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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
3. AHRQ Patient Safety Culture Surveys:c. NHSOPS (Cohort 3)
New
8334
4167
0
Form and Instruction
3c
Attachment G: The Nursing Home Survey on Patient Safety Culture (NHSOPS)
3. AHRQ Patient Safety Culture Surveys:d. MOSOPS (Cohort 4)
New
4167
2084
0
Form and Instruction
3d
Attachment H: The Medical Office Survey on Patient Safety Culture (MOSOPS)
AHRQ Patient Safety Culture Surveys:HSOPS, NHSOPS, MOSOPS (Cohort 1)
New
166
83
0
Form and Instruction
3a
Attachment F: The Hospital Survey on Patient Safety Culture (HSOPS)
Form and Instruction
3a2
Attachment G: The Nursing Home Survey on Patient Safety Culture (NHSOPS)
Form and Instruction
3a3
Attachment H: The Medical Office Survey on Patient Safety Culture (MOSOPS)
EHR data (Cohorts 1, 2, and 3)
New
4008
4008
0
Instruction
Semi-structured qualitative interviews (Cohort 1): Other Health Practitioners
New
120
120
0
Form and Instruction
4 - b
Attachment J: Draft Interview Guide for Semi-Structured Interviews – Frontline workers
Semi-structured qualitative interviews (Cohort 1): Physicians
New
60
60
0
Form and Instruction
4 - I
Attachment I: Draft Interview Guide for Semi-Structured Interviews – Antibiotic
Structural Assessments – Cohort 4 (baseline)
New
167
33
0
Form and Instruction
b1. Structural Assessments – Cohort 4 (baseline)
Attachment B Structural Assessment for Ambulatory Care Setting
Structural Assessments – Cohorts 1, 2 and 3 (baseline, post-intervention)
New
686
137
0
Form and Instruction
a1 Structural Assessments – Cohorts 1, 2 and 3
Attachment A: Structural Assessment for Acute Care Setting
Form and Instruction
a2 Structural Assessments – Cohorts 1, 2 and 3
a2 Structural Assessments – Cohorts 1, 2 and 3
Form and Instruction
a3 Structural Assessments – Cohorts 1, 2 and 3
Attachment C: Structural Assessment for Long Term Care Setting
Team Antibiotic Review Form (Cohorts 1, 2, and 3)
New
30330
7583
0
Form and Instruction
D
Attachment D: Team Antibiotic Review Form
Form and Instruction
E
Attachment E: Completion Guide for Team Antibiotic Review Form
The AHRQ Safety Program for Improving Antibiotic Use b. HSOPS (Cohort 2)
New
8334
4167
0
Form and Instruction
3b
Attachment F: The Hospital Survey on Patient Safety Culture (HSOPS)
Total burden requested under this ICR:
56372
22442
0
To view an IC, click on IC Title