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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0935-0115	ICR Reference No: 200212-0935-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Pilot Data for the Development of Hospital Patient Safety Culture Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/04/2003
	Date Received in OIRA: 12/04/2002
Terms of Clearance: Approved for use through 1/2004 under the conditions that: 1) AHRQ adds one or more for profit hospitals to the pilot sample; AHRQ considers conducting a more extensive pilot with a larger sample before finalizing this instrument; and 3) prior to pilot- ing this survey AHRQ consults extensively with the provider community and reports to OMB on the results of these consultations.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2004	01/31/2004
Responses	900	0	0
Time Burden (Hours)	300	0	0
Cost Burden (Dollars)	50,000,000	0	0

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