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  7. V. Agency Quality Assurance Policies, Standards and Processes for Ensuring the Quality of Information Disseminated to the Public

V. Agency Quality Assurance Policies, Standards and Processes for Ensuring the Quality of Information Disseminated to the Public

HRSA reviews the quality (including the objectivity, utility, and integrity) of information before it is disseminated and treats information quality as integral to every step of the development of information, including its creation, collection, maintenance, and dissemination.

A. Program information:

Program information provided by grantees in the form of application data, reporting requirements, performance reports, and progress reports, receives a series of reviews prior to any dissemination to the public. Grantees conduct internal reviews in order to provide data that are accurate, consistent, and complete. HRSA conducts a standard review to ensure data quality, completeness, and reliability. In addition, HRSA works closely with HHS and to ensure that HRSA grants data is provided accurately and timely to these public-facing websites.

B. Reports, publications, and other products:

HRSA communications products such as publications, audiovisual products, and exhibits are required to be consistent with government-wide and HHS public affairs policies. HRSA has published guidelines which closely follow policies provided by the Office of the Assistant Secretary for Public Affairs.

C. Statistical data disseminated to the public:

At HRSA, the quality assurance process begins at the inception of the information development process. For information disseminated from sample surveys and other research related or evaluative activities, the widely accepted standards of technical and scientific review are utilized to ensure data quality. These standards include, where appropriate, peer review, internal expert review, Institutional Review Board (IRB) review, and OMB review.

As in all research activities involving human subjects, it is HRSA's policy that adequate protection of participants be ensured in accordance with the provisions of 45 CFR Part 46. Project plans and procedures must be submitted to the appropriate IRB for approval, and the program must execute all necessary Assurances of Compliance with HHS Office of Human Research Protections (OHRP).

Further, HRSA strives to demonstrate in its PRA clearance packages that each draft information collection will result in information that will be collected, maintained, and used in a way that is consistent with OMB, HHS, and HRSA information quality guidelines.

For each of the data examples provided earlier, the following quality assurance procedures are employed:

  • Data on the website is reviewed by program staff and the Office of Federal Assistance Management to ensure grant award totals and other year-end program data are consistent and accurate. The data is stored in a centralized database which is the primary source for maps, reports, dashboards, and other tools on the website. Additionally, the Office of Information Technology provides geocoding and address standardization services to ensure locational accuracy of program sites and designated areas. Data from external sources (such as population or demographic data) are sourced from the U.S. Census Bureau or other official sources.

  • The HIV/AIDS Bureau uses CAREWare, an electronic health and social support services information system for use by HRSA’s Ryan White HIV/AIDS Program recipients and providers. The software and manual are available for download online, and the system captures all the data items required for the client-level data reports needed. CAREWare was designed to contain consistency and edit checks on inputted data for quality assurance, and to generate complete reports. Program staff review all data for verification prior to dissemination. Data are not reported when representing information on fewer than six clients.

  • The Maternal and Child Health Bureau uses a web-based application to collect State Title V MCH Program annual applications and annual reports. The system application includes built-in checks and validations to facilitate data quality and completeness. Program staff and consultants conduct reviews of the submitted application/annual reports to ensure data quality prior to dissemination to the public.

  • The quality assurance procedures for the National Survey of Children’s Health, such as the setting of Base Weights and the Adjustments for Screener and Topical Nonresponse, are described in the online supporting materials.

  • Information presented in the Grant Forecast undergoes appropriate internal review and approval by HRSA program staff to ensure accuracy, reliability, and comprehensiveness prior to dissemination to the public. HRSA adheres to all standards regarding the publication of information at as required by the HHS Grants Policy Administration Manual.

  • The Area Health Resource File provides county-level data from a variety of data sources. As a result, the data have a number of limitations and users of the file are provided with a disclaimer as to the applicability and detail of the data. The AHRF utilizes only secondary data. The years and detail for which all county-level data are available are well documented but considerably limited. Each data source conducts its own review prior to the release of information. Knowledgeable staff across HRSA conduct standard reviews for completeness and reliability of the data. The public can explore a portion of the AHRF workforce data using the dashboard developed to visualize some of the data elements by state. AHRF data can be downloaded at no cost.

  • Data from the National Sample Survey of Registered Nurses are reviewed closely by BHW staff and Census Bureau staff (the Census Bureau and BHW work together on the survey) for accuracy, weighting, imputation, and disclosure. The public use file is made available to users on the HRSA website. The restricted use file is made available only to those who meet BHW/Census guidelines for access.

  • Members of the BHW staff review workforce projections for accuracy before they are released to the public. The underlying projections methodology is reviewed annually by BHW staff, and this updated methodology is posted online annually as well.

  • Health Center Program grantees are required to report accurate, complete, and timely UDS data.

    HRSA takes several steps to support health centers in achieving this requirement, including:

    • Development of a reporting manual updated annually with detailed definitions and reporting instructions
    • In-person UDS trainings across the country in coordination with state Primary Care Associations
    • Online technical assistance and trainings
    • Year-round UDS data and technical support line
    • Electronic data edit checks and flags in the online reporting module to mitigate data entry errors
    • Comprehensive review process of all UDS submissions, including individual technical reviews and an overall outlier analysis across the aggregated data set

    HRSA’s review process helps identify potential data inconsistencies or other issues that may occur during data entry. During the UDS reporting process, health centers must resolve any issues flagged by these edit checks before final UDS submission.

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