CDC NHSN C. Diff Reporting, Nursing Home Focus Group Survey

Please complete the survey below to indicate your facility's availability.

Your facility is being invited to Participate in a Focus Group Session exploring a new approach to reduce the burden of reporting Healthcare-Associated Infections (HAIs) to the Centers for Disease Control and Prevention’s (CDC), National Healthcare Safety Network (NHSN).

Note that all answers provided will be kept confidential, will only be accessible by the Arbor Research team, and will only be used for the purposes of scheduling the feedback session.

If you have any questions regarding the survey or the session, please contact Michelle Maxim, Project Manager, at Michelle.Maxim@ArborResearch.org.

Thank you!

1.Please provide the name of your facility:(Required.)

2.Please provide the EHR vendor your facility uses:(Required.)

3.Please indicate which Focus Group session(s) your facility can attend:(Required.)

Wednesday, May 10: 12:30pm-2:00pm Eastern | 11:30am-1:00pm Central | 10:30am-12:00pm Mountain | 9:30am-11:00am Pacific

Thursday, May 11: 11:00am-12:30pm Eastern | 10:00am-11:30am Central | 9:00am-10:30am Mountain | 8:00am-9:30am Pacific

Thursday, May 11: 3:00-4:30pm Eastern | 2:00pm-3:30pm Central | 1:00pm-2:30pm Mountain | 12:00pm-1:30pm Pacific

Tuesday, May 16: 12:30-2:00pm Eastern | 11:30am-1:00pm Central | 10:30am-12:00pm Mountain | 9:30am-11:00am Pacific

Wednesday, May 17: 1:30pm-3:00pm Eastern | 12:30pm-2:00pm Central | 11:30am-1:00pm Mountain | 10:30am-12:00pm Pacific

None of these times work but I would like to be included in a future session.

4.Please provide your contact information:(Required.)

Name:

Title:

Email address:

Phone number:

5.Please list your nursing home chain (if applicable):