Cover Letter

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Questionnaire and Data Collection Testing, Evaluation, and Research for the Agency for Healthcare Research and Quality

Cover Letter

OMB: 0935-0124

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SUBMISSION OF INFORMATION COLLECTION UNDER THE

Request for Approval under AHRQ’s Generic Clearance “Questionnaire and Data Collection Testing, Evaluation, and Research for the Agency for Healthcare Research and Quality” (OMB Control Number: 0935-0124)


DATE OF REQUEST: 02/01/2022


SUB AGENCY (I/C): HHS/AHRQ


TITLE: Pilot Test of the Proposed Workplace Safety Supplemental Item Set

For the AHRQ Surveys on Patient Safety Culture™ (SOPS®) Nursing Home Survey


GENERIC CLEARANCE UNDER OMB#: 0935-0124 EXP. DATE: 01/31/2024


ABSTRACT: In November 2021, AHRQ released a supplemental item set on workplace safety for the hospital setting. Now there is interest in developing a reliable, public-use item set that is limited in scope so it can be used in conjunction with the AHRQ SOPS Nursing Home Survey. The goal is to develop 15-20 items across 5-6 composite measures rather than developing a full-length survey.


The supplemental item set will be used by nursing homes to enable them to assess the organizational culture factors that contribute to workplace safety, and help them identify strengths and areas for improvement to efficiently target resources to improve workplace safety.

Most existing surveys on workplace safety focus on organizational, management, and provider and staff compliance with regulations, and are more like safety checklists. There is currently a dearth of validated survey items focusing on provider and staff perspectives about aspects of organizational culture that support workplace safety. We have been unable to find instruments that address workplace safety for the nursing home setting, in one, brief instrument, development of which is the objective of this research.


TOTAL ANNUAL BURDEN APPROVED: 8,900.


BURDEN USED TO DATE: 800.


BURDEN THIS REQUEST: 1,431 hours.


FEDERAL COST: ____$21,570______________________.


IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ___X___ NO ______ 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

__ _X__ MAIL RESPONSE [email]

____ IN PERSON INTERVIEW

_____ OTHER: ___________________________________


CONTACT INFORMATION:

NAME: ___________Erwin Brown_____________________

TELEPHONE NUMBER: 301.427.1652______________________

EMAIL ADDRESS: ebrown@ahrq.gov______________________

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Form - 04/28/2008
SubjectGeneric Clearance Form - 04/28/2008
AuthorOD/USER
File Modified0000-00-00
File Created2024-07-28

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