Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Learning Collaborative QI Measures – develop system New 24 480 0 Other-Quality Improvement Measures
. Learning Collaborative QI Measures – pull and submit New 96 480 0 Other-Quality Improvement Measures
Attachment D: Learning Collaborative Staff Interview New 96 48 0 Form and Instruction 4
Attachment E: Learning Collaborative Self-Assessment New 24 6 0 Form and Instruction 5
Learning Collaborative Clinical - Staff Survey New 720 240 0 Form and Instruction 2
Learning Collaborative QI Champion Interview (Attachment C) New 72 36 0 Form and Instruction 3
Survey of Primary Care Clinicians about Opioid Use among Older Adults New 1500 375 0 Form and Instruction 1
Total burden requested under this ICR: 2532 1665 0  
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