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

Cover Memo

OMB: 0935-0179

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SUBMISSION OF INFORMATION COLLECTION UNDER THE

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


DATE OF REQUEST: July 20, 2016


SUB AGENCY (I/C): HHS/AHRQ


TITLE: Focus Groups on TeamSTEPPS® for Long-Term Care Curriculum



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


ABSTRACT:



AHRQ requests authorization from OMB to conduct focus groups to test the TeamSTEPPS for Long-Term Care Curriculum.


The mission of TeamSTEPPS for Long-Term Care is to train long-term care providers in effective strategies and tools that can improve the communication and teamwork behaviors among themselves, and with residents and families, and enhance the quality and safety of care provided to residents of long-term care facilities.




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: 108 hours.


FEDERAL COST: The estimated annual cost to the Federal government is $188,808.00_____.


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

___x__ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

___x__ IN PERSON INTERVIEW

_____ OTHER: ___________________________________


CONTACT INFORMATION:

NAME: _Erwin Brown______________________________

TELEPHONE NUMBER: 301.427.1652________________

EMAIL ADDRESS: _ebrown@ahrq.gov________________

File Typeapplication/msword
File TitleGeneric Clearance Form - 04/28/2008
SubjectGeneric Clearance Form - 04/28/2008
AuthorOD/USER
Last Modified ByWindows User
File Modified2016-07-20
File Created2016-07-20

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