PROVIDER SATISFACTION SURVEY NARRATIVE REPORT

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APS H

EALTHCARE

, I

NC

.

S

OUTHWESTERN

PA H

EALTH

C

ARE

Q

UALITY

U

NIT

(HCQU)

P

ROVIDER

S

ATISFACTION

S

URVEY

N

ARRATIVE

R

EPORT

2003-04

APS Healthcare, Inc., SW PA HCQU provides training, technical assistance and data collection for individuals serving those with developmental disabilities in eight (8) Southwestern PA county/joinders. The SW PA HCQU shares the interests of the Office of Mental Retardation (OMR) and the Center for Medicare and Medicaid Services (CMS) in promoting quality services. An integral part of quality is provider satisfaction. The purpose of the Annual Provider Satisfaction Survey is to assess provider satisfaction with HCQU services as well as give providers an opportunity to offer suggestions for improvement. The survey results are then used to improve or expand HCQU services within its scope of practice identified by OMR and its stakeholders. According to these results, the SW PA HCQU is well received in the MR provider community. Almost all responses were noted as “agree to strongly agree”. Many providers commented on how helpful their HCQU nurse or trainings have been in the last year. Interestingly, 46% of providers who identified themselves report using HCQU trainings to meet up to 25% of the required 24 hours of Human Services training. The sincere commitment to quality and provider satisfaction by APS Healthcare is supported by these results.

METHODOLOGY:

The process began with a Provider Satisfaction Survey document reviewed and revised by the HCQU’s Quality Improvement Subcommittee. The database was revised to capture changes for reporting. A second type of report was also designed to show the mean, median and mode of responses. The 2003-04 survey was amended to assess seven (7) areas the committee deemed as critical in delivering quality services. Previously, the survey had only five (5) categories. The seven areas included:

• HCQU accessibility

• HCQU Physical/Behavioral Health Coordinator accessibility

• HCQU responsiveness to requests

• HCQU responsiveness to technical assistance

• HCQU satisfaction with the HRP process and recommendations

• HCQU interest in providing quality service

• Usefulness of HCQU materials

The word “nurse” was removed from the survey and replaced with Physical/Behavioral Health Coordinator due to the HCQU employing behavioral specialists as well as nurses in year two. An increasing volume of technical assistance requests prompted the need to measure satisfaction with this particular service. Here, the HCQU assists providers through an approach grounded in “root cause analysis”. A section to gauge satisfaction with the HRP process was added to guide improvements to that process for year three. An area was also added to capture the percentage of HCQU trainings the provider uses to meet licensing requirements for Human Services training.

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A five point Likert Scale ranging from strongly agree to strongly disagree was used to measure the responses. An area to measure overall satisfaction was provided as well as an area for comments and suggested improvements. The respondent had the option to complete fields for their name, title, organization and county. The respondent making a selection from a predetermined list captured position of the respondent and number of contacts with the HCQU. The goal of the survey was to assess provider satisfaction with the services delivered by the HCQU in its second year of operation. The HCQU in collaboration with the Quality Improvement Subcommittee will amend any areas of deficiency to improve delivery of services for year three.

RESULTS:

Two hundred fifty-six (256) surveys were mailed in May of 2004 to providers of MR Services in the eight county/joinders the HCQU serves. Another fifty (50) surveys were emailed to specific HCQU contacts identified within the provider agencies. This method was employed in year two to increase response rates. The respondents were asked to return the survey by June 23, 2004. However, surveys were accepted until June 30, 2004. Sixty-five (65) surveys were returned, eleven (11) of which were by email. This resulted in a response rate of only 21%. Ninety-four (94) surveys were returned in year one, resulting in a 37.6% response rate. In comparison, other programs within APS Healthcare have received a 45% response rate in their first year. Custom Insight indicates customer satisfaction surveys and market research surveys in the 10-30%

range.1 Custom Insight suggests sending reminders a few days before the survey

deadline. The HCQU will incorporate this suggestion into its survey process for year three.

The survey was aimed at individuals who had contact with the HCQU in the previous year. This included management staff, supports coordinators, nursing staff, county MH/MR staff, direct care staff, families and consumers. The chart below shows the most response was received from senior management, program specialists and supports coordinators and nursing staff equally. This year more training and development staff responded to the survey. This is most likely the result of the HCQU Staff establishing specific contacts within the provider agency. Survey results also revealed that over 20% of those who completed had contact with the HCQU between six to ten times, replicating last years results.

1_{CustomInsight. “Customer Satisfaction Surveys: Maximizing Survey Responses”.}_{www.customInsight.com}_. Retrieved 7-29-04.

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Position of Individual Completing Survey: 2% 22% 14% 16% 16% 8% 11% 2% 7% 2%

CEO/ED Senior Mng Prog Sp/QMRP SC Nursing Res Mng Training Vocational Mng County MH/MR Direct Care

The survey results were analyzed by category of assessment. A chart of the results is provided in the following report to provide a visual summary of the results. The Provider Satisfaction Survey Results reports are attached as Appendix A and B. The following charts are an overview of the Provider Satisfaction Survey results for 2003-2004.

Overview of Survey Results by Percentage of Responses:

0.00% 20.00% 40.00% 60.00% 80.00% 100.00% HCQU Access

Phys/Behav Access Responsive T

e

chnical _Assist HRP

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Overview of Survey Results by Median: 1 2 3 4 5 6 HCQU _Access

Phys/Behav Access Responsive Technical

Assist

HRP

Interest in Quality Materials

Key to Responses:

1=Strongly agree, 2=agree, 3=Not Sure, 4=Disagree, 5=Strongly Disagree, 6=N/A

The survey areas measured had the percent of responses noted as either strongly agree or agree combined to simplify the chart. It was difficult to measure response rates in terms as percentages due to the significant number of “N/A or not answered” responses. The Quality Improvement Plan requires a 95% rate of positive responses (agree to strongly agree) in all areas measured. This goal will be adapted to state “not more than 5% responses noting dissatisfaction (disagree to strongly disagree). Another alternative would be to use the median score of the survey results to set goals for the QI Plan. The Provider Satisfaction Report was revised to show the mean, median and mode of responses. This will also facilitate a more precise assessment of survey responses.

Overall satisfaction received 80% positive responses with 18.5% of that statement not answered. No respondent disagreed or strongly disagreed with overall satisfaction in HCQU services, 1.5% were not sure. The median response for this statement was “strongly agree”. The highest area of satisfaction was in response to the statement:

APS HCQU is accessible. Sixty-four (64) percent of respondents reported strongly

agree, and 30.8% reporting agree. A combined score of over 95% with a median of “agree” in this area reveals the HCQU is successful in establishing accessibility to those it serves. This is established through Physical/Behavioral Health Coordinator and provider staff relationships, HCQU administrative support, syllabus and special event trainings, quarterly newsletters, website “Ask A Question” and “Training Requests”. The

HCQU received the lowest overall response to the statement: “APS HCQU successfully

responds to requests for technical assistance.” Over 30% of the surveys did not have a

response indicated or responded by “N/A”. Technical Assistance requests are unique to the providers needs and generate a “root cause analysis” or “systems” approach from the HCQU in order to assist the provider in identifying training needs. Only 1.5% of the

responses noted “strongly disagree” with the statement: The HRP and APS HCQU’s

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Ironically, a discussion ensued at the June 2004 QI Subcommittee that a dialogue between the HCQU nurse and the provider will occur prior to making recommendations this HRP cycle. The purpose of this discussion will be to gather more information on training needs and to avoid recommending training that might have already been conducted. In year 3, links to community resources will become an integral part of recommendations as the HCQU works to establish capacity with those resources.

HCQU Accessibility:

Respondents were asked to respond to the following statement: APS HCQU is

accessible.

The most favorable responses were received in this area with a median of “strongly agree”. A combined response rate of 95.4% with results ranging from 64.6% noting strongly agree to 0 participants noting strongly disagree. In last year’s survey, a combined score of 90.4% where 57.4% of responses were strongly agreed and 33% of responses were agree. The HCQU offers several means of communication to providers to facilitate requesting training or technical assistance, registering for trainings or general questions. The HCQU office staff is available weekdays 8am to 5pm. Voice mail or email is used after hours. A website with links to individual office staff email and areas to ask questions, request training or register for training is available at the convenience of the user. This year, a general increase in the use of the HCQU website has occurred and there is a continued desire to make the site more user friendly. An update in December of 2003 took place which allowed for further reporting capabilities.

0.00% 20.00% 40.00% 60.00% 80.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree

HCQU Physical/Behavioral Health Coordinator Accessibility:

Each of the eight county/joinders has a designated nurse to field requests and provide technical assistance and training. In addition, two behavioral specialists cover the SW PA HCQU region. Recently, HCQU nurses within larger counties have been assigned to providers within those counties. This strengthens the provider support system. Each HCQU nurse is available by cell phone or via email. Forty-three (43) percent of respondents strongly agreed, and agreed the HCQU Staff is accessible. The HCQU has become more widely known in year two. Contrary to last year’s survey where 1% of individuals disagreed, there were no individuals who disagreed with this statement. Again the accessibility and support of the HCQU is evident.

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0.00% 10.00% 20.00% 30.00% 40.00% 50.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree Responsiveness to Requests

The HCQU receives educational requests by various means. For example: By phone, email, website or face-to-face. Requests have been made to the HCQU for Staff to participate in a particular event or forum at a provider agency. The HCQU has also received request for consult with its consulting Psychiatrist, Medical Doctor or Registered Dietitian. The goal of the HCQU remains to respond to all educational requests with in three business days. The response can vary from scheduling training, sending an information packet or media version of a presentation to informing the provider that further research is needed. A combined positive response rate of 89.2% (strongly agree and agree) was reported in this area. This area received a median score of “strongly agree”. There were no respondents who gave the rating disagree or strongly disagree. This is slightly higher than last years rate of 85%.

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree

Response to Technical Assistance

The following statement was added to the survey this year: APS HCQU successfully

responds to requests for technical assistance. Almost sixty-five (65) percent of survey

participants responded strongly agree to agree. It should be noted that over 30% of respondents did not respond or selected N/A for this statement. No respondent disagreed with this statement. Technical Assistance is a service to meet the individual needs of the provider. The HCQU uses a “root cause analysis” or systems approach to assist providers identify training needs. The SW PA HCQU does not conduct an individual case review, but rather functions to facilitate quality of care through systems level education and training.

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0.00% 10.00% 20.00% 30.00% 40.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree

The HRP and Recommendations:

Measuring the satisfaction with the HRP process and the HCQU’s recommendations was identified as a need for year two. Although HRP’s were conducted prior to Fiscal Year three-four, the first year survey did not capture this and the HCQU and QI Subcommittee deemed it necessary. A sample of HRP’s will be gathered in FY 04-05. Therefore, responses will help guide changes to the HCQU’s HRP process as needed. Favorable responses were received from 75.4% of respondents. The HRP is conducted from a random sample and the HCQU’s first year sample was limited. This is evidenced by 18.5% of respondents indicating N/A or not providing a response. It should be noted that this is the only category in which the HCQU received a strongly disagree response, 1.5%. The QI Subcommittee determined the need for a dialogue between the HCQU nurse and the provider to gather more information on training needs and to avoid recommending training that might have already been conducted. Links to community resources will become an integral part of recommendations as the HCQU works to establish capacity with those resources. The HCQU will also utilize the HRP to gain information on access to care within the dental community as it strives to build capacity. The HCQU nurses will be gathering names and zip codes of local dentists as well as sharing important information with providers on dental disease prevention.

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree

Interest in Proving Quality Services:

This category offered the statement: APS HCQU Staff shows a sincere interest in

providing quality services. This area received mirrored the second highest overall rating

at 89.2%, including those reporting they strongly agree and agree. No respondent reported they strongly disagreed or disagreed with this statement. This area also received a median score of “strongly agree”. Last year this area was the highest with a combined score of 91.5%. There were 7.7% of surveys without a response to this

statement, and 3.1% responded as “not sure”. Four individuals commented they have

not used the HCQU. One individual commented, “...hope to utilize this service more in years to come.” Another individual commented that they frequently refer individuals to

the HCQU. The HCQU continues to hold quality as the core to all of its functions and

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0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree Usefulness of Materials

The HCQU offers various forms of educational resources to providers. The survey assessed overall satisfaction with HCQU materials and then asked the respondent to check which resource they feel as useful. Over a quarter of all respondents (27.7%) strongly agreed APS HCQU materials are useful and 43.1% of respondents agreed these materials are useful. Although last years satisfaction was higher with almost half of respondents indicating they strongly agreed; no respondent disagreed. However the median for this category was “strongly agree”.

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% Strongly Agree Agree Not Sure Disagree Stronly Disagree

The materials or resources offered by the HCQU include: Information packets, training materials/handouts, training syllabus, website, newsletter and HCQU doctor consults. 78.5% of respondents feel the training materials/handouts are most useful. This is close to last year’s result of 74.5%. The training syllabus was rated by 58.5% as most useful. According to last year’s survey, least useful was the provider manual (11.7%), which was not reprinted in year two. The HCQU developed a Training Catalog in September of 2003. It was well received by the provider community, and serves as an excellent resource to select trainings from. The 2004 edition is currently being redesigned to further facilitate ease and readability. It will be included as part of next years options for usefulness of materials. The HCQU also plans to engage in more consumer focused trainings and more advanced level trainings in year three.

Usefulness of Materials 60.00% 78.50% 58.50% 44.60% 33.80% 9.20% _{Information Packets} Training Materials Training Syllabus Website Newsletter

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Overall Satisfaction:

The HCQU received 80% of positive responses from participants for overall satisfaction. There were 46.2% of respondents who strongly agreed and 33.8% who agreed they were satisfied with services from the HCQU. A median of “strongly agree” was noted in this category. No respondents disagreed or strongly disagreed with this statement. However, 18.5% of respondents did not provide a response or indicated N/A. In last year’s survey, an individual did strongly disagree with overall satisfaction.

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% Strongly Agree Agree Not Sure Disagree Strongly Disagree

County of Individual Completing Survey:

The SW PA HCQU serves eight county/joinders throughout Southwestern PA. These county/joinders include: Allegheny, Bedford/Somerset, Cambria, Fayette, Greene, Washington and Westmoreland. Allegheny County had the most survey response, 27.7%. This county also had the largest response last year with close to 34%. However, almost 30% of returned surveys did not indicate a county. This is an optional field on the survey.

27.70% 3.10% 6.20% 6.20% 2% 7.70% 3.10% Allegheny Bedford/Somerset Cambria Fayette Greene Washington Westmoreland

Improvements Suggested from Respondents

Twenty-four (24) of the sixty-five (65) surveys returned had commented in this optional area of the survey. The focus of suggestions remains on training activities. This relates to training being the method in which most providers have contact with the HCQU. Comments ranged from praising a particular nurse, highlighting a special event to suggesting HCQU perform regulatory trainings such as CPR.

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Several comments were complimentary noting: “I am exceptional pleased….”, “This

resource is so viable…”, “APS has been very responsive to our needs…” The HCQU

was also commended for its increasing ability to focus training on individuals with disabilities than in year one. The HCQU continually reviews and updates its trainings based on best practice information available. The success of these efforts is revealed here. The HCQU will review each comment and incorporate changes if needed to its Quality Improvement Plan and operating systems for year three. The HCQU will also evaluate the effectiveness of the Satisfaction Survey document and method of distribution for improvements that will enhance this process for the 2004-2005-survey period.

C

OMPARISON TO

O

THER

S

URVEYS

A

SSESSING

D

EVELOPMENTAL

D

ISABILITIES

S

ERVICES

:

APS Healthcare, SW PA HCQU functions to coordinate and perform all services with a quality improvement approach. An accurate assessment of quality of services includes a comparison to other service delivery systems. A minimal amount of research was obtained due to the unique role of the HCQU. Again, The Minnesota’s Governors

Council on Disabilities Consumer Directed Community Supports Survey2 from 2002 was

used for comparison. It had an overall response rate of 27% with 93% of participants reporting overall satisfaction. The HCQU survey had a similar response rate of 21% response rate with 80% of participants reporting they strongly agreed or agreed with overall satisfaction. It should be noted that the HCQU survey had a median score of “strongly agree”. The Minnesota report was developed based on interviews from stakeholders in the program: social service managers, county fiscal managers and individuals with a developmental disability and their families. The HCQU survey was designed to capture responses from its stakeholders as well. This included management staff, supports coordinators, nursing staff, county MH/MR staff, direct care staff, families and consumers.

8-18-2004/msj

2_{Minnesota Governor’s Council on Developmental Disabilities (May 2002). “Consumer Directed Community} Supports Survey”.

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256 # OF SURVEYS RETURNED: 65 May 26, 2004 REPORTING DATE: June 30, 2004

%

APS HCQU is accessible. Strongly Agree 64.6%

Agree 30.8%

Not Sure 3.1%

Disagree 0.0%

Strongly Disagree 0.0%

N/A or not answered 1.5%

%

APS HCQU Physical/Behavioral Health Coordinators Strongly Agree 43.1%

(trainers) are accessible. Agree 43.1%

Not Sure 7.7%

Disagree 0.0%

%

APS HCQU staff members are responsive to requests. Strongly Agree 55.4%

Agree 33.8%

Not Sure 3.1%

Disagree 0.0%

%

APS HCQU successfully responds to requests for Strongly Agree 27.7%

technical assistance. Agree 36.9%

Not Sure 4.6%

Disagree 0.0%

%

The HRP and APS HCQU's recommendations are Strongly Agree 20.0%

helpful in acquiring appropriate care for consumers. Agree 55.4%

Not Sure 4.6%

Disagree 0.0%

%

APS HCQU staff shows a sincere interest in providing Strongly Agree 55.4%

quality services. Agree 33.8%

Not Sure 3.1%

Disagree 0.0%

APS HEALTHCARE SW PA HCQU - PROVIDER SATISFACTION SURVEY RESULTS FY 2003-2004

# OF SURVEYS MAILED: DATE SURVEYS MAILED:

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Not Sure 1.5%

Disagree 0.0%

N/A or not answered 27.7% %

Overall, I am satisfied with the service provided Strongly Agree 46.2%

by the APS HCQU. Agree 33.8%

Not Sure 1.5%

Disagree 0.0%

APS materials/resources # of surveys indicating usefulness % of Returned Surveys

Informational Packets 39 60.0%

Training Materials / Handouts 51 78.5%

Training Syllabus 38 58.5%

www.hcqu.apshealthcare.com 29 44.6% APS SW PA HCQU-CARES Newsletter 22 33.8% HCQU Doctor Consults for Providers 6 9.2% Position of Individuals Completing Surveys # of surveys indicating title % of Returned Surveys

CEO/Executive Director 1 1.5% Senior Management 14 21.5% Program Specialist/QMRP 9 13.8% Supports Coordinator 10 15.4% Nursing Staff 10 15.4% Residential Manager 5 7.7% Training/Staff Development 7 10.8% Vocational Manager 1 1.5% County MH/MR 4 6.2%

Direct Care Staff 1 1.5%

Family 0 0.0%

Consumer 0 0.0%

Other 2 3.1%

Not Indicated 1 1.5%

County of Individuals Completing Surveys # of surveys indicating county % of Returned Surveys

Allegheny 18 27.7% Bedford/Somerset 2 3.1% Cambria 4 6.2% Fayette 4 6.2% Greene 1 1.5% Washington 5 7.7% Westmoreland 2 3.1%

Multiple Counties within HCQU Region 0 0.0%

Other 10 15.4%

Not Indicated 19 29.2%

# of Times Individual Has Contacted HCQU # of surveys indicating contacts % of Returned Surveys

1 - 5 23 35.4%

6 - 10 13 20.0%

Over 10 9 13.8%

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Appendix B PROVIDER 24HR REQ HCQU ACCESSIBLE NURSE ACCESSIBLE HCQU RESPONSIVE HCQU TECH ASSIST RESPONSE HRP HELPFUL HCQU SINCERE MATERIALS USEFUL OVERALL SATISFACTION

[Provider Not Indicated]

26-50% 1111211 1 Achieva U p t o 2 5% 1111210 1

Allegheny East MH/MR Center

N

/A

2266666

0

Citizen Care, Inc.

N

/A

2126322

2

Emmaus Community of Pittsburgh

U p t o 2 5% 2222111 2 Family Links Not Sure 1616222 2 Not Sure 2222220 2 U p t o 2 5% 2226622 2 U p t o 2 5% 1111110 1 LifesWork of WPA 76-100% 1116111 1

Mercy Health Systems

U p t o 2 5% 1112210 1

Mon Yough Community Services, Inc.

U p t o 2 5% 1111212 0

Nisar Health & Human Services

U p t o 2 5% 1116211 1

Northern Area Multi-service Center

76-100%

1311111

1

Transitional Services, Inc.

U p t o 2 5% 1111112 1 Not Sure 2222622 2 APS SW PA HCQU

PROVIDER SATISFACTION REPORT - FY2003 - 2004

Response Key:

1=Strongly Agree 2=Agree 3=Not Sure 4=Disagree 5=Strongly Disagree 6=Does Not Apply

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Appendix B PROVIDER 24HR REQ HCQU ACCESSIBLE NURSE ACCESSIBLE HCQU RESPONSIVE HCQU TECH ASSIST RESPONSE HRP HELPFUL HCQU SINCERE MATERIALS USEFUL OVERALL SATISFACTION Verland U p t o 2 5% 1111210 1 U p t o 2 5% 3333333 3 Bedford-Somerset MH/MR 51-75% 1111111 1 76-100% 2222222 2 Cambria MH/MR U p t o 2 5% 1112212 1

Cambria Residential Services

Not Sure

1212222

2

Northwestern Human Services

U p t o 2 5% 1111111 0 UCP-Cambria N /A 2266220 0 ARC - Fayette 51-75% 1111211 1 26-50% 1221210 1

Fayette Resources, Inc.

U p t o 2 5% 1116111 0

Twin Trees, Inc.

U p t o 2 5% 1126112 2 ARC - Greene 26-50% 1016612 1 Response Key:

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Appendix B PROVIDER 24HR REQ HCQU ACCESSIBLE NURSE ACCESSIBLE HCQU RESPONSIVE HCQU TECH ASSIST RESPONSE HRP HELPFUL HCQU SINCERE MATERIALS USEFUL OVERALL SATISFACTION ARC - Washington 51-75% 1212211 2 Lifesteps, Inc. U p t o 2 5% 2222222 0 26-50% 1222111 2 U p t o 2 5% 2222222 1 Washington County MH/MR N /A 1111212 1 ARC - Westmoreland 26-50% 1116212 1 UCP-Westmoreland 26-50% 2222222 2

Not Sure

1216111

1

Allegheny East MH/MR Center

N

/A

2226622

2

Diversified Human Services (includes TAC)

76-100%

1211611

1

Family Service of Western Pennsylvania

Not Sure 2311222 1 Lifesteps, Inc. U p t o 2 5% 1212212 2 LifesWork of WPA 51-75% 1111110 1 PA Mentor N /A 2226222 2 Response Key:

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Appendix B PROVIDER 24HR REQ HCQU ACCESSIBLE NURSE ACCESSIBLE HCQU RESPONSIVE HCQU TECH ASSIST RESPONSE HRP HELPFUL HCQU SINCERE MATERIALS USEFUL OVERALL SATISFACTION

Paula Teacher & Associates

U p t o 2 5% 1222221 1

Valley Community Services

26-50%

1112212

1

Washington/Greene Alternative Residential Services

26-50%

1111212

1

N /A 1112211 0 U p t o 2 5% 1116111 1 U p t o 2 5% 1112222 0 N /A 1111010 1 N /A 1222622 1 U p t o 2 5% 2222220 2 2222212 2 N /A 2222000 0 N /A 3333330 0 U p t o 2 5% 2222260 2 Not Sure 1111221 0 U p t o 2 5% 1313510 2 76-100% 1112211 1 26-50% 1226222 2 0000000 0 Not Sure 1666666 1 26-50% 2266222 2 26-50% 2222222 2

Turtle Creek Valley MH/MR, Inc.

U p t o 2 5% 1116610 1 Response Key:

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Appendix B PROVIDER 24HR REQ HCQU ACCESSIBLE NURSE ACCESSIBLE HCQU RESPONSIVE HCQU TECH ASSIST RESPONSE HRP HELPFUL HCQU SINCERE MATERIALS USEFUL OVERALL SATISFACTION Average (Mean): 1.35385 1.70769 1.69231 2.90769 2.35385 1.60000 1.36923 1.18462 Median: 1212211 1 Mode: 1112212 1 Up to 25% 24 37% 26-50% 11 17% 51-75% 4 6% 76%-100% 5 8% Not Sure 8 12% N/A 11 17% Not Answered 2 3%

Total Number of Surveys Received:

65

Response Key: