Survey of Healthcare Experiences of Patients (SHEP)

ICR 202102-2900-017

OMB: 2900-0712

Federal Form Document

IC Document Collections
ICR Details
2900-0712 202102-2900-017
Received in OIRA 201710-2900-010
VA 2900-0712
Survey of Healthcare Experiences of Patients (SHEP)
Reinstatement with change of a previously approved collection   No
Regular 11/08/2021
  Requested Previously Approved
36 Months From Approved
658,920 0
137,415 0
0 0

The overall purpose of the VHA Office of Quality and Performance Survey of Health Experience of Patients (SHEP) Survey Program is to systematically obtain information from patients that can be used to identify problems or complaints that need attention and to improve the quality of health care services delivered to Veterans. Information obtained from the SHEP Program is one component of a larger Network Directors Performance Agreement system in VHA that culminates in the annual Network Performance Report. Results of each of the customer satisfaction surveys are made readily available to VA Central Office (VACO), Veterans Integrated Service Network (VISN), VHA field staff, and stakeholders as part of the Network Performance Report and via the VA Intranet. Data is used to demonstrate that VA is providing timely, high quality health care services to patients and to measure improvement toward the goal of matching or exceeding the non-VA external benchmark performance.

EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None

Not associated with rulemaking

  86 FR 17891 04/06/2021
86 FR 33014 06/23/2021
No

1
IC Title Form No. Form Name
SHEP - Nationwide Customer Satisfaction Surveys VA Form 10-1465-2, VA Form 10-1465-7, VA Form 10-1465-5, VA Form 10-1465-8, VA Form 10-1465-10, VA Form 10-1465-9, VA Form 10-1465-1, VA Form10-1465-3, VA Form 10-1465-4, VA Form 10-1465-6, VA Form 10-1465-11 SHEP Inpatient Short Form ,   SHEP Patient Centered Medical Homes (PCMH) Short Form ,   SHEP Home Healthcare CAHPS Long Form ,   SHEP In-Center Hemodialysis (ICHemo) Long Form ,   SHEP Specialty Care Survey ,   SHEP VA Community Care ,   SHEP Recent Visit Survey ,   SHEP Inpatient Long Form ,   SHEP Ambulatory Care Long Form ,   SHEP Ambulatory Care Short Form ,   SHEP PCMH Ambulatory CareLong Form

  Total Request 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 658,920 0 0 -135,480 0 794,400
Annual Time Burden (Hours) 137,415 0 0 -39,225 0 176,640
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Historical data has enabled the program office to provide more accurate burden numbers for the SHEP surveys.

$12,500,000
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/08/2021


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