Federal Register / Vol. 75, No. 232 / Friday, December 3, 2010 / Notices 75471 

discussed in the Federal Register Notice 

and background paper that 

accompanied the public posting of the 

initial, recommended core set (http:// 

www.ahrq.gov/chip/ 

chipraact.htm#Core), not all CHIPRA 

criteria were able to be met for the 

initial core set. Public comments on the 

initial, recommended core set, and an 

expert meeting on measure criteria for 

the CHIPRA PQMP (http:// 

www.AHRQ.gov/chipra/#Expert) 

provided additional insights into 

potential priorities for the PQMP. The 

combination of these efforts and events 

led to the identification of the following 

potential priorities for measure 

enhancement and development of new 

measures: 

1. Development or enhancement of 

methods to: 

a. Standardize measures across all 

payers, programs, and providers, public 

and private, as appropriate, to ensure 

that comparisons are valid. 

b. Assess disparities in quality by 

race, ethnicity, socioeconomic status, 

geographic region and residence, and 

special health care needs, for example 

by developing new measurement 

methods or enhancing existing 

measurement methods. 

c. Adjust for risk by enrollment 

duration. 

d. Stratify or adjust for risk by depth 

and breadth of coverage. 

e. Stratify or adjust for risk by medical 

conditions, including severity and 

acuity. 

f. Capitalize on current and coming 

investments in health information 

technology (e.g., patient and procedure 

registries, electronic health records, 

health information exchanges, 

interoperability), including meaningful 

use criteria under the American 

Recovery and Reinvestment Act 

(ARRA). 

g. Increase State programs’ and CMS’s 

ability to rely on non-Medicaid and 

CHIP data sources through improvement 

in public health sector measurement 

(e.g., birth certificate data; 

immunization surveys). 

h. Come to consensus on the meaning 

and application of ‘‘evidence-based’’ in 

the context of healthcare quality 

measurement for children. 

i. Incorporate patient and family 

perspectives into measurement to 

increase understandability. 

2. Development or enhancement of 

measures in key topic areas: 

a. Most integrated healthcare settings. 

b. Availability of services. 

c. Duration of enrollment as a 

standalone measure. 

d. Measures of the content (quality) of 

care now typically measured as broad 

utilization categories (e.g., prenatal, 

postpartum, newborn care (including 

breastfeeding support), well-child and 

adolescent well-care visits, screening 

services, and follow-up visits for 

chronic conditions and related 

medications). 

e. Specific care settings and 

conditions: 

i. Perinatal care (e.g., family planning 

clinics, obstetric and gynecological care, 

birth centers). 

ii. Quality of mental/behavioral health 

and substance abuse services, including 

prevention and treatment services, 

across all settings. 

iii. Quality of care in settings beyond 

traditional medical care settings (e.g., 

for screening, diagnostic services and 

therapies). 

iv. Inpatient settings (including 

specialty inpatient settings). 

v. Specialty care for child conditions 

and diseases. 

vi. Care transitions for patients 

transitioning within and across health 

care settings. 

vii. Additional measures related to 

family experiences of care (e.g., child or 

adolescent self-reports; perinatal 

experiences of care; inpatient 

experiences) 

viii. Health outcome measures (e.g., 

measures of patient and population 

health or other outcomes of 

healthcare).2

ix. Structural measures (e.g., measures 

of system design features that are 

causally linked to improved healthcare 

processes and outcomes). 

Those submitting comments are 

encouraged to include a summary of 

evidence for the readiness of a topic for 

quality measurement and the 

importance of a topic or method. 

Additional background information may 

be attached. Commenters may wish to 

address these issues using the following 

questions. Commenters may also wish 

to include in their comments a summary 

score based on a scale of 1–5, where 1 

is a high score, 3 is a medium score, and 

5 is a low score. 

Validity/Underlying Scientific 

Soundness: To what extent is there a 

demonstrated causal relationship 

between the element of quality to be 

measured (as a structure, process, or 

health outcome of healthcare delivery) 

and another element of the healthcare 

delivery system (e.g., structure and 

process; process and outcome). 

Commenters may wish to use as a guide 

to assessing underlying scientific 

soundness the method and criteria used 

by the AHRQ National Advisory 

Council Subcommittee on Children’s 

Healthcare Quality Measures for 

Medicaid and CHIP, where appropriate 

http://www.AHRQ.gov/chipra/

corebackground/

corebacktab.htm#note5). 

Importance: Importance has several 

dimensions: 

• To what extent is the topic 

important to children’s health 

outcomes, family functioning, or 

societal functioning, including but not 

necessarily limited to high monetary 

costs of poor quality healthcare to 

children, families, or Society? 

• To what extent is the topic 

important to reducing disparities in the 

quality of care for particular racial and 

ethnic groups of children, 

socioeconomic groups, geographically 

underserved groups, and children with 

special healthcare needs? 

• To what extent is the topic 

important as a sentinel measure that 

could have spillover effects to the rest 

of the children’s healthcare delivery 

system? 

• To what extent is the proposed 

methodology important for addressing 

current shortcoming of healthcare 

quality measurement? 

We strongly encourage comments to 

be as succinct as possible (250 words or 

less per topic, with additional 

supporting data allowed). 

3. Collection of Information 

Requirements 

This voluntary request does not 

impose information collection and 

recordkeeping requirements. 

Consequently, it need not be reviewed 

by the Office of Management and 

Budget under the authority of the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 35). 

4. Regulatory Impact Analysis 

As this notice does not meet the 

significance criteria of Executive Order 

12866, it was not reviewed by the Office 

of Management and Budget. 

Dated: November 24, 2010. 

Carolyn M. Clancy, 

AHRQ Director. 

[FR Doc. 2010–30262 Filed 12–2–10; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Patient Safety Organizations: 

Voluntary Delisting 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice of Delisting. 

mstockstill on DSKH9S0YB1PROD with NOTICES

75472 Federal Register / Vol. 75, No. 232 / Friday, December 3, 2010 / Notices 

SUMMARY: AHRQ has accepted a 

notification of voluntary relinquishment 

from ORQA, LLC of its status as a 

Patient Safety Organization (PSO). The 

Patient Safety and Quality Improvement 

Act of 2005 (Patient Safety Act), Public 

Law 109–41, 42 U.S.C. 299b–21—b–26, 

provides for the formation of PSOs, 

which collect, aggregate, and analyze 

confidential information regarding the 

quality and safety of health care 

delivery. The Patient Safety and Quality 

Improvement Final Rule (Patient Safety 

Rule), 42 CFR Part 3, authorizes AHRQ, 

on behalf of the Secretary of HHS, to list 

as a PSO an entity that attests that it 

meets the statutory and regulatory 

requirements for listing. A PSO can be 

‘‘delisted’’ by the Secretary if it is found 

to no longer meet the requirements of 

the Patient Safety Act and Patient Safety 

Rule, including when a PSO chooses to 

voluntarily relinquish its status as a 

PSO for any reason. 

DATES: The directories for both listed 

and delisted PSOs are ongoing and 

reviewed weekly by AHRQ. The 

delisting was effective at 12 Midnight 

ET (2400) on October 13, 2010. 

ADDRESSES: Both directories can be 

accessed electronically at the following 

HHS Web site: http:// 

www.pso.AHRQ.gov/index.html. 

FOR FURTHER INFORMATION CONTACT: 

Diane Cousins, RPh., Center for Quality 

Improvement and Patient Safety, AHRQ, 

540 Gaither Road, Rockville, MD 20850; 

Telephone (toll free): (866) 403–3697; 

Telephone (local): (301) 427–1111; TTY 

(toll free): (866) 438–7231; TTY (local): 

(301) 427–1130; E-mail: 

pso@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Background 

The Patient Safety Act authorizes the 

listing of PSOs, which are entities or 

component organizations whose 

mission and primary activity is to 

conduct activities to improve patient 

safety and the quality of health care 

delivery. HHS issued the Patient Safety 

Rule to implement the Patient Safety 

Act. AHRQ administers the provisions 

of the Patient Safety Act and Patient 

Safety Rule (PDF file, 450 KB. PDF 

Help) relating to the listing and 

operation of PSOs. Section 3.108(d) of 

the Patient Safety Rule requires AHRQ 

to provide public notice when it 

removes an organization from the list of 

federally approved PSOs. AHRQ has 

accepted a notification from ORQA, 

LLC, PSO number P0013, to voluntarily 

relinquish its status as a PSO. 

Accordingly, ORQA, LLC was delisted 

effective at 12 Midnight ET (2400) on 

October 13, 2010. 

More information on PSOs can be 

obtained through AHRQ’s PSO Web site 

at http://www.pso.AHRQ.gov/ 

index.html. 

Dated: November 24, 2010. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2010–30263 Filed 12–2–10; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Patient Safety Organizations: 

Voluntary Delisting 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice of Delisting. 

SUMMARY: AHRQ has accepted a 

notification of voluntary relinquishment 

from Helmet Fire, Inc. Patient Safety 

Group (A Component of Helmet Fire, 

Inc. of its status as a Patient Safety 

Organization (PSO). The Patient Safety 

and Quality Improvement Act of 2005 

(Patient Safety Act), Public Law 109–41, 

42 U.S.C. 299b–21—b–26, provides for 

the formation of PSOs, which collect, 

aggregate, and analyze confidential 

information regarding the quality and 

safety of health care delivery. The 

Patient Safety and Quality Improvement 

Final Rule (Patient Safety Rule), 42 CFR 

Part 3, authorizes AHRQ, on behalf of 

the Secretary of HHS, to list as a PSO 

an entity that attests that it meets the 

statutory and regulatory requirements 

for listing. A PSO can be ‘‘delisted’’ by 

the Secretary if it is found to no longer 

meet the requirements of the Patient 

Safety Act and Patient Safety Rule, 

including when a PSO chooses to 

voluntarily relinquish its status as a 

PSO for any reason. 

DATES: The directories for both listed 

and delisted PSOs are ongoing and 

reviewed weekly by AHRQ. The 

delisting was effective at 12 Midnight 

ET (2400) on October 13, 2010. 

ADDRESSES: Both directories can be 

accessed electronically at the following 

HHS Web site: http:// 

www.pso.AHRQ.gov/index.html. 

FOR FURTHER INFORMATION CONTACT: 

Diane Cousins, RPh., Center for Quality 

Improvement and Patient Safety, AHRQ, 

540 Gaither Road, Rockville, MD 20850; 

Telephone (toll free): (866) 403–3697; 

Telephone (local): (301) 427–1111; TTY 

(toll free): (866) 438–7231; TTY (local): 

(301) 427–1130; E-mail: 

pso@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Background 

The Patient Safety Act authorizes the 

listing of PSOs, which are entities or 

component organizations whose 

mission and primary activity is to 

conduct activities to improve patient 

safety and the quality of health care 

delivery. 

HHS issued the Patient Safety Rule to 

implement the Patient Safety Act. 

AHRQ administers the provisions of the 

Patient Safety Act and Patient Safety 

Rule (PDF file, 450 KB. PDF Help) 

relating to the listing and operation of 

PSOs. Section 3.108(d) of the Patient 

Safety Rule requires AHRQ to provide 

public notice when it removes an 

organization from the list of federally 

approved PSOs. AHRQ has accepted a 

notification from Helmet Fire, Inc. 

Patient Safety Group (A Component of 

Helmet Fire, Inc., PSO number P0023, to 

voluntarily relinquish its status as a 

PSO. Accordingly, Helmet Fire, Inc. 

Patient Safety Group (A Component of 

Helmet Fire, Inc) was delisted effective 

at 12 Midnight ET (2400) on October 13, 

2010. 

More information on PSOs can be 

obtained through AHRQ’s PSO Web site 

at http://www.pso.AHRQ.gov/ 

index.html. 

Dated: November 24, 2010. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2010–30267 Filed 12–2–10; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Patient Safety Organizations: 

Voluntary Delisting 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Notice of Delisting. 

SUMMARY: AHRQ has accepted a 

notification of voluntary relinquishment 

from Human Performance Technology 

Group, Inc. of its status as a Patient 

Safety Organization (PSO). The Patient 

Safety and Quality Improvement Act of 

2005 (Patient Safety Act), Public Law 

109–41, 42 U.S.C. 299b–21—b–26, 

provides for the formation of PSOs, 

which collect, aggregate, and analyze 

confidential information regarding the 

quality and safety of health care 

delivery. The Patient Safety and Quality 

Improvement Final Rule (Patient Safety 

Rule), 42 CFR Part 3, authorizes AHRQ, 

mstockstill on DSKH9S0YB1PROD with NOTICES