EFFORT SURVEY
For the time period July 1, 2016 through June 30, 2017
Remember: Effort should be updated upon any material change.
Name:
Effort Certification and Determining Percentages of Effort:REVISED 12/2016
Faculty and Staff Effort Survey Instructions

Why?
Effort Reporting is a proportional distribution of 100% of an employee's University effort across categories of activity for a stated time period. Certification of reported effort for research and cross-functional activity is required by the federal government (OMB Circular A-21), and confirmation of time allocated for physician costs is required to annually file the Hospital Cost Report.

When?
Once a year you will be asked to sign an Effort Certification Report. By doing so, you certify that percentages shown on the report are reasonable in relation to the work performed for the period indicated on the report.

Process
To provide greater detail for your activities, please complete the percentage column on the attached worksheet. Examples of activities are shown in the middle column. Specify all sponsored activity (i.e. Project/Grant Number and effective date of any changes). Date and initial document when complete.

When determining your effort for each activity, please consider the following:
• Estimate your effort for the period July 1 – June 30.
• Direct patient care and teaching associated with patient care (E.G. “teaching at the scope”) must be split based on your best judgement and department guidelines. A common ratio is 2 – 1, but your actual activity may vary.

• Effort should be updated upon any material change, which for some categories is 1% change in effort.
• Base your percentage of effort on a reasonable estimation of the time you devote to each activity.
• Exclude vacation, sick, and approved consulting time from your estimations.


For more information:
• Contact the Effort Reporting Task Force at effortreportingtaskforce@umich.edu
• Visit the Effort Reporting section of the Compliance Website at: http://www.med.umich.edu/u/compliance/areas/effort/index.htm

The following can be used as a guide to assist you in completing the survey:
Average Work WeekNumber of ANNUAL HOURS you would need to work in any category to reflect these percentages:
40 hours / week1%=21hrs, 2%=42hrs, 3%=62hrs, 4%=83hrs, 5%=104hrs
50 hours / week 1%=26hrs, 2%=52hrs, 3%=78hrs, 4%=104hrs, 5%=130hrs
60 hours / week 1%=31hrs, 2%=62hrs, 3%=94hrs, 4%=125hrs, 5%=156hrs



Name of Activity on Effort Certification Form Definition & Source Examples(General and Specific) Activity Percentage
of Effort
ADMINISTRATION CATEGORIES
11100
General Departmental
Administration
(Administration)
182841
Definition
Non-patient care administration.
General Examples
Committee work, budget and financial management, faculty and staff recruiting. All non-hospital / non-patient care administration related to the operations of the departmental division.
EFFORT
31103
Hospital Administration
(Faculty only)
(Administration)
279053 (M.D.)
275531 (Ph.D.)
Definition
Administration of hospital laboratories and institutional administrative functions.
Does not include medical school or University administrative functions
(See 11100 OR 31102)
1% Effort variation must be reported
General Examples
Clinical laboratory administration, Hospitals committee participation, service chief role, on-call time, indirect care, patient and physician consultation. Full list attached
EFFORT
31104
Transplant
Administration
(Administration)
290140
Definition
Pre-transplant administration relating to the identification and/or evaluation of potential organ donors and/or recipients
General Examples
Committee participation, patient group meetings, donor/recipient evaluation. PRE-TRANSPLANT activities only
EFFORT
46100
Academic Personal
Development (CME)
(Administration)
278251
Definition
Formally organized activities that provide faculty with opportunities for personal and professional growth and development (CME).
1% variation or greater is expected for clinical faculty
General Examples
CME related activities and personal development.
EFFORT
51000
Student Services Admin
(Administration)
279509
Definition
Organized administrative activities that provide assistance and support (excluding academic support) to the needs and interests of students and/or that provide central adminstrative services related to various student service activities.
General Examples
Student counseling, recruiting, planning and administration.
NOTE:
(Teaching in classrooms would fall under General Academic Instruction - 11000)
EFFORT
46000
Academic Administration
(Administration)
279508
Definition
Administration in the Dean’s Office and at the Dean level.
General Examples
Academic administration of deans, associate deans, assistant deans and related staff. Includes faculty with less than 100% effort as assistant or associate deans as long as activity is academic administration.
EFFORT
71000
Plant Operations &
Maintenance
(Administration)
287431 (M.D., Ph.D.)
Definition
All activities related to facilities planning, for medical school facilities.
General Examples
Facility management, facility planning, space surveys
EFFORT
31100
Other Institutional
Activity (Administration)
105555
Definition
Participation by faculty that is sponsored by the University or through a combination of the University and external sponsor related to professional societies.
Includes journal activities.
General Examples
In general, this includes faculty activity funded by the Hospital. Conferences, service on board of directors, editor, service for professional societies.
EFFORT
EDUCATIONAL CATEGORIES
11000
General Academic
Instruction
(Education)
182840
Definition
Teaching activities directed to undergraduate, graduate and medical students.
General Examples
This includes activities funded by the Hospital such as conferences or services for professional societies or service on a board of directors.
EFFORT
31102
Hospital Teaching
(Faculty Only)
(Education)
279052 (M.D.)
279310 (Ph.D.)
269859
(Residency & Fellowship Administration)
Definition
Administration and coordination of GME educational programs and teaching activities directed to house officers and fellows
General Examples
Includes house officer/fellow teaching during sign-out, presenting at grand rounds, preparing and conducting lectures and development of house officer/fellow education structures.
EFFORT
31107
Allied Health Teaching
(Faculty Only)
(Education)
279054 (M.D.)
279311 (Ph.D.)
Definition
Teaching of Paramedical and Allied Health Students, including nursing students.
General Examples
Allied Health teaching - teaching of paramedical and allied health students
EFFORT
CLINICAL EFFORT CATEGORIES
31101
Patient Care
275521

Note: If a billable service is rendered, effort in patient care must be reflected
Definition
Direct Patient Care.

Patient care activity should be reflected on your effort report if you have any clinical responsibilities.
General Examples
All patient care activities including notes and coding.
EFFORT
RESEARCH CATEGORIES
22000
On-Campus Organized Research (Research)
Variable Shortcodes
Definition
Research activities that are separately budgeted and accounted for.
General Examples
Sponsored research grants, or specific funds from the University for activities performed in facilities owned or leased by the University.

Please List Your Research Grants







 


EFFORT







21000
Department Research
(Research)
274451 (M.D.)
416824 (CP Ph.D.)
Variable shortcodes
Definition
Academic and scholarly activities that are not funded by a sponsored project
General Examples
Research incentives and research start-up funds. Also includes participation in study sections/grant review, grant writing/preparation, seminars/lectures if a benefit to their research, manuscript review for journal publication. (Excludes departmental administrative activities.)
EFFORT
16000
Research Training Grants
(Research)
Variable Shortcodes
Definition
Externally funded training programs.
General Examples
Pre- and post-doctoral training awards and fellowships.
EFFORT
31000
Other Sponsored Activity
(Research)
Variable Shortcodes
Definition
Activities funded by an external sponsor; i.e., consulting, independent partnership agreements, workshops.
General Examples
Funding from a sponsoring agency, within University role, but not research
EFFORT
TOTAL ALL EFFORT
(CANNOT EXCEED 100%)
 
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