends to address this charge through the development and implementation of a customer satisfaction survey that will be distributed through the NHLBI’s Health Information Center (HIC). The HIC serves the public by responding to health information inquiries through multiple channels, including phone, email, mail, fax, and Live Chat. The purpose of the planned customer satisfaction survey is to: (1) assess customer satisfaction with current NHLBI services, (2) collect customer feedback on NHLBI’s online and printed health information and (3) gather actionable data on customer content needs, options for digital publication delivery, and ways to improve the services.
DESCRIPTION OF RESPONDENTS:
Customers who contact the NHLBI HIC by phone will be invited to take a five-question survey at the end of the call using an interactive voice response (IVR) system. At the end of each phone inquiry, the information specialist will ask the customer whether they are interested in participating in a survey and, if they reply ‘Yes’, they will be transferred to the IVR system to take the survey.
Other customers who have contacted the HIC by any mode of inquiry except the telephone (email, mail, or Live Chat) or have ordered NHLBI publications through the Online Catalog, will be provided the same chance to take the survey, but in these instances, the customer will be invited to take the survey through a Web-based form instead of the IVR option.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey
[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group
[ ] Focus Group [ ] Other: ______________________
CERTIFICATION:
I certify the following to be true:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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: Mauricio Medina, Contracting Officer’s Representative
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ ] Yes [X] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No
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
ESTIMATED BURDEN HOURS and COSTS
Category of Respondent |
No. of Respondents |
No. of Responses per Respondent |
Time per Response (in hours) |
Total Burden Hours |
Individual customers who contact the NHLBI HIC by telephone |
130 |
5 |
2/60 |
22 |
Individual customers who contact the NHLBI HIC using other methods of communication (email, mail, Online Catalog) |
1,125 |
18 |
4/60 |
1,350 |
Totals |
1255 |
20,900 |
|
1,372 |
FEDERAL COST: The estimated annual cost to the Federal government is __$2,000_______
Staff |
Grade/Step |
Salary |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Medical Officer |
AD/00/10 |
200,000 |
1% |
|
2,000 |
|
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Contractor Cost |
|
|
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|
|
Project Manager |
N/A |
|
5% |
|
|
Travel |
|
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|
N/A |
Other Cost |
|
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N/A |
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Total |
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|
2,000 |
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
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? [ ] Yes [X] 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?
Administration of the Instrument
How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[X] Telephone
[X] In-person
[ ] Other, Explain
Will interviewers or facilitators be used? [X] Yes [ ] No
Please make sure that all instruments, instructions, and scripts are submitted with the request.
File Type | application/msword |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
Last Modified By | Abdelmouti, Tawanda (NIH/OD) [E] |
File Modified | 2016-06-14 |
File Created | 2016-06-14 |