[Federal Register Volume 77, Number 10 (Tuesday, January 17, 2012)]
[Notices]
[Page 2349]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-675]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0712]


Proposed Information Collection (Nation-wide Customer 
Satisfaction Surveys) Activity: Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA) is announcing an 
opportunity for public comment on the proposed collection of certain 
information by the agency. Under the Paperwork Reduction Act (PRA) of 
1995, Federal agencies are required to publish notice in the Federal 
Register concerning each proposed collection of information, including 
each revision of a previously approved collection, and allow 60 days 
for public comment in response to the notice. This notice solicits 
comments on information needed to identify problems or complaints in 
VA's health care services.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before March 19, 2012.

ADDRESSES: Submit written comments on the collection of information 
through the Federal Docket Management System (FDMS) at 
www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health 
Administration (10P7BFP) Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420 or email: <a href="/cdn-cgi/l/email-protection#95f6ecfbe1fdfcf4bbfdf4e7e3f0ecb8e5e7ecfae7d5e3f4bbf2fae3"><span class="__cf_email__" data-cfemail="36554f58425e5f57185e574440534f1b46444f594476405718515940">[email protected]</span></a>. 
Please refer to ``OMB Control No. 2900-0712'' in any correspondence. 
During the comment period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor at (202) 461-5870 
or FAX (202) 273-9381.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from OMB for 
each collection of information they conduct or sponsor. This request 
for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Title: Nation-wide Customer Satisfaction Surveys, VA Forms 10-1465-
2 through 10-1465-6.
    OMB Control Number: 2900-0712.
    Type of Review: Revision of a previously approved collection.
    Abstract: The Survey of Health Experience of Patients (SHEP) Survey 
is used to obtain information from VA patients that will be used to 
identify problems or compliant and to improve the quality of health 
care services delivered to veterans. Data will be use to measure 
improvement toward the goal of matching or exceeding non-VA external 
benchmark performance.
    Affected Public: Individuals or households.

Estimated Annual Burden

    a. Inpatient Short Form, VA Form 10-1465-2--18,750 hours.
    b. Ambulatory Care Long Form, VA Form 10-1465-3--9,802 hours.
    c. Ambulatory Care Short Form, VA Form 10-1465-4--42,233 hours.
    d. Clinician and Group Survey Patient Centered Medical Home, Short 
Form, VA Form 10-1465-5.--20,000 hours.
    e. Clinician and Group Survey Patient Centered Medical Home, Long 
Form, VA Form 10-1465-6--3,333 hours.

Estimated Average Burden per Respondent

    a. Inpatient Short Form, VA Form 10-1465-2--15 minutes.
    b. Ambulatory Care Long Form, VA Form 10-1465-3--25 minutes.
    c. Ambulatory Care Short Form, VA Form 10-1465-4--20 minutes.
    d. Clinician and Group Survey Patient Centered Medical Home, Short 
Form, VA Form 10-1465-5--15 minutes.
    e. Clinician and Group Survey Patient Centered Medical Home, Long 
Form, VA Form 10-1465-6--25 minutes.
    Frequency of Response: On occasion.

Estimated Number of Respondents

    a. Inpatient Short Form, VA Form 10-1465-2--75,000.
    b. Ambulatory Care Long Form, VA Form 10-1465-3--23,524.
    c. Ambulatory Care Short Form, VA Form 10-1465-4--126,700.
    d. Clinician and Group Survey Patient Centered Medical Home, Short 
Form, VA Form 10-1465-5--20,000.
    e. Clinician and Group Survey Patient Centered Medical Home, Long 
Form, VA Form 10-1465-6--3,333.

    Dated: January 11, 2012.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2012-675 Filed 1-13-12; 8:45 am]
BILLING CODE 8320-01-P


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