Agency Information Collection Activities: Proposed Collection; Comment Request, 69674-69677 [2010-28368]
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69674
Federal Register / Vol. 75, No. 219 / Monday, November 15, 2010 / Notices
Secure Communication Network (Epi–
X) OMB Control No. 0920–0636. During
this revision, we are requesting the title
be revised to read—Centers for Disease
Control and Prevention (CDC) Secure
Communications Network (Epi–X).
This IC is also being revised to
improve the effectiveness of CDC
communications with its public health
partners during public health incident
responses. Improvements include the
addition of new data collection
instruments related to six specific
public health incidents. The addition of
these instruments and the associated
increase in burden hours is required to
ensure that CDC and other Federal
agencies will have secure, timely, and
accurate information from our public
health partners. This information is
required by CDC during a public health
incident for decision making and for
effective and efficient execution of
CDC’s response activities. Public health
partners include public health officials
and agencies at the state and local level.
From 2005–2009, CDC conducted
incident specific, public health
emergency response operations on
average of four public health incidents
a year with an average emergency
response length of 48 days for each
incident. The effectiveness and
efficiency of CDC’s response to any
public health incident depends on
information at the agency’s disposal to
characterize and monitor the incident,
make timely decisions, and take
appropriate actions to prevent or reduce
the impact of the incident.
Available information during many
public health incident responses is often
incomplete, is not easily validated by
state and local health authorities, and is
sometimes conflicting. This lack of
reliable information often creates a high
level of uncertainty with potential
negative impacts on public health
response operations.
Secure communications with CDC’s
state and local public health partners is
essential to de-conflict information,
validate incident status, and establish
and maintain accurate situation
awareness. Reliable, secure
communications are essential for the
agency to, make informed decisions,
and to respond in the most appropriate
manner possible in order to minimize
the impact of an incident on the public
health of the United States.
Epi–X is CDC’s Web-based
communication system for securely
communicating during public health
emergencies that have multijurisdictional impact and implications.
Epi–X was specifically designed to
provide public health decision-makers
at the state and local levels a secure,
reliable tool for communicating
information about sensitive, unusual, or
urgent public health incidents to
neighboring jurisdictions as well as to
CDC. The system was also designed to
generate a request for epidemiologic
assistance (Epi–Aid) from CDC using a
secure, paperless environment.
Epi–X designers have developed
functionalities that permit targeting of
critical outbreak information to specific
public health authorities who can act
quickly to prevent the spread of diseases
and other emergencies in multijurisdictional settings, such as those that
could occur during an influenza
pandemic, infection of food and water
resources, and natural disasters.
CDC has recognized a need to expand
the use of Epi–X to collect specific
response related information during
public health emergencies. Authorized
Officials from state and local health
departments impacted by the public
health incident will be surveyed only by
Epi–X. Respondents will be informed of
this data collection first through an Epi–
X Facilitator, who will work closely
with Epi–X program staff to ensure that
Epi–X incident specific IC is
understood. The survey instruments
will contain specific questions relevant
to the current and ongoing public health
incident and response activities.
The Web-based tool for data
collection under Epi–X already is
established for the current IC and has
been in use since 2003. CDC will adapt
it as needed to accommodate the data
collection instruments. Respondents
will receive the survey instrument as an
official CDC e-mail, which is clearly
labeled, ‘‘Epi–X Emergency Public
Health Incident Information Request.’’
The e-mail message will be
accompanied by a link to an Epi–X
Forum discussion web page.
Respondents can provide their answers
to the survey questions by posting
information within the discussion.
There are no costs to respondents
except their time. The total estimated
annual burden hours are 24,400.
ESTIMATED ANNUALIZED BURDEN HOURS
Type of
respondent
No. of
respondents
State epidemiologists ...................................................................................................................
City and county health officials ....................................................................................................
Dated: November 4, 2010.
Carol Walker,
Acting Reports Clearance Officer, Centers for
Disease Control and Prevention.
[FR Doc. 2010–28577 Filed 11–12–10; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:
This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
SUMMARY:
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50
1600
No. of
responses per
respondent
Average burden per response
(in hours)
104
12
1
1
that the Office of Management and
Budget (OMB) approve the proposed
information collection project:
‘‘Development of the Guide to Patient
and Family Engagement in Health Care
Quality and Safety in the Hospital
Setting.’’ In accordance with the
Paperwork Reduction Act, 44 U.S.C.
3501–3520, AHRQ invites the public to
comment on this proposed information
collection.
Comments on this notice must be
received by January 14, 2011.
DATES:
Written comments should
be submitted to: Doris Lefkowitz,
ADDRESSES:
E:\FR\FM\15NON1.SGM
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Federal Register / Vol. 75, No. 219 / Monday, November 15, 2010 / Notices
Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@AHRQ.hhs.gov.
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
srobinson on DSKHWCL6B1PROD with NOTICES
Development of the Guide to Patient
and Family Engagement in Health Care
Quality and Safety in the Hospital
Setting
Improving the quality and safety of
health care in the United States is one
of the most significant challenges facing
the American health care system. Too
many Americans continue to receive
health care that is not grounded in a
reliable evidence base of what is proven
appropriate, safe, and effective.
Extensive studies conducted during
recent decades demonstrate that the
U.S. health care system provides
continuing unwarranted variation and
costly, inefficient, and simply unsafe
care. Involving patients and families in
improving quality and safety in
hospitals has the potential to improve
health care experiences, delivery, and
outcomes. AHRQ has been at the
forefront of supporting increased
involvement for patients, families, and
the public in all aspects of health care.
This project will develop a program to
help patients, families, and health
professionals in the hospital support
one another to improve quality and
safety. To accomplish these goals,
patients and families must be able to
express what they want from their
hospital care and how they want to be
involved and then effectively
communicate this information with
health professionals. Conversely, health
professionals must be able to
understand what patients want to do
and what is appropriate for them to do
and feel that they have the system
supports and tools to facilitate these
actions.
To address this issue and help fulfill
AHRQ’s mission of health care quality
improvement, AHRQ will develop a set
of interventions and materials, entitled
the Guide to Patient and Family
Engagement in Health Care Quality and
Safety in the Hospital Setting (‘‘the
Guide’’), for use by patients, their family
members, health care professionals, and
hospital leaders to foster patient and
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family engagement around the issues of
hospital safety and quality.
The goals of this project are to:
(1) Identify the barriers and
facilitators to implementing the Guide,
including how barriers were overcome;
(2) Assess staff satisfaction with the
Guide and change in staff behavior
before and after implementation of the
Guide including organizational culture
with respect to patient- and family
engagement and patient- and familycentered care;
(3) Assess patient satisfaction with the
Guide and change in patient experience
of care before and after implementation
of the Guide including patient/family
involvement in their own health care
and patient/family involvement in
quality improvement and patient safety
activities; and
(4) Refine the Guide as necessary to
improve implementation and
effectiveness.
The Guide will be tested in three
hospitals which will vary in terms of
size, location, teaching status, and
ownership.
This study is being conducted by
AHRQ through its contractor, the
American Institutes for Research (AIR),
pursuant to AHRQ’s statutory authority
to promote health care quality
improvement by conducting and
supporting research that develops and
presents scientific evidence regarding
all aspects of health care, including the
development and assessment of
methods for enhancing patient
participation in their own care and for
facilitating shared patient-physician
decision-making. 42 U.S.C. 299(b)(1)(A).
Method of Collection
To achieve the goals of this project the
following data collections will be
implemented:
(1) Semi-structured interviews will be
conducted in-person with hospital staff
and hospital leaders from each of the
participating health care facilities. Both
pre- and postimplementation interviews
will be conducted and separate
interview guides will be used for staff
and leaders. Pre-implementation, the
interviews will focus on current
knowledge, attitudes and beliefs around
patient and family engagement and on
the current organizational culture and
climate surrounding patient and family
engagement. Post-implementation,
interviews will be conducted to
understand the hospital’s experiences
implementing the Guide interventions,
including how easy or difficult the
Guide was to implement; the perceived
effects of the Guide implementation;
and the sustainability of the Guide
interventions.
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69675
(2) Collection of documentation from
each participating facility. The purpose
of this collection of documentation is to
gather documentation of the
implementation of the Guide and to
document policies and procedures
related to patient and family
engagement through a review of records
and other materials. To the extent that
it is available, the following types of
documentation will be collected:
Æ Background on organizational
structure and vision.
Æ Policies and procedures related to
Component 1 and Component 2
strategies of the Guide.
Æ Tools used to foster communication
between patients, family members and
health care team.
Æ Policies and procedures related to
patient and family engagement, patientand family-centered care, quality and
safety.
This task will consist of forwarding
emails and or photocopying and
sending documents to the project team
both pre- and post-implementation.
(3) Bi-weekly semi-structured
interviews will be conducted by
telephone with the implementation
coordinators from each participating
facility. At each hospital site, an
implementation coordinator will be
responsible for overseeing
implementation activities and serving as
a primary point-of-contact. Interviews
with these individuals will provide a
complete understanding of the Guide
implementation and the ability to track
the implementation in real time. These
interviews will occur bi-weekly for 9
months.
(4) Observation of Guide
implementation around different
activities targeted in the Guide
components. The purpose of these
observations is to directly assess how
the Guide is being implemented and to
determine which follow up questions
from the semi-structured interview
protocol should be prioritized or
removed during the in-person semistructured interviews. As such,
observations will occur postimplementation only. Observations will
be conducted by the project staff so this
data collection does not impose a
burden on the participating hospitals;
therefore it is not included in Exhibit 1.
(5) Focus groups with patients and
family members at each of the
participating sites. The purpose of these
groups is to elicit information about
patients’ and families’ experiences of
care at the hospital along with their
reactions to tools in the Guide and their
implementation. Three focus groups of
up to 8 individuals will be conducted at
each hospital post implementation. One
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Federal Register / Vol. 75, No. 219 / Monday, November 15, 2010 / Notices
focus group will be conducted with
patients only, one with family members
only and one with patients and family
members together.
(6) Staff Survey with hospital staff.
The purpose of the pre- and postimplementation Staff Survey is to assess
changes in organizational culture
related to patient safety and
engagement, and to assess significant
changes in staff knowledge, attitudes,
and behaviors. Items from the Medical
College of Georgia (MCG) Patient- and
Family-Centered Care Culture Survey
will be used in this data collection
activity. The survey items will be
supplemented with questions from
AHRQ’s Hospital Survey on Patient
Safety Culture (HSOPS) and from the
Army Medical Department Climate
Survey. At each of the three hospital
sites, it is estimated that survey
responses will be collected from at least
50 health professionals. The same
questionnaire will be used at pre- and
post-implementation.
(7) Patient Survey. The patient survey
which will be administered preimplementation and again at postimplementation will be built around the
CAHPS® Hospital Survey (HCAHPS)
domains that assess aspects of patientphysician interaction around the
hospital stay, including Communication
with Nurses, Communication with
Doctors, Communication about
Medicines, Responsiveness of Hospital
Staff, and Discharge Information. These
scales directly assess the aspects of the
hospital stay and encounters that we are
hoping the Guide will affect. Additional
questions to address any aspects of care
covered by the Guide that are not
adequately addressed by the HCAHPS
composites will also be included in this
survey. Additionally, measures from the
Patient Activation Measures (PAM)
Survey will also be included. The same
questionnaire will be used pre- and
post-implementation.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated burden
hours for the respondents’ time to
participate in this project. Semistructured interviews will be conducted
with about 4 hospital staff members
both pre- and post-implementation and
requires one hour to complete. Semistructured interviews will also be
conducted with 2 hospital leaders, preand post-implementation, and will take
one hour to complete. Collection of
documentation will occur twice at each
hospital and requires 4 hours to
complete. Bi-weekly semi-structured
interviews will be conducted with the
implementation coordinator at each
hospital. A total of 18 interviews per
hospital over a 9 month period will
occur with each interview taking about
30 minutes. Focus groups will take
place separately with patients, their
families, and both patients and their
families and will last for about an hour
and a half. The staff survey will be
completed by approximately SO
hospital staff members from each
hospital, pre- and post-implementation,
and requires 15 minutes to complete.
The patient survey will be conducted
twice, pre- and post-implementation, by
about 884 patients across all 3
participating hospitals and will take 30
minutes to complete. The total
annualized burden hours are estimated
to be 1,190 hours.
Exhibit 2 shows the estimated
annualized cost burden associated with
the respondents’ time to participate in
this project. The total cost burden is
estimated to be $27,316.
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of respondents
Number of responses per
respondent
Hours per response
Semi-structured leader interviews—pre-implementation .................................
Semi-structured leader interviews—post-implementation ...............................
Semi-structured staff interviews—pre-implementation ....................................
Semi-structured staff interviews—pre-implementation ....................................
Collection of documentation ............................................................................
Bi-weekly semi-structured interviews ...............................................................
Focus group with patients ...............................................................................
Focus group with patients’ family ....................................................................
Focus group with patients & family .................................................................
Staff survey ......................................................................................................
Patient survey ..................................................................................................
3
3
3
3
3
3
24
24
24
3
884
4
4
8
8
2
18
1
1
1
100
2
1
1
1
1
4
30/60
90/60
90/60
90/60
15/60
30/60
12
12
24
24
24
27
36
36
36
75
884
Total ..........................................................................................................
977
na
na
1,190
Data collection activity
Total burden
hours
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
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Form name
Semi-structured leader interviews—pre-implementation .................................
Semi-structured leader interviews—post-implementation ...............................
Semi-structured staff interviews—pre-implementation ....................................
Semi-structured staff interviews—post-implementation ...................................
Collection of documentation ............................................................................
Bi-weekly semi-structured interviews ...............................................................
Focus group with patients ...............................................................................
Focus group with patients’ family ....................................................................
Focus group with patients & family .................................................................
Staff survey ......................................................................................................
Patient survey—pre-implementation ................................................................
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Total burden
hours
3
3
3
3
3
3
24
24
24
3
884
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12
12
24
24
24
27
36
36
36
75
884
15NON1
Average hourly wage rate*
$43.74
43.74
33.51
33.51
21.16
33.51
20.90
20.90
20.90
33.51
20.90
Total cost
burden
$525
525
804
804
508
905
752
752
752
2,513
18,476
69677
Federal Register / Vol. 75, No. 219 / Monday, November 15, 2010 / Notices
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued
Number of
respondents
Form name
Total ..........................................................................................................
Total burden
hours
977
Average hourly wage rate*
1,190
n/a
Total cost
burden
27,316
* Based upon the mean of the wages for 11–9111 Medical & Health Services Manager ($43.74), 29–000 Healthcare Practitioner and Technical
Occupations ($33.51), 43–6011 Executive Secretaries and Administrative Assistants ($21.16) and 00–0000 All Occupations ($20.90), May 2009
National Occupational Employment and Wage Estimates. United States, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’ https://
www.bls.gov/oes/current/oes_nat.htm#b29–0000.
Estimated Annual Costs to the Federal
Government
Exhibit 3 below breaks down the costs
related to this study. Since this study
will span two years, the costs have been
annualized over a two year period. The
total annualized cost is estimated to be
$536,396.50.
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
Cost component
Total cost
Guide Development ...............................................................................................................................................
Data Collection Activities .......................................................................................................................................
Data Processing and Analysis ...............................................................................................................................
Project Management ..............................................................................................................................................
Overhead ...............................................................................................................................................................
$526,214
310,006
110,620
20,270
105,683
Total ................................................................................................................................................................
1,072,793
srobinson on DSKHWCL6B1PROD with NOTICES
Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
comments on AHRQ’s information
collection are requested with regard to
any of the following: (a) Whether the
proposed collection of information is
necessary for the proper performance of
AHRQ healthcare research and
healthcare information dissemination
functions, including whether the
information will have practical utility;
(b) the accuracy of AHRQ’s estimate of
burden (including hours and costs) of
the proposed collection(s) of
information; (c) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.
Dated: November 1, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010–28368 Filed 11–12–10; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:
This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
information collection project:
‘‘Standardizing Antibiotic Use in Longterm Care Settings.’’ In accordance with
the Paperwork Reduction Act, 44 U.S.C.
3501–3520, AHRQ invites the public to
comment on this proposed information
collection.
DATES: Comments on this notice must be
received by January 14, 2011.
ADDRESSES: Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@AHRQ.
hhs.gov.
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
SUMMARY:
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Annualized cost
$263,107
155,003
55,310
10,135
52,842
536,396.50
Clearance Officer, (301) 427–1477, or by
e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Standardizing Antibiotic Use in Longterm Care Settings
This project seeks to contribute to
AHRQ’s mission by optimizing
antibiotic prescribing practices in
nursing homes. Nursing homes serve as
one of our most fertile breeding grounds
for antibiotic-resistant strains of
bacteria. Nursing home residents, with
their combination of the effects of
normal aging and multiple chronic
diseases, have relatively high rates of
infection. With high rates of respiratory,
urinary, skin, and other infection comes
a very high rate of antibiotic use that
gives rise to Methicillin-resistant
Staphylococcus aureus (MRSA),
Vancomycin-resistant Enterococci
(VRE), fluoroquinolone-resistant strains
of a variety of bacteria, and multi-drug
resistant organisms (MDROs).
Inappropriate antibiotic prescribing
practices by primary care clinicians
caring for residents in long-term care
(LTC) communities is becoming a major
public health concern. Antibiotics are
among the most commonly prescribed
pharmaceuticals in LTC settings, yet
reports indicate that a high proportion
of antibiotic prescriptions are
inappropriate.
In an effort to reduce antibiotic
overprescribing, Loeb and colleagues
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]]>Agencies
[Federal Register Volume 75, Number 219 (Monday, November 15, 2010)]
[Notices]
[Pages 69674-69677]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-28368]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Development of the Guide to Patient and Family Engagement in
Health Care Quality and Safety in the Hospital Setting.'' In accordance
with the Paperwork Reduction Act, 44 U.S.C. 3501-3520, AHRQ invites the
public to comment on this proposed information collection.
DATES: Comments on this notice must be received by January 14, 2011.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
[[Page 69675]]
Reports Clearance Officer, AHRQ, by e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Development of the Guide to Patient and Family Engagement in Health
Care Quality and Safety in the Hospital Setting
Improving the quality and safety of health care in the United
States is one of the most significant challenges facing the American
health care system. Too many Americans continue to receive health care
that is not grounded in a reliable evidence base of what is proven
appropriate, safe, and effective. Extensive studies conducted during
recent decades demonstrate that the U.S. health care system provides
continuing unwarranted variation and costly, inefficient, and simply
unsafe care. Involving patients and families in improving quality and
safety in hospitals has the potential to improve health care
experiences, delivery, and outcomes. AHRQ has been at the forefront of
supporting increased involvement for patients, families, and the public
in all aspects of health care.
This project will develop a program to help patients, families, and
health professionals in the hospital support one another to improve
quality and safety. To accomplish these goals, patients and families
must be able to express what they want from their hospital care and how
they want to be involved and then effectively communicate this
information with health professionals. Conversely, health professionals
must be able to understand what patients want to do and what is
appropriate for them to do and feel that they have the system supports
and tools to facilitate these actions.
To address this issue and help fulfill AHRQ's mission of health
care quality improvement, AHRQ will develop a set of interventions and
materials, entitled the Guide to Patient and Family Engagement in
Health Care Quality and Safety in the Hospital Setting (``the Guide''),
for use by patients, their family members, health care professionals,
and hospital leaders to foster patient and family engagement around the
issues of hospital safety and quality.
The goals of this project are to:
(1) Identify the barriers and facilitators to implementing the
Guide, including how barriers were overcome;
(2) Assess staff satisfaction with the Guide and change in staff
behavior before and after implementation of the Guide including
organizational culture with respect to patient- and family engagement
and patient- and family-centered care;
(3) Assess patient satisfaction with the Guide and change in
patient experience of care before and after implementation of the Guide
including patient/family involvement in their own health care and
patient/family involvement in quality improvement and patient safety
activities; and
(4) Refine the Guide as necessary to improve implementation and
effectiveness.
The Guide will be tested in three hospitals which will vary in
terms of size, location, teaching status, and ownership.
This study is being conducted by AHRQ through its contractor, the
American Institutes for Research (AIR), pursuant to AHRQ's statutory
authority to promote health care quality improvement by conducting and
supporting research that develops and presents scientific evidence
regarding all aspects of health care, including the development and
assessment of methods for enhancing patient participation in their own
care and for facilitating shared patient-physician decision-making. 42
U.S.C. 299(b)(1)(A).
Method of Collection
To achieve the goals of this project the following data collections
will be implemented:
(1) Semi-structured interviews will be conducted in-person with
hospital staff and hospital leaders from each of the participating
health care facilities. Both pre- and postimplementation interviews
will be conducted and separate interview guides will be used for staff
and leaders. Pre-implementation, the interviews will focus on current
knowledge, attitudes and beliefs around patient and family engagement
and on the current organizational culture and climate surrounding
patient and family engagement. Post-implementation, interviews will be
conducted to understand the hospital's experiences implementing the
Guide interventions, including how easy or difficult the Guide was to
implement; the perceived effects of the Guide implementation; and the
sustainability of the Guide interventions.
(2) Collection of documentation from each participating facility.
The purpose of this collection of documentation is to gather
documentation of the implementation of the Guide and to document
policies and procedures related to patient and family engagement
through a review of records and other materials. To the extent that it
is available, the following types of documentation will be collected:
[cir] Background on organizational structure and vision.
[cir] Policies and procedures related to Component 1 and Component
2 strategies of the Guide.
[cir] Tools used to foster communication between patients, family
members and health care team.
[cir] Policies and procedures related to patient and family
engagement, patient- and family-centered care, quality and safety.
This task will consist of forwarding emails and or photocopying and
sending documents to the project team both pre- and post-
implementation.
(3) Bi-weekly semi-structured interviews will be conducted by
telephone with the implementation coordinators from each participating
facility. At each hospital site, an implementation coordinator will be
responsible for overseeing implementation activities and serving as a
primary point-of-contact. Interviews with these individuals will
provide a complete understanding of the Guide implementation and the
ability to track the implementation in real time. These interviews will
occur bi-weekly for 9 months.
(4) Observation of Guide implementation around different activities
targeted in the Guide components. The purpose of these observations is
to directly assess how the Guide is being implemented and to determine
which follow up questions from the semi-structured interview protocol
should be prioritized or removed during the in-person semi-structured
interviews. As such, observations will occur post-implementation only.
Observations will be conducted by the project staff so this data
collection does not impose a burden on the participating hospitals;
therefore it is not included in Exhibit 1.
(5) Focus groups with patients and family members at each of the
participating sites. The purpose of these groups is to elicit
information about patients' and families' experiences of care at the
hospital along with their reactions to tools in the Guide and their
implementation. Three focus groups of up to 8 individuals will be
conducted at each hospital post implementation. One
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focus group will be conducted with patients only, one with family
members only and one with patients and family members together.
(6) Staff Survey with hospital staff. The purpose of the pre- and
post-implementation Staff Survey is to assess changes in organizational
culture related to patient safety and engagement, and to assess
significant changes in staff knowledge, attitudes, and behaviors. Items
from the Medical College of Georgia (MCG) Patient- and Family-Centered
Care Culture Survey will be used in this data collection activity. The
survey items will be supplemented with questions from AHRQ's Hospital
Survey on Patient Safety Culture (HSOPS) and from the Army Medical
Department Climate Survey. At each of the three hospital sites, it is
estimated that survey responses will be collected from at least 50
health professionals. The same questionnaire will be used at pre- and
post-implementation.
(7) Patient Survey. The patient survey which will be administered
pre-implementation and again at post-implementation will be built
around the CAHPS[reg] Hospital Survey (HCAHPS) domains that assess
aspects of patient-physician interaction around the hospital stay,
including Communication with Nurses, Communication with Doctors,
Communication about Medicines, Responsiveness of Hospital Staff, and
Discharge Information. These scales directly assess the aspects of the
hospital stay and encounters that we are hoping the Guide will affect.
Additional questions to address any aspects of care covered by the
Guide that are not adequately addressed by the HCAHPS composites will
also be included in this survey. Additionally, measures from the
Patient Activation Measures (PAM) Survey will also be included. The
same questionnaire will be used pre- and post-implementation.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated burden hours for the respondents'
time to participate in this project. Semi-structured interviews will be
conducted with about 4 hospital staff members both pre- and post-
implementation and requires one hour to complete. Semi-structured
interviews will also be conducted with 2 hospital leaders, pre- and
post-implementation, and will take one hour to complete. Collection of
documentation will occur twice at each hospital and requires 4 hours to
complete. Bi-weekly semi-structured interviews will be conducted with
the implementation coordinator at each hospital. A total of 18
interviews per hospital over a 9 month period will occur with each
interview taking about 30 minutes. Focus groups will take place
separately with patients, their families, and both patients and their
families and will last for about an hour and a half. The staff survey
will be completed by approximately SO hospital staff members from each
hospital, pre- and post-implementation, and requires 15 minutes to
complete. The patient survey will be conducted twice, pre- and post-
implementation, by about 884 patients across all 3 participating
hospitals and will take 30 minutes to complete. The total annualized
burden hours are estimated to be 1,190 hours.
Exhibit 2 shows the estimated annualized cost burden associated
with the respondents' time to participate in this project. The total
cost burden is estimated to be $27,316.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Data collection activity Number of responses per Hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
Semi-structured leader interviews--pre- 3 4 1 12
implementation.................................
Semi-structured leader interviews--post- 3 4 1 12
implementation.................................
Semi-structured staff interviews--pre- 3 8 1 24
implementation.................................
Semi-structured staff interviews--pre- 3 8 1 24
implementation.................................
Collection of documentation..................... 3 2 4 24
Bi-weekly semi-structured interviews............ 3 18 30/60 27
Focus group with patients....................... 24 1 90/60 36
Focus group with patients' family............... 24 1 90/60 36
Focus group with patients & family.............. 24 1 90/60 36
Staff survey.................................... 3 100 15/60 75
Patient survey.................................. 884 2 30/60 884
---------------------------------------------------------------
Total....................................... 977 na na 1,190
----------------------------------------------------------------------------------------------------------------
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Form name respondents hours wage rate* burden
----------------------------------------------------------------------------------------------------------------
Semi-structured leader interviews--pre- 3 12 $43.74 $525
implementation.................................
Semi-structured leader interviews--post- 3 12 43.74 525
implementation.................................
Semi-structured staff interviews--pre- 3 24 33.51 804
implementation.................................
Semi-structured staff interviews--post- 3 24 33.51 804
implementation.................................
Collection of documentation..................... 3 24 21.16 508
Bi-weekly semi-structured interviews............ 3 27 33.51 905
Focus group with patients....................... 24 36 20.90 752
Focus group with patients' family............... 24 36 20.90 752
Focus group with patients & family.............. 24 36 20.90 752
Staff survey.................................... 3 75 33.51 2,513
Patient survey--pre-implementation.............. 884 884 20.90 18,476
[[Page 69677]]
Total....................................... 977 1,190 n/a 27,316
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the wages for 11-9111 Medical & Health Services Manager ($43.74), 29-000 Healthcare
Practitioner and Technical Occupations ($33.51), 43-6011 Executive Secretaries and Administrative Assistants
($21.16) and 00-0000 All Occupations ($20.90), May 2009 National Occupational Employment and Wage Estimates.
United States, ``U.S. Department of Labor, Bureau of Labor Statistics.'' https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.
Estimated Annual Costs to the Federal Government
Exhibit 3 below breaks down the costs related to this study. Since
this study will span two years, the costs have been annualized over a
two year period. The total annualized cost is estimated to be
$536,396.50.
Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
Annualized
Cost component Total cost cost
------------------------------------------------------------------------
Guide Development....................... $526,214 $263,107
Data Collection Activities.............. 310,006 155,003
Data Processing and Analysis............ 110,620 55,310
Project Management...................... 20,270 10,135
Overhead................................ 105,683 52,842
-------------------------------
Total............................... 1,072,793 536,396.50
------------------------------------------------------------------------
Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, comments on AHRQ's information collection are requested
with regard to any of the following: (a) Whether the proposed
collection of information is necessary for the proper performance of
AHRQ healthcare research and healthcare information dissemination
functions, including whether the information will have practical
utility; (b) the accuracy of AHRQ's estimate of burden (including hours
and costs) of the proposed collection(s) of information; (c) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (d) ways to minimize the burden of the collection of
information upon the respondents, including the use of automated
collection techniques or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
Dated: November 1, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010-28368 Filed 11-12-10; 8:45 am]
BILLING CODE 4160-90-M
