Building Diagnostic Safety Capacity – TeamSTEPPS® Course Evaluation

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0935-0179

IC ID: 244358

Documents and Forms

Document Name Document Type
Form 1 Building Diagnostic Safety Capacity – TeamSTEPPS® Course Evaluation Form and Instruction
1 Appendix A: Setting Demographics Survey Appendix A_final cg 11 12 20.docx Form and Instruction
1 Appendix A: Setting Demographics Survey Appendix A_final cg 11 12 20.docx Form and Instruction
2 Appendix B: Individual Respondent Characteristics (Provi Appendix B_final_v2 cg 11 12 20.docx Form
2 Appendix B: Individual Respondent Characteristics (Provi Appendix B_final_v2 cg 11 12 20.docx Form
3 Appendix C: Individual Respondent Characteristics (Staff Appendix C_final_v2 cg 11 12 20.docx Form and Instruction
3 Appendix C: Individual Respondent Characteristics (Staff Appendix C_final_v2 cg 11 12 20.docx Form and Instruction
4 Appendix D: Individual Respondent Characteristics (Admin Appendix D_final_v2 cg 11 12 20.docx Form and Instruction
4 Appendix D: Individual Respondent Characteristics (Admin Appendix D_final_v2 cg 11 12 20.docx Form and Instruction
5 Appendix E: Organizational Readiness for Implementation Appendix E.docx Form and Instruction
5 Appendix E: Organizational Readiness for Implementation Appendix E.docx Form and Instruction
6 Appendix F: Pilot Test Interview Protocol for Providers Appendix F.docx Form and Instruction
6 Appendix F: Pilot Test Interview Protocol for Providers Appendix F.docx Form and Instruction
7 Appendix G: Pilot Test Interview Protocol for Providers Appendix F.docx Form and Instruction
7 Appendix G: Pilot Test Interview Protocol for Providers Appendix F.docx Form and Instruction
8 Appendix H: Pilot Test Evaluation Protocol for Staff – T Appendix H.docx Form and Instruction
8 Appendix H: Pilot Test Evaluation Protocol for Staff – T Appendix H.docx Form and Instruction
9 Appendix I: Pilot Test Evaluation Protocol for Staff – N Appendix I.docx Form and Instruction
9 Appendix I: Pilot Test Evaluation Protocol for Staff – N Appendix I.docx Form and Instruction
10 Appendix J: Pilot Test Evaluation Protocol for Administr Appendix J.docx Form and Instruction
10 Appendix J: Pilot Test Evaluation Protocol for Administr Appendix J.docx Form and Instruction
11 Appendix K: Pilot Test Evaluation Protocol for Administr Appendix K.docx Form and Instruction
11 Appendix K: Pilot Test Evaluation Protocol for Administr Appendix K.docx Form and Instruction
12 Appendix L: Training Observation Tool Appendix L.docx Form and Instruction
12 Appendix L: Training Observation Tool Appendix L.docx Form and Instruction
OMB Cover Letter.docx Cover Letter IC Document
OMB Cover Letter.docx Cover Letter IC Document
Supporting Statement Part A.docx Supporting Statement IC Document
Supporting Statement Part A.docx Supporting Statement IC Document