Assessing the Impact of the National Implementation of TeamSTEPPS Master Training Program

Forms and Documents

Document Name	Status
Form 1 Training participant questionnaire Form and Instruction	Modified
Form 2 Semi-structured interview Form and Instruction	Modified
Supporting Statement Part B -v2.docx Supporting Statement B	2014-03-20
Attachment G -- 30 day FRN.pdf Supplementary Document	2014-03-20
ATTACHMENT B--Logic Model of Post-TeamSTEPPS Master Training Patient Safety Activities and Outcomes by Participant Role-v2.docx Supplementary Document	2014-03-20
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document	2014-03-20
ATTACHMENT F -- AHRQ NITS Informed Consent Form.docx Supplementary Document	2010-07-09
ATTACHMENT D -- Advance notice invitation reminder notices and thank you letters for training participant questionnaire-v2.docx Supplementary Document	2014-03-20
ATTACHMENT F -- AHRQ NITS Informed Consent Form-v2.docx Supplementary Document	2014-03-20
Supporting Statement Part A - Assessing the Impact of the TeamSTEPPS Revised.docx Supporting Statement A	2014-05-22

IC Document Collections

IC ID	Document Title	Status
193967	Training participant questionnaire Form and Instruction	Modified
193966	Semi-structured interview Form and Instruction	Modified

ICR Details

OMB Control No: 0935-0170	ICR Reference No: 201403-0935-002
Status: Historical Active	Previous ICR Reference No: 201007-0935-003
Agency/Subagency: HHS/AHRQ	Agency Tracking No: 21620
Title: Assessing the Impact of the National Implementation of TeamSTEPPS Master Training Program
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/03/2014
	Date Received in OIRA: 03/28/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2015	12 Months From Approved
Responses	2,481	0	0
Time Burden (Hours)	881	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Implementation of TeamSTEPPS program represents a new approach to team training for AHRQ. This program focused on disseminating teamwork, communication, and patient safety information, building skill sets, and ultimately fostering a national network of individuals who support and promote the adoption of TeamSTEPPS. To meet the objective of creating a national infrastructure, AHRQ first required that each organization's application include a readiness assessment and a letter of endorsement and support from each team member's Chief Executive Officer (CEO) or equivalent regarding the organization's participation in the program. In addition, participants were selected, in part, on the expectation that they would later disseminate their newly acquired knowledge and skills to others in their home organizations or in other organizations locally, regionally, or state-wide. The program involved training teams of participants, led by representatives from either Quality Improvement Organizations (QIOs) or members of individual hospitals or healthcare systems. As a result of the time and commitment invested over the three years of program implementation, AHRQ seeks to learn the extent to which they have succeeded in spreading TeamSTEPPS and forming the requisite infrastructure to support on-going and future patient safety efforts.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 52928	08/27/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 9212	02/18/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Semi-structured interview	2	Semi-structured interview guide
Training participant questionnaire	1	Training participant questionnaire

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,481	0	0	0	0	2,481
Annual Time Burden (Hours)	881	0	0	0	0	881
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $181,521

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/28/2014

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