4038 Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 

EXHIBIT 2—ESTIMATED ANNUALIZED TOTAL COST BURDEN

Type of data 

collection 

Number of 

respondents 

Total 

burden hours 

Average 

hourly wage 

rate * 

Total 

cost burden 

Focus Groups with Clinicians .......................................................... 30 23 $83.59 $1,923 

Focus Groups with Support Staff .................................................... 36 27 14.31 386 

Patient Interviews ............................................................................ 300 75 21.35 1,601 

Feedback Questionnaire for Patients Requesting Mailed Guides .. 200 33 21.35 705 

Feedback Questionnaire for Patients Visiting Mobile Web site ...... 200 33 21.35 705 

Total .......................................................................................... 766 191 na 5,320 

* Based upon the mean wages for clinicians (29–1062 family and general practitioners), clinical team members (31–9092 medical assistants) 

and consumers (00–0000 all occupations), National Compensation Survey: Occupational wages in the United States May 2010, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’ 

Estimated Annual Costs to the Federal 

Government 

The maximum cost to the Federal 

Government is estimated to be $203,531 

annually. Exhibit 3 shows the total and 

annualized cost by the major cost 

components. 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost component Total cost Annualized cost 

Project Development ....................................................................................................................................... $146,175 $73,088 

Data Collection Activities ................................................................................................................................. 85,425 42,713 

Data Processing and Analysis ......................................................................................................................... 65,375 32,688 

Project Management ........................................................................................................................................ 47,588 23,794 

Overhead ......................................................................................................................................................... 62,500 31,250 

Total .......................................................................................................................................................... 407,063 203,531 

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: January 17, 2012. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2012–1402 Filed 1–25–12; 8:45 am] 

BILLING CODE 4160–90–M 

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: ‘‘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. 

This proposed information collection 

was previously published in the Federal 

Register on November 2nd, 2011 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by February 27, 2012. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at 

OIRA_submission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

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 

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Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 4039 

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 

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/ 

nhsurvey11/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 deidentified 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. 

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4040 Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 

• 5 POCs for vendors outside of QIOs 

submitting on behalf of 10 nursing 

homes each. 

• 50 independent nursing homes 

submitting on their own behalf. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name 

Number of 

respondents/ 

POCs 

Number of 

responses per 

POC 

Hours per 

response 

Total burden 

hours 

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 

Total .......................................................................................... 340 NA NA 511 

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 COST BURDEN

Form name 

Number of 

respondents/ 

POCs 

Total burden 

hours 

Average hourly 

wage rate * Total cost burden 

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 

Data Submission .............................................................................. 85 468 41.39 19,371 

Total .......................................................................................... 340 511 NA 21,152 

* The wage rate in Exhibit 2 is based on May 2009 National Industry-Specific Occupational Employment and Wage Estimates, Bureau of 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

Cost component Total cost Annualized cost 

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 

Total .......................................................................................................................................................... 930,000 310,000 

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. 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 77, No. 17 / Thursday, January 26, 2012 / Notices 4041 

Dated: January 17, 2012. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2012–1400 Filed 1–25–12; 8:45 am] 

BILLING CODE 4160–90–M 

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: 

‘‘Assessing the Feasibility of 

Disseminating Effective Health Care 

Products through a Shared Electronic 

Medical Record Serving Member 

Organization of a Health Information 

Exchange.’’ In accordance with the 

Paperwork Reduction Act, 44 U.S.C. 

3501–3521, AHRQ invites the public to 

comment on this proposed information 

collection. 

This proposed information collection 

was previously published in the Federal 

Register on November 15th, 2011 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by February 27, 2012. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at 

OIRA_submission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

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 

Assessing the Feasibility of 

Disseminating Effective Health Care 

Products through a Shared Electronic 

Medical Record Serving Member 

Organization of a Health Information 

Exchange 

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 this collection of 

information from users of work products 

and services initiated by the John M. 

Eisenberg Clinical Decisions and 

Communications Science Center 

(Eisenberg Center). 

AHRQ is the lead agency charged 

with supporting research designed to 

improve the quality of healthcare, 

reduce its cost, improve patient safety, 

decrease medical errors, and broaden 

access to essential services. AHRQ’s 

Eisenberg Center’s mission is improving 

communication of findings to a variety 

of audiences (‘‘customers’’), including 

consumers, clinicians, and health care 

policy makers. The Eisenberg Center 

compiles research results into useful 

formats for customer stakeholders. The 

Eisenberg Center also conducts 

investigations into effective 

communication of research findings in 

order to improve the usability and rapid 

incorporation of findings into medical 

practice. The Eisenberg Center is one of 

three components of AHRQ’s Effective 

Health Care (EHC) Program. The 

collections proposed under this 

clearance include activities to assess the 

feasibility of disseminating materials 

developed by the Eisenberg Center 

through the use of an electronic medical 

record (EMR) shared by a network of 

clinical care providers that are part of a 

Health Information Exchange (HIE) 

operating in multiple sites in several 

states. Our Community Health 

Information Network (OCHIN) members 

include 30 clinical care organizations 

operating more than 230 primary care 

clinics in six states. Data will be 

gathered from three different OCHINmember organizations representing a 

total of 10 primary care clinics. The 

information generated will be provided 

to AHRQ to guide decision making and 

planning for additional efforts to foster 

EHC Program product distribution via 

EMR prompting and product linkages. 

This research has the following goals: 

(1) Identify facilitators and barriers to 

successful efforts to implement 

processes that: (a) Support use of EHC 

Program products by clinicians in 

practice, and (b) place relevant clinical 

information in the hands of patients and 

family members in languages and 

formats that are appropriate to patients’ 

information needs; 

(2) Examine ways in which EHC 

Program products can be used in 

concert with other support programs 

and products (e.g., healthwise® 

resources available through the EMR; 

brief patient instructions and letters, 

including those designed for use with 

persons having very low literacy skills); 

(3) Assess the extent to which EHC 

Program products are used (e.g., 

accessed by clinicians, provided to 

patients in relevant formats) in settings 

where use is supported by automated 

EMR features, such as on-screen 

prompts and reminders; and 

(4) Document the perceived value of 

integrating EHC Program products into 

systems of care supported by an EMR 

system as self-reported by clinicians 

involved in direct care of patients and 

clinic support personnel who interact 

with patients. 

This study is being conducted by 

AHRQ through its contractor, the 

Eisenberg Center—Baylor College of 

Medicine, pursuant to AHRQ’s statutory 

authority to conduct and support 

research, and disseminate information, 

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 clinical practice. 42 U.S.C. 

299a(a)(1) and (4). 

Method of Collection 

To achieve the goals of this project the 

following data collections will be 

implemented: 

(1) Automated Data Capture from 

EMR Usage Logs. Electronic usage data 

will be collected to determine the extent 

to which EHC Program guides for 

clinicians and patients were accessed to 

support shared decision making and 

patient education. The data will be 

retrieved from the existing EMR-linked 

database operated by the Kaiser 

Permanente staff in their coordination of 

activities related to the OCHIN HIE. 

Data will include: (a) Number and 

frequency of retrieval of EHC resource 

materials; (b) specific types of materials 

retrieved; and (c) health topic or 

condition targeted in the EHC materials. 

These data will inform the development 

of follow-up questions to be 

administered to clinicians and patients 

in the interviews and surveys described 

below. Because the data will be 

obtained using automated systems 

already in place, no special effort will 

be needed to generate these data, and 

thus this task is not included in the 

burden estimates in Exhibits 1 and 2. 

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