```

[Federal Register Volume 80, Number 69 (Friday, April 10, 2015)]
[Notices]
[Pages 19321-19322]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-07700]

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

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 Impact of the National Implementation of 
TeamSTEPPS Master Training Program.'' In accordance with the Paperwork 
Reduction Act, 44 U.S.C. 3501-3520, AHRQ invites the public to comment 
on this proposed information collection.

DATES: Comments on this notice must be received by June 9, 2015.

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

Assessing the Impact of the National Implementation of TeamSTEPPS 
Master Training Program

    AHRQ, in collaboration with the Department of Defense's (DoD) 
Tricare Management Activity (TMA), developed TeamSTEPPS[supreg] (``Team 
Strategies and Tools to Enhance Performance and Patient Safety'') to 
provide an evidence-based suite of tools and strategies for teaching 
teamwork-based patient safety to health care professionals. In 2007, 
AHRQ and DoD coordinated the national implementation of the TeamSTEPPS 
Program. The main objective of this program is to improve patient 
safety by training a select group of stakeholders such as Quality 
Improvement Organization (QIO) personnel, High Reliability Organization 
(HRO) staff, and health care system staff in various teamwork, 
communication, and patient safety concepts, tools, and techniques. 
Ultimately TeamSTEPPS will help to build a national and state-level 
infrastructure for supporting teamwork-based patient safety efforts in 
health care organizations.
    The National Implementation of TeamSTEPPS Master Training Program 
includes the training of ``Master Trainers'' in various health care 
systems capable of stimulating the utilization and adoption of 
TeamSTEPPS in their health care delivery systems, providing technical 
assistance and consultation on implementing TeamSTEPPS, and developing 
various channels of learning (e.g., user networks, various educational 
venues) for continuing support and improvement of teamwork in health 
care. AHRQ has already trained a corps of over 5,000 participants to 
serve as the Master Trainer infrastructure supporting national adoption 
of TeamSTEPPS. An anticipated 2,400 participants who are registering 
for the program will be studied in this assessment. Participants in 
training become Master Trainers in TeamSTEPPS and are afforded the 
opportunity to observe the program's tools and strategies in action. In 
addition to developing a corps of Master Trainers, AHRQ has also 
developed a series of support mechanisms for this effort including a 
data collection Web tool, a TeamSTEPPS call support center, and a 
monthly consortium to address any challenges encountered implementing 
TeamSTEPPS.
    Participants applied to the program as teams representing their 
organizations and were accepted as training participants after having 
completed an organizational readiness assessment. Due to the 
differences among the types of organizations participating in the 
program, each participant has a different potential to apply tools and 
concepts within and/or beyond their home organizations. For example:
     Health care system staff (or implementers) from hospitals, 
home health agencies, nursing homes, large physician practices, and 
other direct care organizations are more likely than other participants 
to implement the TeamSTEPPS materials on a daily basis and will be more 
likely to affect specific work processes being conducted within an 
organization. As a result, health care system participants are likely 
to have a focused and specific impact that is limited to their 
organization.
     QIO\HRO\Hospital Association\State Health Department 
participants (or facilitators) will be more likely to have both an in-
depth and broad impact if they use the TeamSTEPPS materials to assist a 
particular organization inits patient safety activities, as well as to 
provide general patient safety guidance to a large number of 
organizations.
    To clarify the differences among the participants, a logic model 
has been developed that highlights the roles of the different types of 
participants, the types of activities in which they are likely to 
engage post-training, and the potential outcomes that may stem from 
these activities. The logic model served as a guide for developing 
questions for a web-based questionnaire and qualitative interviews to 
ensure that participant and leadership feedback is captured as 
thoroughly and accurately as possible.
    AHRQ is conducting an ongoing evaluation of the National 
Implementation of TeamSTEPPS Master Training Program. The goals of this 
evaluation are to examine the extent to which training participants 
have been able to:
    (1) Implement the TeamSTEPPS products, concepts, tools, and 
techniques in their home organizations and,
    (2) the extent to which participants have spread that training, 
knowledge, and skills to their organizations, local areas, regions, and 
states.
    The National Implementation of TeamSTEPPS program is led by AHRQ 
through its contractor, the Health Research and Educational Trust 
(HRET). This study is being conducted by HRET's subcontractor, IMPAQ 
International. The work is being conducted pursuant to AHRQ's statutory 
authority to conduct and support research, evaluations, and training on 
health care and on systems for the delivery of such care, including 
activities with respect to the quality, effectiveness, efficiency, 
appropriateness and value of health care 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 this assessment the following two data 
collections will be implemented:
    (1) Training participant questionnaires to examine post-training 
activities and teamwork outcomes as a

[[Page 19322]]

result of training from multiple perspectives. The questionnaire is 
directed to all Master Training participants, and will cover post-
training activities, implementation experiences, facilitators and 
barriers to implementation encountered, and perceived outcomes as a 
result of these activities. Advance notice, invitations to participate, 
reminder emails, and thank you letters to respondents are included in 
the participant questionnaire.
    (2) Semi-structured interviews will be conducted with members from 
organizations who participated in the TeamSTEPPS Master Training 
Program. Information gathered from these interviews will be analyzed 
and used to draft a ``lessons learned'' document that will capture 
additional detail on the issues related to participants' and 
organizations' abilities to implement and disseminate TeamSTEPPS post-
training. The organizations will vary in terms of type of organization 
(e.g., QIO or hospital associations versus health care systems) and 
region (i.e., Northeast, Midwest, Southwest, Southeast, Mid-Atlantic, 
West Coast). In addition, we will strive to ensure that the 
distribution of organizations mirrors the distribution of organizations 
in the Master Training population. For example, if the distribution of 
organizations is such that only one out of every five organizations is 
a QIO, we will ensure that a maximum of two organizations in the site 
visit sample are QIOs. The interviews will more accurately reveal the 
degree of training spread for the organizations included. Interviewees 
will be drawn from qualified individuals serving in one of two roles 
(i.e., implementers or facilitators). The interview protocol will be 
adapted for each role based on the respondent group and to some degree, 
for each individual, based on their training and patient safety 
experience. There is also an informed consent form that each 
participant will be required to sign prior to beginning the interview.
    The final product for this evaluation will be a report that 
documents the background, methodology, results (including any patterns 
or themes emerging from the data), limitations of the study, and 
recommendations for future training programs and tool development. The 
results of this evaluation will help AHRQ understand the extent to 
which participants and participating organizations have been able to 
employ various TeamSTEPPS tools and concepts and the barriers and 
facilitators they encountered. This information will help guide AHRQ in 
developing and refining other patient safety tools and future training 
programs for patient safety.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondent's time to participate in the study. Semi-structured 
interviews will be conducted with a maximum of 9 individuals from each 
of 9 participating organizations and will last about one hour each. The 
training participant questionnaire will be completed by approximately 
10 individuals from each of about 240 organizations and is estimated to 
require 20 minutes to complete. The total annualized burden is 
estimated to be 881 hours.
    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to participate in the study. The total cost burden is 
estimated to be $39,240.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Semi-structured interview.......................               9               9           60/60              81
Training participant questionnaire..............             240              10           20/60             800
                                                 ---------------------------------------------------------------
    Total.......................................             249              NA              NA             881
----------------------------------------------------------------------------------------------------------------

                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Total burden   Average hourly    Total cost
     Form name           Number of respondents           hours        wage rate*        burden
--------------------------------------------------------------------------------------------------
Semi-structured     9.............................              81          $44.54          $3,608
 interview
 Training           240...........................             800           44.54          35,632
 participant
 questionnaire
                   ---------------------------------------------------------------------------------------------
    Total.........  249...........................             881              NA          39,240
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the average wages for all health professionals (29-0000) for the training participant
  questionnaire and for executives, administrators, and managers for the organizational leader questionnaire
  presented in the National Compensation Survey: Occupational Wages in the United States, May 2013, U.S.
  Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes_nat.htm 35.93 53.15.

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: March 31, 2015.
Sharon B. Arnold,
Deputy Director.
[FR Doc. 2015-07700 Filed 4-09-15; 8:45 am]
BILLING CODE 4160-90-P
```