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VALIDATION PILOT FOR THE AHRQ PATIENT SAFETY INDICATORS PHASE II
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #1 Yes Yes Fillable Fileable
Form Form #3 No No Paper Only
Form and Instruction Form #2 No No Paper Only
Form Form #4 No No Paper Only
Form Form #5 No No Paper Only
Form Form #6 No No Paper Only
Form Form #7 No No Paper Only

Health Consumer Health and Safety

 

320 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,700 0 0 0 0 0
Annual IC Time Burden (Hours) 2,845 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Part A -- Phase II PSI Validation 6-27-2008 06/27/2008
Supporting Statement Part B -- Phase II PSI Validation 6-19-2008 06/27/2008
Attachment I -- Training manual 06/27/2008
Attachment B -- Phase I Participant Survey 06/27/2008
Attachment C1--Instructions for foreign body left during procedure abstraction tool 06/27/2008
Attachment D1 -- Instructions for postoperative hemorrhage or hematoma abstraction tool 06/27/2008
Attachment E1 -- Instructions for postoperative physiologic & metabolic derangement abstraction 06/27/2008
Attachment F1 -- Instructions for postoperative respiratory failure abstraction tool 06/27/2008
Attachment G1 -- Instructions for postoperative wound dehiscence abstraction tool 06/27/2008
memocoverletter 06/27/2008
Revised Supporting Statement Part A 11/17/2008
AHRQ memo 11-10-08 11/17/2008
terms of clearance: PSI pilot phase II 11/17/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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