[Federal Register Volume 76, Number 212 (Wednesday, November 2, 2011)]
[Notices]
[Pages 67732-67734]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-28403]
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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: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
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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: ``Nursing Home Survey on Patient Safety Culture Comparative
Database.'' In accordance with the Paperwork Reduction Act, 44 U.S.C.
3501-3521, AHRQ invites the public to comment on this proposed
information collection.
DATES: Comments on this notice must be received by January 3, 2012.
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
Clearance Officer, (301) 427-1477, or by email at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Nursing Home Survey on Patient Safety Culture Comparative Database
The Agency for Healthcare Research and Quality (AHRQ) requests that
the Office of Management and Budget (OMB) approve, under the Paperwork
Reduction Act of 1995, AHRQ's collection of information for the AHRQ
Nursing Home Survey on Patient Safety Culture (Nursing Home SOPS)
Comparative Database. The Nursing Home SOPS Comparative Database
consists of data from the AHRQ Nursing Home Survey on Patient Safety
Culture. Nursing homes in the U.S. are asked to voluntarily submit data
from the survey to AHRQ through its contractor, Westat. The Nursing
Home SOPS Database is modeled after the Hospital SOPS Database [OMB No.
0935-0162, approved 05/04/2010] that was originally developed by AHRQ
in 2006 in response to requests from hospitals interested in knowing
how their patient safety culture survey results compare to those of
other hospitals.
In 1999, the Institute of Medicine called for health care
organizations to develop a ``culture of safety'' such that their
workforce and processes focus on improving the reliability and safety
of care for patients (IOM, 1999; To Err is Human: Building a Safer
Health System). To respond to the need for tools to assess patient
safety culture in nursing homes, AHRQ developed and pilot tested the
Nursing Home Survey on Patient Safety Culture with OMB approval (OMB
No. 0935-0132; Approved July 5, 2007).
The survey is designed to enable nursing homes to assess provider
and staff opinions about patient safety issues, medical error, and
error reporting and includes 42 items that measure 12 dimensions of
patient safety culture. AHRQ released the survey into the public domain
along with a Survey User's Guide and other toolkit materials in
November 2008 on the AHRQ Web site (located at http://www.ahrq.gov/qual/patientsafetyculture/nhsurvindex.htm). Since its release, the
survey has been voluntarily used by hundreds of nursing homes in the
U.S.
The Nursing Home SOPS and the Comparative Database are supported by
AHRQ to meet its goals of promoting improvements in the quality and
safety of health care in nursing home settings. The survey, toolkit
materials, and preliminary comparative database results are all made
available in the public domain along with technical assistance provided
by AHRQ through its contractor at no charge to nursing homes, to
facilitate the use of these materials for nursing home patient safety
and quality improvement.
The goal of this project is to create the Nursing Home SOPS
Comparative Database. This database will (1) allow nursing homes to
compare their patient safety culture survey results with those of other
nursing homes; (2) provide data to nursing homes to facilitate internal
assessment and learning in the patient safety improvement process; and
(3) provide supplemental information to help nursing homes identify
their strengths and areas with potential for improvement in patient
safety culture. De-identified data files will also be available to
researchers conducting patient safety analysis. The database will
include 42 items that measure 12 areas, or composites of patient safety
culture.
This study is being conducted by AHRQ through its contractor,
Westat, pursuant to AHRQ's statutory authority to conduct and support
research on healthcare and on systems for the
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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, and database development. 42 U.S.C. 299a(a)(1) and (2),
and (a)(8).
Method of Collection
To achieve the goal of this project the following activities and
data collections will be implemented:
(1) Nursing Home Eligibility and Registration Form--The purpose of
this form is to determine the eligibility status and initiate the
registration process for nursing homes seeking to voluntarily submit
their NH SOPS data to the NH SOPS Comparative Database. The nursing
home (or parent organization) point of contact (POC) will complete the
form. The POC is either a corporate level health care manager for a
Quality Improvement Organization (QIO), a survey vendor who contracts
with a nursing home to collect their data, or a nursing home Director
of Nursing or nurse manager. Many nursing homes are part of a QIO or
larger nursing home or health system that includes many nursing home
sites.
(2) Data Use Agreement--The purpose of this form is to obtain
authorization from nursing homes to use their voluntarily submitted NH
SOPS data for analysis and reporting according to the terms specified
in the Data Use Agreement (DUA). The nursing home POC will complete the
form.
(3) Nursing Home Site Information Form -- The purpose of this form
is to obtain basic information about the characteristics of the nursing
homes submitting their NH SOPS data to the NH SOPS Comparative Database
(e.g., bed size, urbanicity, ownership, and geographic region). The
nursing home POC will complete the form.
(4) Data Submission--After the nursing home POC has completed the
Nursing Home Eligibility and Registration Form, the Data Use Agreement
and the Nursing Home Site Information Form, they will submit their data
from the NH SOPS to the NH SOPS Comparative Database.
Data from the AHRQ Nursing Home Survey on Patient Safety Culture
are used to produce three types of products: (1) A Nursing Home SOPS
Comparative Database Report that is produced periodically and made
available in the public domain on the AHRQ Web site (see http://www.ahrq.gov/qual/nhsurveyll/nhsurv111.pdf for the 2011 report); (2)
Nursing Home Survey Feedback Reports that are confidential, customized
reports produced for each nursing home that submits data to the
database; and (3) Research data sets of staff-level and nursing home-
level de-identified data that enable researchers to conduct additional
analyses.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
nursing home to participate in the Nursing Home SOPS Comparative
Database. The POC completes a number of data submission steps and
forms, beginning with completion of the online Nursing Home SOPS
Database Eligibility and Registration form and Data Use Agreement,
which will be completed for 85 nursing homes or groups of affiliated
nursing homes annually. The Nursing Home Site Information Form will be
completed for each individual nursing home; since each POC represents
an average of 5 nursing homes a total of 425 Information Forms will be
completed annually and requires about 5 minutes to complete. The POC
will submit data for all of the nursing homes they represent which will
take about 5 and \1/2\ hours, including the amount of time POCs
typically spend deciding whether to participate in the database and
preparing their materials and data set for submission to the database,
and performing the submission. The total annual burden hours are
estimated to be 511.
Nursing homes administer the AHRQ Nursing Home Survey on Patient
Safety Culture on a periodic basis. Hospitals submitting to the
Hospital SOPS Comparative Database administer the survey every 16
months on average. Similarly, the number of nursing home submissions to
the database is likely to vary each year because nursing homes do not
administer the survey and submit data every year. The 85 respondents/
POCs shown in Exhibit 1 are based on an estimate of nursing homes
submitting data in the coming years, with the following assumptions:
30 POCs for QIOs submitting on behalf of 10 nursing homes
each
5 POCs for vendors outside of QIOs submitting on behalf of
10 nursing homes each
50 independent nursing homes submitting on their own
behalf
Estimated Annualized Burden Hours
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Number of Number of
Form name respondents/ responses per Hours per Total burden
POCs POC response hours
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Eligibility/Registration Forms.......... 85 1 3/60 4
Data Use Agreement...................... 85 1 3/60 4
Nursing Home Site Information Form...... 85 5 5/60 35
Data Submission......................... 85 1 5.5 468
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Total............................... 340 NA NA 511
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Exhibit 2 shows the estimated annualized cost burden based on the
respondents' time to submit their data. The cost burden is estimated to
be $21,152 annually.
Exhibit 2--Estimated Annualized Cosy Burden
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Number of Total burden Average hourly Total cost
Form name respondents/POCs hours wage rate* burden
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Eligibility/Registration Forms.......... 85 4 $41.39 $166
Data Use Agreement...................... 85 4 41.39 166
Nursing Home Site Information Form...... 85 35 41.39 1,449
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Data Submission......................... 85 468 41.39 19,371
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Total............................... 340 511 NA 21,152
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* The wage rate in Exhibit 2 is based on May 2009 National Industry-Specific Occupational Employment and Wage
Estimates Bureau o Labor Statistics, U.S. Dept of Labor. Mean hourly wages for nursing home POCs are located
at http://www.bls.gov/oes/2009/may/naics4 623100.htm and http://www.bls.gov/oes/2009/may/naics2 62.htm. The
hourly wage of $41.39 is the weighted mean of $41.94 (General and Operations Managers; N = 25), $37.29
(Medical and Health Services Managers; N = 25), $42.89 (General and Operations Managers; N = 30) and $50.00
(Computer and Information Systems Managers; N = 5).
Estimated Annual Costs to the Federal Government
The estimated annualized cost to the government for developing,
maintaining, and managing the database and analyzing the data and
producing reports is shown below. The cost is estimated to be $310,000
annually. The total cost over the three years of this information
collection request is $930,000.
Exhibit 3--Estimated Annualized Cost
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Cost component Total cost Annualized cost
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Project Development............. $59,715 $19,905
Data Collection Activities...... 82,107 27,369
Data Processing and Analysis.... 111,963 37,321
Publication of Results.......... 111,966 37,322
Project Management.............. 7,464 2,488
Overhead........................ 556,785 185,595
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Total....................... 930,000 310,000
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Request for Comments
In accordance with the Paperwork Reduction Act, 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: October 25, 2011.
Carolyn M. Clancy,
Director.
[FR Doc. 2011-28403 Filed 11-1-11; 8:45 am]
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