Agency Information Collection Activities: Proposed Collection; Comment Request, 44983-44987 [2024-11199]

Agencies

• Agency for Healthcare Research and Quality
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 89, Number 100 (Wednesday, May 22, 2024)]
[Notices]
[Pages 44983-44987]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-11199]


-----------------------------------------------------------------------

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 ``Implementation and Testing of Diagnostic Safety Resources.'' 
This proposed information collection was previously published in the 
Federal Register on March 7th, 2024 and allowed 60 days for public 
comment. AHRQ received no substantive comments from members of the 
public. The purpose of this notice is to allow an additional 30 days 
for public comment.

DATES: Comments on this notice must be received by June 21, 2024.

ADDRESSES: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. 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 email 
[email protected].

SUPPLEMENTARY INFORMATION:

Proposed Project

Implementation and Testing of Diagnostic Safety Resources

    Patient safety is a pillar of the Agency for Healthcare Research 
and Quality's (AHRQ's) mission to support the highest quality 
healthcare. While progress has been made in many areas of patient 
safety, the field of diagnostic safety has emerged as a particular area 
of concern. It is estimated that every person in the United States will 
experience a diagnostic error in their lifetime (Institute of Medicine, 
2015) which can lead to inappropriate, delayed, or withheld treatment 
and ultimately poor health outcomes, distress, and increased costs. 
Diagnostic errors can occur for many reasons: lack of meaningful 
engagement between clinicians, patients, and families; a fragmented 
healthcare system not designed to account for an increasingly complex 
diagnostic process; minimal (if any) feedback to clinicians about their 
diagnostic performance; and a culture that does not always support 
transparent disclosure of diagnostic errors (Institute of Medicine, 
2015). Leaders in diagnostic excellence suggest that multi-pronged 
efforts are needed to address this complex problem and go beyond 
individual behaviors to system-level changes and empowering patients to 
engage in their care (Institute of Medicine, 2015; Henriksen, et al., 
2017).
    Improving diagnostic safety and quality is an AHRQ priority. In 
recognition of the multifaceted approach needed to effectively advance 
diagnostic safety, AHRQ recently supported the development of three 
tools to prevent diagnostic errors and have prioritized these tools for 
implementation and testing. These resources vary in the types of 
stakeholders they target, a critical advancement in our approach to 
diagnostic excellence.
     Calibrate Dx. This tool, targeted to individual 
clinicians, invites users to select a topic or condition, review 
diagnostic performance on a sample of cases for insights and learning 
opportunities, and debrief with a peer. This resource will be tested in 
all settings where clinicians are involved in the diagnostic process, 
including both inpatient and ambulatory settings.
     Measure Dx. This tool supports healthcare organizations in 
building sustainable teams for improving diagnostic excellence, 
identifying current capacity gaps, engaging in measurement strategies 
as part of a systematic approach to reviewing available data, and 
translating findings into learning opportunities. This resource will be 
tested in both inpatient and ambulatory settings; it is expected to be 
implemented more commonly in inpatient settings.
     Toolkit for Engaging Patients to Improve Diagnostic Safety 
(Patient Toolkit). This tool prepares patients, families, and health 
professionals to work together as partners to improve diagnostic 
safety; encourages patients to prepare for visits; and encourages 
providers to listen for 60 seconds before interrupting the patient. 
This resource will be tested in ambulatory settings only.
    The goal of this research is to implement and test these three 
diagnostic safety resources to identify specific ways in which each 
resource can be used to maximize its value. For each resource the 
following will be examined:
    (1) Feasibility of implementation--barriers, facilitators, success 
factors, and time needed for implementation
    (2) Level of adoption--number and type of clinicians aware of and/
or using the resource, number of organizational leaders endorsing the 
resource
    (3) Effectiveness of the resource--number of diagnostic safety 
events (Measure Dx and Patient Toolkit), clinician self-efficacy for 
diagnostic decision-making (Calibrate Dx)
    (4) Maintenance and sustainability--the number and type of patient 
safety processes in place, barriers and facilitators to maintenance and 
sustainability
    This project will implement and test these three diagnostic safety 
resources across a minimum of 150 sites to up to 219 sites (i.e., 50 to 
73 sites per resource). An Implementation and Testing period for each 
resource will last 12 months, with Calibrate Dx starting implementation 
first and Measure Dx and the Toolkit for

[[Page 44984]]

Engaging Patients starting implementation six months later. This timing 
allows for staggered recruitment to ensure adequate sample size and to 
pilot implementation processes with a single diagnostic safety resource 
first, transferring lessons learned about implementation and testing to 
the implementation of the two other resources. A Sustainability period 
will begin as soon as the 12-month Implementation and Testing Period is 
complete and will continue for 14 additional months for each resource.
    To achieve the goals of this project the following data collections 
will be implemented:
    1. Site Interest Form--A short form completed once by up to 1060 
sites interested in participating in the project. Used to indicate 
interest in the project and by AHRQ to evaluate whether the site meets 
the minimum participation criteria.
    2. Site Information Form--Completed once by site leaders at 265 
sites that begin the project enrollment process, this form collects 
additional contact information, data on patient mix, and information on 
the organization's diagnostic safety teams, resource commitments, and 
capacity for implementing the resources.
    3. Safer Dx Checklist--Completed once by 219 sites who fully 
complete enrollment activities and begin implementation of one of the 
three resources (82.6% of the 265 sites who begin enrollment 
activities). The Safer Dx Checklist is a tool that allows healthcare 
organizations to understand the current state of their diagnostic 
practices, identify areas to improve, and track progress toward 
diagnostic excellence over time. This will be completed prior to actual 
implementation of the resource.
    4. Exit Interviews Protocol--Completed once by an estimated 69 
sites (30% of those implementing one of the three resources) that 
withdraw from the project, this telephone interview will collect 
information on why the site could not sustain their efforts or 
participation.
    5. A baseline assessment of patient safety culture will be 
conducted once for each of the 219 sites that begin participation. 
Completed once by site leads depending on the setting:
    a. SOPS[supreg] Medical Office Survey with Diagnostic Safety 
Supplemental Item Set--Completed once by the site lead for 109 
ambulatory clinics.
    b. SOPS[supreg] Hospital Survey with Diagnostic Safety Supplemental 
Item Set--Completed once by the site lead for 110 inpatient sites.
    6. Post-training Evaluation Form--Completed once by 1,350 
clinicians and managers (90% of the 1,500 participants) attending the 
project's training sessions. The data will be used to track the 
perceived value of the training provided to enrolled sites.
    7. Post-technical Assistance Evaluation Form--Administered up to 3 
times to 1,500 clinicians and managers participating in the project's 
Learning Collaborative sessions; an estimated 90% response rate to this 
collection with a total of 4,050 forms completed. The data will be used 
to track the perceived value of the technical assistance provided to 
enrolled sites.
    8. Clinical Sustainability Assessment Tool (CSAT)--Completed by 219 
site leaders once between months 9 to 12 in advance of the 14-month 
sustainability period. The CSAT is a self-assessment to evaluate 
sustainability capacity of a clinical practice.
    9. Implementation Interviews Protocol--A qualitative, semi-
structured interview will be conducted with 438 site leads and/or 
frontline staff (up to 2 individuals from each site) at two points in 
time during implementation (e.g., 6- and 18-months). The protocol is 
designed to elicit participant perspectives on implementation of the 
resource, capture lessons learned and best practices, and when 
possible, to provide support for adjustment to the implementation.
    In addition to those noted above, the project will implement the 
following data collections specific to the individual resources.
    For Measure Dx, the following data collections will be implemented:
    10. Measure Dx Organizational Self-Assessment--This is one of the 
main components of the Measure Dx resource and is designed to gauge the 
organization's readiness to engage with Measure Dx. This checklist will 
be completed once by up to 73 Measure Dx sites during the project 
onboarding process.
    11. Measure Dx Declaration of Measurement Strategy--The 73 Measure 
Dx sites will complete this form once to indicate their selection of 
measurement strategy to be implemented and provide confirmation of 
minimum necessary capabilities.
    12. Diagnostic Safety Event Report--These reports will provide 
aggregate information on diagnostic safety events identified during a 
12-month reporting period. The report will be completed by each 
participating site 3 times over the course of the testing and 
sustainability period at 3-, 12-, and 24-months; a total of 219 reports 
will be completed over the course of the project. Note that the 
contractor is not attempting to collect these reports at Month 0. Since 
part of the Measure Dx resource's goal is to support implementation of 
a measurement strategy, Month 3 will serve as the baseline.
    13. Additional information on site safety culture, including use of 
diagnostic safety event data, activities to improve the quality of 
care, and the work environment will be collected through a survey at 3-
, 12-, and 24-months during the implementation/sustainment. Five 
members of the Measure Dx team at each site will be surveyed; the 
expected response rate is 85% at each of the three administration 
periods. Depending on the setting, the following survey will be 
fielded:
    a. Omnibus Safety and Culture Survey_Medical Offices--Completed by 
clinicians at 36 ambulatory clinics.
    b. Omnibus Safety and Culture Survey_Hospitals--Completed by 
clinicians at 37 inpatient sites.
    For Calibrate Dx, the following data collections will be 
implemented:
    14. Calibrate Dx Survey--This survey collects clinicians' 
reflections on their diagnostic performance for 3-5 cases, with 
additional metrics around time to complete the review and the number of 
cases reviewed. This will be completed quarterly (following the 
Calibrate Dx guidance for implementation) during the implementation and 
testing period by up to 5 clinicians per site; with an estimated a 90% 
response rate to this collection.
    15. Clinician Self-Efficacy Survey--The survey assesses clinician 
self-efficacy with diagnostic safety case review and improvement. Up to 
5 clinicians per site will be asked to complete this survey two times, 
after training and again at the end of the testing phase, with an 
estimated 90% response rate to this collection.
    For Patient Toolkit, the following data collections will be 
implemented:
    16. Provider Characteristics Form--This form will be completed once 
by up to 15 providers at each of the 73 enrolled sites. This form 
collects information on practitioner type, years in practice, 
specialty, subspecialty, and percent of time spent in clinical 
practice.
    17. Patient Toolkit Survey--Provider--This survey assesses 
provider-perceived skills and quality of communication. It will be 
administered to up to 15 providers at each site at five timepoints 
(Baseline, 3-, 6-, 9-, and 12-months), with a 90% anticipated response 
rate.
    18. Provider Interview Protocol--A total of 50 qualitative, semi-
structured interviews with site clinicians will be

[[Page 44985]]

conducted during implementation. The interview protocol collects 
information related to diagnostic safety events; patient safety 
culture; feasibility, acceptability, utility, adoption, and spread of 
the Patient Toolkit; and insights into clinician experience.
    19. Patient Toolkit Survey--Patient--The survey assesses patient-
perceived experience and quality of communication, and collects basic 
patient demographics (e.g., age, gender, education, race, ethnicity). 
This will be administered to site patients over a 1-week period at five 
timepoints (Baseline, 3-, 6-, 9-, and 12-months). The survey will be 
provided to patients upon check-out from a healthcare visit. A total of 
12,500 surveys will be completed during each 1-week period.
    20. Patient Interview Protocol--A total of 50 qualitative, semi-
structured interviews will be completed with site patients during 
implementation. The interview protocol collects information on reason 
for visit, provider communication, and other insights into patient 
experience.
    This study is being conducted by AHRQ through its contractor, RAND, 
pursuant to AHRQ's statutory authority to conduct and support research 
on healthcare and on systems for the delivery of such care, including 
activities with respect to the quality, effectiveness, efficiency, 
appropriateness, and value of healthcare services and with respect to 
quality measurement and improvement. 42 U.S.C. 299a(a)(1) and (2).

Method of Collection

    The data collection methods for this evaluation were selected to 
reduce participant burden and, where possible, to allow participants a 
choice of response mode. In addition, technology is used for data 
capture and qualitative coding and analysis.
    Several forms and data collection instruments will be administered 
using a web mode. Site leads and participants will receive a link 
allowing them to complete the form online. The Site Interest Form will 
also be accepted as a hardcopy should organizations prefer to mail or 
fax these forms. All other forms will be administered either by a 
fillable form that can be returned via email, mail, or fax depending on 
the site or participant preference.
    Interviews will be conducted by phone or video call (e.g., 
Microsoft Teams, Zoom) with interviewers using a hardcopy version of 
the protocol. Interviews will be audio-recorded and transcribed, 
following verbal consent from participants. Qualitative software will 
be used for data coding and analysis of interviews.
    The patient surveys will be provided to patients upon check-out 
from a healthcare visit and they will be encouraged to complete the 
survey before leaving the office. The survey will include a QR code to 
allow patients to access a web version of the form. Alternatively, the 
patient can complete the paper survey and it will be collected at the 
site, minimizing the need for patients to return the paper survey by 
mail. The paper surveys will be formatted for data scanning, and data 
from all paper surveys returned to the contractor will be scanned into 
an electronic datafile.

Estimated Annual Respondent Burden

    This section summarizes the total burden hours for this information 
collection effort in addition to the cost associated with those hours.
    Exhibit 1 contains estimated response burdens for each subject 
population participating in the evaluation's data collection 
activities.
    1. Site Interest Form--A physician or manager at an interested site 
will complete the form only once to indicate interest in participating. 
The form will be completed by 1,060 respondents and requires 6 minutes 
to complete.
    2. Site Information Form--A physician or manager at an interested 
site will complete the form only once to provide additional contact 
information, data on patient mix, and information on the organization's 
diagnostic safety teams, resource commitments, and capacity for 
implementing the resources. The form will be completed by 265 
respondents and requires 20 minutes to complete.
    3. Safer Dx Checklist--A physician or manager at participating 
sites will complete the form only once to allow the participating site 
to understand the current state of their diagnostic practices, identify 
areas to improve, and track progress toward diagnostic excellence over 
time. The form will be completed by 219 respondents and requires 15 
minutes to complete.
    4. Exit Interviews Protocol--A physician or manager at sites that 
withdraw from the project will complete the form once to provide 
information on why the site could not sustain their efforts or 
participation. The form will be completed by 69 respondents and 
requires 10 minutes to complete.
    5a. SOPS[supreg] Medical Office Survey with Diagnostic Safety 
Supplemental Item Set--A physician or manager at participating 
ambulatory sites will complete the form to provide a baseline 
assessment of patient safety culture. The form will be completed by 109 
respondents and requires 15 minutes to complete.
    5b. SOPS[supreg] Hospital Survey with Diagnostic Safety 
Supplemental Item Set--A physician or manager at participating hospital 
sites will complete the form to provide a baseline assessment of 
patient safety culture. The form will be completed by 110 respondents 
and requires 15 minutes to complete.
    6. Post-Training Evaluation Form--A physician, nurse practitioner, 
physician assistant, or manager will complete the form once to indicate 
the perceived value of the training provided to participating sites. 
The form will be completed by 1350 respondents and requires 3 minutes 
to complete.
    7. Post-Technical Assistance Evaluation Form--A physician, nurse 
practitioner, physician assistant, or manager will complete the form up 
to three times to indicate the perceived value of the technical 
assistance provided to participating sites. The form will be completed 
by 1350 respondents, three times, and requires 2 minutes to complete.
    8. Clinical Sustainability Assessment Tool (CSAT)--A physician or 
manager at participating sites will complete the form to evaluate the 
sustainability capacity of a clinical practice. The form will be 
completed by 219 respondents and requires 15 minutes to complete.
    9. Implementation Interviews Protocol--A physician, nurse 
practitioner, physician assistant, or manager will participate in an 
interview two times to provide their perspectives at different stages 
of the implementation. The interview will be completed by up to 438 
respondents, two times, and requires 1 hour to complete.
    10. Measure Dx Organizational Self-Assessment--A physician, nurse 
practitioner, physician assistant, or manager will complete the form 
only once to gauge the organization's readiness to engage with Measure 
Dx. The form will be completed by 73 respondents and requires 30 
minutes to complete.
    11. Measure Dx Declaration of Measurement Strategy--A physician, 
nurse practitioner, physician assistant, or manager will complete the 
form only once to indicate their selection of measurement strategy to 
be implemented and provide confirmation of minimum necessary 
capabilities. The form will be completed by 73 respondents and requires 
5 minutes to complete.
    12. Diagnostic Safety Event Report--A physician, nurse 
practitioner,

[[Page 44986]]

physician assistant, or manager will complete the form three times to 
provide aggregate information on diagnostic safety events. The form 
will be completed by 73 respondents, three times, and requires 1 hour 
to complete.
    13a. Omnibus Safety and Culture Survey_Medical Offices--A 
physician, nurse practitioner, physician assistant, or manager will 
complete the form three times to provide information on safety culture 
at ambulatory sites. The form will be completed by 162 respondents, 
three times, and requires 20 minutes to complete.
    13b. Omnibus Safety and Culture Survey_Hospitals--A physician, 
nurse practitioner, physician assistant, or manager will complete the 
form three times to provide information on safety culture at inpatient 
sites. The form will be completed by 167 respondents, three times, and 
requires 20 minutes to complete.
    14. Calibrate Dx Survey--A physician, nurse practitioner, or 
physician assistant will complete the form four times to provide 
reflections on their diagnostic performance for 3-5 cases, with 
additional metrics around time to complete the review and the number of 
cases reviewed. The form will be completed by 329 respondents, four 
times, and requires 30 minutes to complete.
    15. Clinician Self-Efficacy Survey--A physician, nurse 
practitioner, or physician assistant will complete the form two times 
to provide information on their self-efficacy with diagnostic safety 
case review and improvement. The form will be completed by 329 
respondents, two times, and requires 3 minutes to complete.
    16. Provider Characteristics Form--A physician, nurse practitioner, 
or physician assistant will complete the form once to provide 
information on practitioner type, years in practice, specialty, 
subspecialty, and percent of time spent in clinical practice. The form 
will be completed by 986 respondents and requires 1 minute to complete.
    17. Patient Toolkit Survey--Provider--A physician, nurse 
practitioner, or physician assistant will complete the form five times 
to provide information on provider-perceived skills and quality of 
communication. The form will be completed by 986 respondents, five 
times, and requires 2 minutes to complete.
    18. Provider Interview Protocol--A physician, nurse practitioner, 
or physician assistant will participate in an interview once to provide 
information related to diagnostic safety events; patient safety 
culture; feasibility, acceptability, utility, adoption, and spread of 
the Patient Toolkit; and insights into clinician experience. The 
interview will be completed by up to 50 respondents and requires 45 
minutes to complete.
    19. Patient Toolkit Survey--Patient--Patients will complete the 
form only once to provide information on their experience and quality 
of communication, and demographics information. The form will be 
completed by 62,500 respondents and requires 5 minutes to complete.
    20. Patient Interview Protocol--Patients will participate in an 
interview once to provide information on reason for visit, provider 
communication, and other insights into patient experience. The 
interview will be completed by up to 50 respondents and requires 45 
minutes to complete.
    For the three-year clearance period, the estimated annualized 
burden hours for the data collection activities are 8,195.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                           Number of                    Total
                        Form name                           Number of    responses per   Hours per      burden
                                                           respondents    respondent      response      hours
----------------------------------------------------------------------------------------------------------------
1: Site Interest Form....................................        1,060               1         6/60          106
2: Site Information Form.................................          265               1        20/60           88
3: Safer Dx Checklist....................................          219               1        15/60           55
4: Exit Interviews Protocol..............................           69               1        10/60           12
5a: SOPS[supreg] Medical Office Survey with Diagnostic             109               1        15/60           27
 Safety Supplemental Item Set............................
5b: SOPS[supreg] Hospital Survey with Diagnostic Safety            110               1        15/60           28
 Supplemental Item Set...................................
6: Post-training Evaluation Form.........................        1,350               1         3/60           68
7: Post-technical Assistance Evaluation Form.............        1,350               3         2/60          135
8: Clinical Sustainability Assessment Tool (CSAT)........          219               1        15/60           55
9: Implementation Interviews Protocol....................          438               2            1          876
10: Measure Dx Organizational Self-Assessment............           73               1        30/60           37
11: Measure Dx Declaration of Measurement Strategy.......           73               1         5/60            6
12: Diagnostic Safety Event Report.......................           73               3            1          219
13a: Omnibus Safety and Culture Survey_Medical Offices...          162               3        20/60          162
13b: Omnibus Safety and Culture Survey_Hospitals.........          167               3        20/60          167
14: Calibrate Dx Survey..................................          329               4        30/60          657
15: Clinician Self-Efficacy Survey.......................          329               2         3/60           33
16: Provider Characteristics Form........................          986               1         1/60           16
17: Patient Toolkit Survey--Provider.....................          986               5         2/60          164
18: Provider Interview Protocol..........................           50               1        45/60           38
19: Patient Toolkit Survey--Patient......................       62,500               1         5/60        5,208
20: Patient Interview Protocol...........................           50               1        45/60           38
                                                          ------------------------------------------------------
    Total................................................  ...........  ..............  ...........        8,195
----------------------------------------------------------------------------------------------------------------

    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to complete the data collection forms. The total cost 
burden is estimated to be $457,432.

[[Page 44987]]



                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                                           Total
                        Form name                           Number of      burden    Average hourly   Total cost
                                                           respondents     hours       wage rate *      burden
----------------------------------------------------------------------------------------------------------------
1: Site Interest Form....................................        1,060          106      \a\ $97.30      $10,314
2: Site Information Form.................................          265           88       \a\ 97.30        8,562
3: Safer Dx Checklist....................................          219           55       \a\ 97.30        5,352
4: Exit Interviews Protocol..............................           69           12       \a\ 97.30        1,168
5a: SOPS[supreg] Medical Office Survey with Diagnostic             109           27       \a\ 97.30        2,627
 Safety Supplemental Item Set............................
5b: SOPS[supreg] Hospital Survey with Diagnostic Safety            110           28       \a\ 97.30        2,724
 Supplemental Item Set...................................
6: Post-training Evaluation Form.........................        1,350           68      \b\ 102.90        6,997
7: Post-technical Assistance Evaluation Form.............        1,350          135      \b\ 102.90       13,892
8: Clinical Sustainability Assessment Tool (CSAT)........          219           55       \a\ 97.30        5,352
9: Implementation Interviews Protocol....................          438          876      \b\ 102.90       90,140
10: Measure Dx Organizational Self-Assessment............           73           37      \b\ 102.90        3,807
11: Measure Dx Declaration of Measurement Strategy.......           73            6      \b\ 102.90          617
12: Diagnostic Safety Event Report.......................           73          219      \b\ 102.90       22,535
13a: Omnibus Safety and Culture Survey_Medical Offices...          162          162      \b\ 102.90       16,670
13b: Omnibus Safety and Culture Survey_Hospitals.........          167          167      \b\ 102.90       17,184
14: Calibrate Dx Survey..................................          329          657      \c\ 102.83       67,559
15: Clinician Self-Efficacy Survey.......................          329           33      \c\ 102.83        3,393
16: Provider Characteristics Form........................          986           16      \c\ 102.83        1,645
17: Patient Toolkit Survey--Provider.....................          986          164      \c\ 102.83       16,864
18: Provider Interview Protocol..........................           50           38      \c\ 102.83        3,908
19: Patient Toolkit Survey--Patient......................       62,500        5,208       \d\ 29.76      154,990
20: Patient Interview Protocol...........................           50           38       \d\ 29.76        1,131
                                                          ------------------------------------------------------
    Total................................................  ...........  ...........  ..............      457,432
----------------------------------------------------------------------------------------------------------------
* National Compensation Survey: Occupational wages in the United States May 2022, ``U.S. Department of Labor,
  Bureau of Labor Statistics.''
\a\ Based on the weighted mean hourly wage for physicians (broad) ($121.15; occupation code 29-1210; 60%) and
  Medical and Health Services Managers ($61.53; Code 11-9111; 40%).
\b\ Based on the weighted mean hourly wage for physicians (broad) ($121.15; occupation code 29-1210; 70%); nurse
  practitioners (broad) ($59.94; occupation code 29-1170; 15%); physician assistants (broad) ($60.23; occupation
  code 29-1070; 10%); and medical and health services managers (broad) ($61.53; Code 11-9111; 5%).
\c\ Based on the weighted mean hourly wage for physicians (broad) ($121.15; occupation code 29-1210; 70%); nurse
  practitioners (broad) ($59.94; occupation code 29-1170; 15%); and physician assistants (broad) ($60.23;
  occupation code 29-1070; 15%).
\d\ Based on the mean wages for All Occupations (Code 00-0000).

Request for Comments

    In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3520, 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's health 
care research and health care 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.
    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: May 16, 2024.
Mamatha Pancholi,
Deputy Director.
[FR Doc. 2024-11199 Filed 5-21-24; 8:45 am]
BILLING CODE 4160-90-P