### 38107 Federal Register / Vol. 75, No. 126 / Thursday, July 1, 2010 / Notices

E XHIBIT 

### 2—E STIMATED 

### A NNUALIZED 

### C OST 

### B URDEN

Form name Number of nursing homes Total burden hours Average hourly wage rate* Total cost burden

Pre-implementation semi-structured interviews ............................................... 6 18 **51.68 $930 Administrator Interviews .................................................................................. 12 3 ***46.59 140 Train-the-trainer training .................................................................................. 6 48 31.31 1,503 Train-the-nurses training .................................................................................. 6 156 77.64 12,112 Train-the-physicians training ............................................................................ 6 18 31.31 564 Final Semi-Structured Interview ....................................................................... 6 24 77.64 1,863 Nurse survey .................................................................................................... 12 144 ***46.596,709 Physician survey .............................................................................................. 12 30 46.10 1,383

Total .......................................................................................................... 66 441 n/a 25,20 4
* Based upon the mean of the average wages, National Occupational Employment and Wage Estimates, U.S. Department of Labor, Bureau of Labor Statistics. May 2008.

** Average wages for one registered nurse ($31.31), one physician ($77.64), and one Administrator ($46.10). *** Average wages for two registered nurse ($31.31), one physician ($77.64), and one Administrator ($46.10).

Estimated Annual Costs to the Federal Government

Exhibit 3 shows the total and annualized cost for conducting this research. The total budget for this three year study is $999,976. The administration task includes costs associated with the initial kick-off conference call with AHRQ and monthly progress reports and ongoing conference calls. The research plan task includes costs to finalize the research plan; conduct the literature search; prepare and submit the IRB applications and OMB package; recruit facilities; collect baseline and monthly data from medical record reviews and conduct pre- and post-intervention provider interviews; implement the intervention; and write the final report on the explanatory model. The dissemination costs include the writing of a dissemination plan and two manuscripts for publication as well as presentations at two national conferences. The final report costs include the writing of a draft and final report.



### E XHIBIT 

### 3—E STIMATED 

### TOTAL AND 

### A NNUALIZED 

### C OST

Cost component Total Annualized cost

Administration ................................................................................................................. ......................................... $24,474 $8,158 Research Plan .................................................................................................................. ....................................... 591,788 197,263 Dissemination Plan ............................................................................................................. ..................................... 63,397 21,132 Final Report ................................................................................................................... .......................................... 46,501 15,500 Overhead ....................................................................................................................... .......................................... 273,816 91,272

Total .......................................................................................................................... ........................................ 999,976 333,325

Request for Comments

In accordance with the above-cited Paperwork Reduction Act legislation, 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: June 22, 2010. Carolyn M. Clancy,

Director.
[FR Doc. 2010–15796 Filed 6–30–10; 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 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


### 38108 Federal Register / Vol. 75, No. 126 / Thursday, July 1, 2010 / Notices

comment on this proposed information collection.

This proposed information collection was previously published in the Federal Register on May 3rd, 2010 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 August 2, 2010.

**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 e-mail at doris.lefkowitz@AHRQ.hhs.gov.

**SUPPLEMENTARY INFORMATION :**  Proposed Project Assessing the Impact of the National Implementation of TeamSTEPPS Master Training Program

As part of their effort to fulfill their mission goals, AHRQ, in collaboration with the Department of Defense’s (DoD) Tricare Management Activity (TMA), developed TeamSTEPPS ® (aka Team Strategies and Tools for Enhancing Performance and Patient Safety) to provide an evidence-based suite of toolsand strategies for training teamworkbased 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 healthcare system staff in various teamwork, communication, and patient safety concepts, tools, and techniques and ultimately helping to build a national infrastructure for supporting teamwork-based patient safety efforts in healthcare organizations and at the state level. The implementation 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 continuation support and improvement of teamwork in health care. During this effort, AHRQ has trained a corps of 2400 participants to serve as the Master Trainer infrastructure supporting national adoption of TeamSTEPPS. Participants in training become Master Trainers in TeamSTEPPS and are afforded the opportunity to observe the tools and strategies provided in the program 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 by implementers of TeamSTEPPS.

To understand the extent to which this infrastructure of patient safety knowledge and skills has been created, AHRQ will conduct an 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.

This study is being conducted by AHRQ through its contractor, American Institutes for Research (AIR), 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. 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) Web-based questionnaire to examine post-training activities and teamwork outcomes as a result of training from multiple perspectives. The questionnaire is directed to all master training participants. Items will cover post-training activities, implementation experiences, facilitators and barriers to implementation encountered, and perceived outcomes as a result of these activities.

(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 implementand disseminate the TeamSTEPPS posttraining. The organizations will vary in terms of type of organization ( e.g., QIO or hospital associations versus healthcare systems) and region ( i.e., Northeast, Midwest, Southwest, Southeast, Mid-Atlantic, West Coast). In addition, we will strive to ensure representativeness of the site visits by ensuring 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. 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 $28,594.


### 38109 Federal Register / Vol. 75, No. 126 / Thursday, July 1, 2010 / Notices

E XHIBIT 

### 1—E STIMATED ANNUALIZED BURDEN HOURS

Form Name Number of respondents Number of responses per

respondent Hours per response Total burden hours

Semi-structured interview ................................................................................ 9 9 60/60 81 Training participant questionnaire ................................................................... 240 10 20/60 800

Total .......................................................................................................... 249 NA NA 881



### E XHIBIT 

### 2—E STIMATED 

### A NNUALIZED 

### C OST 

### B URDEN

Form name Number of respondents Total burden hours Average hourly wage rate Total cost burden

Semi-structured interview ................................................................................ 9 81 $32.64 $2,644 Training participant questionnaire ................................................................... 240 800 32.64 26,112

Total .......................................................................................................... 249 881 NA 28,75 6
* 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, 2008, U.S. Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes

_ nat.htm#b29- 0000.

Estimated Annual Costs to the Federal Government

Exhibit 3 shows the total cost for this one year project; since the project is for only one year these are also the annualized costs. The total cost to the government for this activity is estimated to be $181,521 to conduct the one-time questionnaire and conduct nine site visits, as well as to analyze and present all results. This amount includes costs for developing the data collection tools ($24,889); collecting the data ($108,667); and analyzing the data ($35,061) and reporting the findings ($12,903).



### E XHIBIT 

### 3—E STIMATED 

### TOTAL AND 

### A NNUALIZED 

### C OST

Cost component Total cost

Project Development ................ $24,889 Data Collection Activities .......... 108,667 Data Processing and Analysis 35,061 Publication of Results ............... 12,903

Total ................................... 181,521

Request for Comments

In accordance with the above-cited Paperwork Reduction Act legislation, 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: June 22, 2010. Carolyn M. Clancy,

Director.
[FR Doc. 2010–15795 Filed 6–30–10; 8:45 am]

**BILLING CODE 4160–90–M**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Health Resources and Services Administration** 

**Notice of Availability of Draft Policy Document for Comment** 

**AGENCY :**  Health Resources and Services Administration (HRSA), HHS.

**ACTION :**  The Federal Tort Claims Act (FTCA) Policy Manual was developed to serve as the primary policy source for information on FTCA for Health Center Program grantees funded under section 330 of the Public Health Service (PHS) Act ( ‘‘ section 330 ’’ ). The Policy Manual is currently posted on the Internet at http://bphc.hrsa.gov/draftsforcomment/ ftcamanual/. **DATES :**  Comments must be received by August 6, 2010.

**ADDRESSES :**  Comments should be submitted to OPPDGeneral@hrsa.gov by close of business on August 6, 2010.
**SUMMARY :**  HRSA believes that community input is valuable to the development of policies and policy documents related to the implementation of HRSA programs, including the Health Center Program. Therefore, we are requesting comments on the FTCA Policy Manual referenced above. Comments will be reviewed and analyzed, and a summary and general response to comments will be published as soon as possible after the comment submission deadline.

**BACKGROUND :**  HRSA administers the Health Center Program, which supports more than 1,100 organizations operating almost 8,000 health care delivery sites, including community health centers, migrant health centers, health care for the homeless centers, and public housing primary care centers. Health centers serve medically underserved communities delivering preventive and primary care services to patients regardless of their ability to pay.

Health Center Program grantees funded under section 330 of the PHS Act, including Community Health Centers, Migrant Health Centers, Health Care for the Homeless Health Centers, and Public Housing Primary Care Health Centers, have access to medical malpractice coverage under the Federal Tort Claims Act (FTCA). FTCA, enacted in 1946, is the legal mechanism for compensating people who have suffered personal injury due to the negligent or wrongful action of employees of the