2 Attachment C: Nursing Home Point of Contact (POC) Instru

Pilot Test of the Proposed Workforce Safety Supplemental Item Set for the Surveys on Patient Safety Culture™, Supporting Statement A

Attachment C: Nursing Home Point of Contact (POC) Instructions

Form Approved
OMB No. XXXX-XXXX
Exp. Date XX/XX/20XX

Draft Workforce Safety Supplemental Item Set

Nursing Home Point of Contact (POC) Instructions

1/20/2022

Public reporting burden for this collection of information is estimated to average 3 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

SOPS® Nursing Home Survey with Workforce Safety Supplemental Items

Survey Procedures for Nursing Home Points of Contact (POC):

Web Survey Administration

Westat will electronically provide you with promotional flyers and a draft letter of support that you will customize and have signed by your leadership. Please notify [insert Westat staff} If someone on your staff list no longer works in your nursing home.

WHAT YOU NEED TO DO NOW

Target Dates	Activities
Upon receipt	Disseminate promotional flyers to eligible staff on your sample list.
	Beta test the web survey URL link in your nursing home to ensure that web survey is accessible.
NEXT STEPS
Target Dates	Activities
Beginning of Week 1: Start of Survey Data Collection	Westat will distribute letters of support from your leadership to all eligible staff that are listed on your staff list. A few days later, Westat will send the web survey invitation email to all eligible staff.
Week 2	Westat will send email thank you/reminders with a web survey invitation to eligible staff that did not complete the survey.
Week 3	Westat will send 2nd email thank you/reminders with a web survey invitation to eligible staff that did not complete the survey.
Week 5	Westat will send the final email thank you/reminders with a web survey invitation to eligible staff that did not complete the survey.

Thank you for your support in promoting staff participation, as it is crucial to getting results that accurately represent your nursing home and getting 100% response! Contact [insert Westat staff], Study Manager at WorkforceSafety@westat.com or 1-855-390-2448 if you have questions.

SOPS® Nursing Home Survey with Workforce Safety Supplemental Items

Survey Procedures for Nursing Home Points of Contact (POC):

Web and Paper Survey Administration

Westat will electronically provide you with promotional flyers and a draft letter of support that you will customize and have signed by your leadership. Please notify [insert Westat staff} If someone on your staff list no longer works in your nursing home.

WHAT YOU NEED TO DO NOW

Target Dates	Activities
Upon receipt	Disseminate promotional flyers to eligible staff on your sample list.
	Beta test the web survey URL link in your nursing home to ensure that web survey is accessible. Distribute paper surveys upon receipt to staff with no email address.
NEXT STEPS
Target Dates	Activities
Beginning of Week 1: Start of Survey Data Collection	Westat will distribute letters of support from your leadership to all eligible staff that are listed on your staff list. A few days later, Westat will send the web survey invitation email to all eligible staff. Westat will send letters of support and paper surveys to POC to distribute to staff with no email address.
Week 2	Westat will send email thank you/reminders with a web survey invitation to eligible staff that did not complete the survey. Westat will send a thank you/reminder and paper surveys to POC to distribute to all staff with no email address that did not complete the survey.
Week 3	Westat will send 2nd email thank you/reminders with a web survey invitation to eligible staff that did not complete the survey. Westat will send a 2nd thank you/reminder and paper surveys to POC to distribute to all staff with no email address that did not complete the survey.
Week 5	Westat will send the final email thank you/reminders with a web survey invitation to eligible staff that did not complete the survey. Westat will send a final thank you/reminder and paper surveys to POC to distribute to all staff with no email address that did not complete the survey.

Thank you for your support in promoting staff participation, as it is crucial to getting results that accurately represent your nursing home and getting 100% response! Contact [insert Westat staff], Study Manager at WorkforceSafety@westat.com or 1-855-390-2448 if you have questions.

SOPS® Nursing Home Survey with Workforce Safety Supplemental Items

Survey Procedures for Nursing Home Points of Contact (POC):

Paper Survey Administration

Westat will electronically provide you with promotional flyers and a draft letter of support that you will customize and have signed by your leadership. Please notify [insert Westat staff} If someone on your staff list no longer works in your nursing home.

WHAT YOU NEED TO DO NOW

Target Dates	Activities
Upon receipt	Disseminate promotional flyers to eligible staff on your sample list.
	Distribute paper surveys upon receipt to staff with no email address.
NEXT STEPS
Target Dates	Activities
Beginning of Week 1: Start of Survey Data Collection	Westat will distribute letters of support from your leadership to all eligible staff that are listed on your staff list. Westat will send letters of support and paper surveys to POC to distribute to all eligible staff.
Week 2	Westat will send a thank you/reminder and paper surveys to POC to distribute to all eligible staff that did not complete the survey.
Week 3	Westat will send a 2nd thank you/reminder and paper surveys to POC to distribute to all eligible staff that did not complete the survey.
Week 5	Westat will send a final thank you/reminder and paper surveys to POC to distribute to all eligible staff that did not complete the survey.

Thank you for your support in promoting staff participation, as it is crucial to getting results that accurately represent your nursing home and getting 100% response! Contact [insert Westat staff], Study Manager at WorkforceSafety@westat.com or 1-855-390-2448 if you have questions.