```

[Federal Register Volume 79, Number 78 (Wednesday, April 23, 2014)]
[Notices]
[Pages 22683-22685]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-09172]

=======================================================================
-----------------------------------------------------------------------

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: ``Phase II of a Longitudinal Program Evaluation of Health and 
Human Services (HHS) Healthcare Associated Infections (HAI) National 
Action Plan (NAP).'' 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 June 23, 2014.

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

Phase II of a Longitudinal Program Evaluation of Heath Human Services 
(HHS) Healthcare Associated Infections (HAI) National Action Plan (NAP)

    This evaluation of HHS' Healthcare Associated Infections National 
Action Plan will assess the efficacy, efficiency and coordination of 
federal efforts to mitigate and prevent Healthcare Associated 
Infections (HAIs). As such, the evaluation represents a critical 
component of AHRQ's mission to promote health care quality improvement.
    HAIs are infections that patients acquire while receiving treatment 
for other conditions while in a healthcare setting. They affect care in 
hospitals-hereafter referred to as ``acute care'', ambulatory care 
settings, and long-term care facilities, and represent a significant 
cause of illness and death in the United States. Over one million HAIs 
occur across health care settings every year.
    In 2008, amidst growing demands on the healthcare system, rising 
healthcare costs, and increasing concerns about antimicrobial-resistant 
pathogens, HHS established a senior-level Steering Committee for the 
Prevention of HAIs. Charged with improving coordination and maximizing 
the efficiency of prevention efforts across HHS, the Steering Committee 
released the first ``National Action Plan to Prevent Health Care-
Associated Infections'' (HAI NAP) in 2009. This plan outlined a 
systematic and phased approach to reducing HAIs and associated 
morbidity, mortality, and costs. Phase One of HAI NAP, which concluded 
in 2012, focused on HAI prevention in acute care hospitals, where data 
on prevention and the capacity to measure improvement were most 
complete.
    Additionally, the plan set specific targets for reducing rates of 
six high priority HAIs or specific causative organisms: Surgical site 
infection (SSI),

[[Page 22684]]

central-line associated bloodstream infection (CLABSI), ventilator-
associated pneumonia (VAP), catheter-associated urinary tract infection 
(CAUTI), Clostridium difficile infection, and methicillin-resistant 
Staphylococcus aureus infection (MRSA).
    Phase II of the Action Plan, entitled National Action Plan to 
Prevent Healthcare-Associated Infections: Roadmap to Elimination was 
released in April 2012. Phase II expanded the Action Plan to include 
prevention of HAIs in ambulatory surgical centers (ASCs) and end-stage 
renal disease (ESRD) facilities, and increasing influenza vaccination 
coverage of healthcare personnel. Phase III of the HAI NAP, released 
for public comment in April 2013, further expanded the Action Plan to 
include prevention of HAIs in long-term care facilities.
    Evaluation of HAI NAP. In 2009, AHRQ funded an independent, outside 
evaluation of HHS' HAI prevention efforts, as guided by the Action 
Plan. The goals of this evaluation were to: (1) Record the content and 
scope of the Action Plan, its current design, its progress, and impact 
on the future; (2) establish baseline data and provide additional 
information on the HAI landscape prior to and following the initiation 
of the Action Plan effort; and (3) provide strategic insights from 
ongoing processes for reducing HAIs and outcomes of these processes.
    The current evaluation will expand upon this initial effort, 
encompassing the additional health care settings outlined in Phases II 
and III of the HAI NAP.
    The goals of this Phase II evaluation are to:
    1. Identify commonalities, gaps, themes, and opportunities for 
collaboration across six Federal quality improvement and patient safety 
efforts to eliminate HAIs; and
    2. highlight actionable opportunities across HHS to collaborate and 
efficiently utilize resources in these quality improvement and patient 
safety efforts; and
    3. assess the unique and aggregate contributions of each quality 
improvement and patient safety effort to the mitigation and prevention 
of HAIs.
    This study is being conducted by AHRQ through its contractor, 
Insight Policy Research, Inc. and its subcontractors, IMPAQ 
International and RAND Corporation, pursuant to AHRQ's statutory 
authority to conduct and support research and evaluations 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

    To achieve the goals of the HAI NAP evaluation, the following data 
collections will be implemented:
    Semi-structured interviews. Key informant interviews with 
stakeholders of the HAI National Action Plan or the Quality Improvement 
(QI) initiatives that the Action Plan seeks to coordinate and align. 
These stakeholders will have knowledge of the QI initiatives as 
implemented in acute care, ambulatory care, long term care or ESRD 
facilities. AHRQ plans to conduct 33 interviews each year, over the 
course of two years. The semi-structured interviews will inform the 
process evaluation.
    AHRQ will use the interview data to assess the processes and 
methods used, results achieved, and lessons learned from patient 
quality and safety programs that are directed at reducing the incidence 
of HAIs. This information will enable AHRQ to identify redundancies in 
program efforts and provide effective approaches for coordinating and 
aligning Federal efforts to prevent the incidence of HAIs. Finally, 
collecting data from these stakeholders will allow AHRQ to detect gaps 
in the HAI science base and opportunities for funding additional 
projects focused on generating and implementing knowledge on preventing 
HAIs.
    The information gathered through the key informant interviews will 
be presented to members of a Federal Action Working Group (FAWG), 
comprising representatives from the various federal agencies and 
operating divisions of HHS who are actively involved in the HAI NAP. 
Presentations to the FAWG will provide continual and rapid-cycle 
feedback on evaluation findings. This feedback will accomplish several 
goals--namely, it will apprise the FAWG members of the study's 
formative findings, provide a medium to obtain feedback from the FAWG 
regarding the unique and aggregate impact of the national programs, and 
engage the FAWG in a discussion about gaps and future requirements.
    Ultimately, the information gathered through this data collection 
effort will appear in annual reports, along with results of secondary 
data analyses. These reports will provide AHRQ and HHS with 
comprehensive, evaluative findings across and within individual patient 
safety programs as well as findings specific to the HAI NAP, and the 
extent to which the goals outlined in the plan have been achieved.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in this evaluation. The total burden 
hours are estimated to be 66, which covers two years of interviews. The 
exhibits below indicate annualized burden hours in one year.
    In-Depth Interviews with Stakeholders: AHRQ plans to conduct 33 
semi-structured interviews each year for two years, totaling 66 semi-
structured interviews during the course of the evaluation. These 
interviews will be conducted with key HAI NAP stakeholders with 
expertise in one or more of the four targeted healthcare settings. 
These healthcare settings include: Acute care hospital settings, 
ambulatory surgical centers, ESRD facilities, and long term care 
settings. Respondents will be interviewed by telephone. Participant 
recruitment should take no longer than five minutes. Scheduling will 
take place through email and will include an attached letter of support 
from AHRQ. Interviews will last up to one hour.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                     Number of       Number of
            Data collection activity                respondents    responses per     Hours per     Total burden
                                                     per year       respondent       response          hours
----------------------------------------------------------------------------------------------------------------
In-depth Interviews with HAI NAP Stakeholders
 with expertise pertaining to:
     Acute Care Hospital Settings.......               9               1               1               9
     Ambulatory Surgical Centers........               8               1               1               8
     ESRD facilities....................               8               1               1               8
     Long Term Care Settings............               8               1               1               8
----------------------------------------------------------------------------------------------------------------

[[Page 22685]]

 
        Total...................................              33               1               1              33
----------------------------------------------------------------------------------------------------------------

                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of     Total burden   Average hourly    Total cost
            Data collection activity                respondents        hours         wage rate        burden
----------------------------------------------------------------------------------------------------------------
In-depth Interviews with external stakeholders:
     Acute Care Hospital Settings.......               9               9         $34.33*         $309.00
     Ambulatory Surgical Centers........               8               8          34.33*          275.00
     ESRD facilities....................               8               8          34.33*          275.00
     Long Term Care Settings............               8               8          34.33*          275.00
----------------------------------------------------------------------------------------------------------------
        Total...................................              33              na              na        1,134.00
----------------------------------------------------------------------------------------------------------------
* Based upon May 2012 National Occupational Employment and Wage Estimates for Epidemiologists, retrieved from
  http://www.bls.gov/oes/current/oes_nat.htm#19-0000 on February 20, 2014.

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 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.

    Dated: April 9, 2014.
Richard Kronick,
Director.
[FR Doc. 2014-09172 Filed 4-22-14; 8:45 am]
BILLING CODE 4160-90-P
```