40740 Federal Register / Vol. 78, No. 130 / Monday, July 8, 2013 / Notices 

Virginia; to acquire 100 percent of the 

voting shares of Virginia Commerce 

Bancorp, Inc, and thereby indirectly 

acquire Virginia Commerce Bank, both 

of Arlington, Virginia. 

B. Federal Reserve Bank of St. Louis 

(Yvonne Sparks, Community 

Development Officer) P.O. Box 442, St. 

Louis, Missouri 63166–2034: 

1. Banc Investors, L.L.C., Town and 

Country, Missouri; to acquire 33.32 

percent of the voting shares of 1st 

Advantage Bancshares, Inc., and thereby 

indirectly acquire 1st Advantage Bank, 

both of St. Peters, Missouri. 

Board of Governors of the Federal Reserve 

System, July 2, 2013. 

Michael J. Lewandowski, 

Associate Secretary of the Board. 

[FR Doc. 2013–16280 Filed 7–5–13; 8:45 am] 

BILLING CODE 6210–01–P 

GOVERNMENT ACCOUNTABILITY 

OFFICE 

Advisory Council on the Standards for 

Internal Control in the Federal 

Government 

AGENCY: Government Accountability 

Office. 

ACTION: Notice of teleconference 

meeting. 

SUMMARY: The US Government 

Accountability Office (GAO) is 

preparing to revise the Standards for 

Internal Control in the Federal 

Government, known as the ‘‘Green 

Book,’’ under the authority provided in 

the Federal Managers’ Financial 

Integrity Act. As part of the revision 

process, GAO is holding a 

teleconference with the Green Book 

Advisory Council (GBAC). The 

Comptroller General has established the 

GBAC to provide input and 

recommendations to the Comptroller 

General on revisions to the ‘‘Green 

Book.’’ The purpose of the meeting is to 

discuss proposed revisions to the 

‘‘Green Book.’’ 

DATES: The meeting will be held July 25, 

2013 from 10:00 a.m. to 12:00 p.m. EDT. 

FOR FURTHER INFORMATION CONTACT: For 

information on the Green Book 

Advisory Council and the Standards for 

Internal Control in the Federal 

Government please contact Kristen 

Kociolek, Assistant Director, Financial 

Management and Assurance telephone 

202–512–2989, 441 G Street NW., 

Washington, DC 20548–0001. 

SUPPLEMENTARY INFORMATION: The 

meeting will be a teleconference held by 

the US Government Accountability 

Office. This teleconference meeting 

follows an initial meeting, on May 20, 

2013, of the GBAC. During the May 20, 

2013 meeting the GBAC discussed an 

initial Green Book draft. Members of the 

public will be provided an opportunity 

to address the Council with a brief (fiveminute) comment period on matters 

directly related to the proposed update 

and revision. Any interested person 

who plans to participate in the 

teleconference as an observer must 

contact Kristen Kociolek, Assistant 

Director, 202–512–2989, prior to July 

19, 2013. The toll free call-in number is 

1–800–369–1927, and the participant 

code is 41706. 

Authority: 31 U.S.C. 3512 (c), (d). 

James Dalkin, 

Director, Financial Management and 

Assurance, U.S. Government Accountability 

Office. 

[FR Doc. 2013–16256 Filed 7–5–13; 8:45 am] 

BILLING CODE 1610–02–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: ‘‘Pretest 

of the Ambulatory Surgery/Procedure 

Survey on Patient Safety Culture 

Questionnaire (Ambulatory Surgery 

SOPS).’’ 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 September 6, 2013. 

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 

Pretest of the Ambulatory Surgery/ 

Procedure Survey on Patient Safety 

Culture Questionnaire (Ambulatory 

Surgery SOPS) 

One setting which has demonstrated 

tremendous growth both in the volume 

and complexity of procedures being 

performed is ambulatory surgical and 

procedure centers (ASCs). ASCs are 

defined by the Centers for Medicare & 

Medicaid Services (CMS) as distinct 

entities that operate exclusively to 

provide surgical services to patients 

who do not require hospitalization and 

are not expected to need to stay in a 

surgical facility longer than 24 hours (42 

CFR 416.2). Many of the services 

performed in these facilities extend 

beyond procedures traditionally thought 

of as surgery, including endoscopy, and 

injections to treat chronic pain. 

Currently, there are over 5,300 

Medicare-certified ASCs in the U.S., 

which represents a greater than 54% 

increase since 2001. In 2007, Medicare 

paid for more than 6 million surgeries 

performed in these facilities at a cost of 

nearly $3 billion. Recent CMS audits 

suggest infection control deficiencies in 

these facilities are widespread. For 

example, preliminary data from 2011 

found that 51 percent of ASCs surveyed 

had an infection control deficiency; 11 

percent were considered very serious 

deficiencies. These findings are only 

slightly lower than 2010 audits and a 

2008 sample of ASCs in three states. 

Given the widespread impact of ASCs 

on patient safety, the new Ambulatory 

Surgery/Procedure Survey on Patient 

Safety Culture (Ambulatory Surgery 

SOPS) will measure ASC staff 

perceptions about what is important in 

their organization and what attitudes 

and behaviors related to patient safety 

culture are supported, rewarded, and 

expected. The survey will help ASCs to 

identify and discuss strengths and 

weaknesses of patient safety culture 

within their individual facilities. They 

can then use that knowledge to develop 

appropriate action plans to improve 

their practices and their culture of 

patient safety. This survey is designed 

for use in ASCs that practice all types 

of surgical procedures including those 

that require incisions and less invasive 

or non-surgical procedures such as 

gastrointestinal procedures or pain 

management injections. 

This research has the following goals: 

(1) Develop, cognitively test and 

modify as necessary the Ambulatory 

Surgery/Procedure Survey on Patient 


emcdonald on DSK67QTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 130 / Monday, July 8, 2013 / Notices 40741 

Safety Culture Questionnaire 

(Ambulatory Surgery SOPS); and 

(2) Pretest and modify the 

questionnaire as necessary; and 

(3) Make the final questionnaire 

publicly available. 

This study is being conducted by 

AHRQ through its contractor, Health 

Research & Educational Trust (HRET), 

and subcontractor, 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. 42 

U.S.C. 299a(a)(1) and (2). 

Method of Collection 

To achieve the projects’ goals the 

following activities-and data collections 

will be implemented: 

(1) Cognitive interviews. One round of 

cognitive interviews on the Ambulatory 

Surgery SOPS will be conducted by 

telephone with 15 respondents from 

ASCs. The purpose of these interviews 

is to understand the cognitive processes 

the respondent engages in when 

answering a question on the survey and 

to refine the survey’s items and 

composites. These interviews will be 

conducted with a mix of physicians, 

management, nurses, surgical 

technicians, and administrative staff 

throughout the U.S. from ASCs with 

varying characteristics (e.g., size, 

geographic location, and type of 

ownership). 

(2) Pretest for the Ambulatory Surgery 

SOPS. The draft questionnaire will be 

pretested with physicians and staff from 

40 ASCs. The purpose of the pretest is 

to collect data for an assessment of the 

reliability and construct validity of the 

survey items and composites, allowing 

for their further refinement. A site-level 

point of contact (POC) will be recruited 

in each ASC to manage the data 

collection at that organization (compile 

sample information, distribute surveys, 

promote survey response, etc.). 

(3) Dissemination activities. The final 

questionnaire will be made publicly 

available through the AHRQ Web site. 

This activity does not impose a burden 

on the public and is therefore not 

included in the burden estimates in 

Exhibit 1. 

The information collected will be 

used to test and improve the draft 

survey items in the Ambulatory Surgery 

SOPS. Psychometric analysis will be 

conducted on the pretest data to 

examine item nonresponse, item 

response variability, factor structure, 

reliability, and construct validity of the 

items included in the survey. Because 

the survey items are being developed to 

measure specific aspects of patient 

safety culture in the ambulatory surgery 

setting, the factor structure of the survey 

items will be evaluated through 

multilevel confirmatory factor analysis. 

On the basis of the data analyses, items 

or factors may be dropped. 

The final survey instrument will be 

made available to the public for use in 

ASCs to assess their safety culture from 

the perspectives of their staff. The 

survey can be used by ASCs to identify 

areas for patient safety culture 

improvement. Researchers are also 

likely to use the survey to assess the 

impact of ASC’s patient safety culture 

improvement initiatives such as the 

implementation of a surgical safety 

checklist. This survey is an expansion of 

AHRQ’s suite of surveys on patient 

safety culture, which are available on 

the AHRQ Web site at (http:// 

www.ahrq.gov/professionals/qualitypatient-safety/surveys/index.html). 

Those surveys have been used by 

thousands of hospitals, nursing homes, 

medical offices, and pharmacies across 

the U.S. to assess patient safety culture. 

The Ambulatory Surgery SOPS contains 

new and revised questions and 

composites that more accurately apply 

to the ambulatory surgery setting. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

respondents’ time to participate in this 

research. Cognitive interviews will be 

conducted with 15 ASC staff 

(approximately three physicians, six 

nurses, two medical technicians, two 

administrative managers, and two 

administrative assistants) and will take 

about one hour and 30 minutes to 

complete. The Ambulatory Surgery 

SOPS will be completed by 529 ASC 

staff from 40 facilities (about 13 per 

facility). Each survey will require 

approximately 15 minutes to complete. 

A site-level POC will spend 

approximately 6 hours administering 

the Ambulatory Surgery SOPS. The total 

burden is estimated to be 395 hours 

annually. 

Exhibit 2 shows the estimated 

annualized cost burden associated with 

the respondents’ time to participate in 

this research. The total cost burden is 

estimated to be $16,173 annually. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Hours per 

response 

Total burden 

hours 

Cognitive interviews ......................................................................................... 15 1 1.5 23 

Pretest for the Ambulatory Surgery SOPS ...................................................... 529 1 15/60 132 

POC Administration of the survey ................................................................... 40 1 6 240 

Total .......................................................................................................... 584 na na 395 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate* 

Total cost 

burden 

Cognitive interviews ......................................................................................... 15 23 a $46.52 $1,070 

Pretest for the Ambulatory Surgery SOPS ...................................................... 529 132 b 46.04 6,077 

POC Administration of the survey ................................................................... 40 240 c 37.61 9,026 


emcdonald on DSK67QTVN1PROD with NOTICES
40742 Federal Register / Vol. 78, No. 130 / Monday, July 8, 2013 / Notices 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued 

orm name 

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate* 

Total cost 

burden 

Total .......................................................................................................... 584 395 na 16,173 

aBased on the weighted average wages for 1 Anesthesiologist (29–1061, $108.35), 2 Surgeons (29–1067, $106.48), 2 Administrative Services 

Managers (11–3011, $37.61), 6 Registered Nurses (29–1141, $34.23), 2 Medical and Clinical Laboratory Technicians (29–2030, $28.90), 1 Licensed Practical or Licensed Vocational Nurse (29–2061, $21.17), and 1 Office and Administrative Support Workers, All Other (43–9199, 

$16.92). bBased on the weighted average wages for 150 Registered Nurses, 85 Office and Administrative Support Workers, 85 Medical and Clinical 

Laboratory Technicians, 70 Surgeons, 50 Licensed Practical/Vocational Nurses, 49 Anesthesiologists, and 40 Administrative Services Managers. cBased on the on the average wages for 1 Administrative Services Managers. 

* National Occupational Employment and Wage Estimates in the United States, May 2012, ‘‘U.S. Department of Labor, Bureau of Labor Statistics’’ (available at http://www.bls.gov/oes/current/naics4_621400.htm [for outpatient care setting] 

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: June 25, 2013. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2013–16076 Filed 7–5–13; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30Day–13–13PQ] 

Agency Forms Undergoing Paperwork 

Reduction Act Review 

The Centers for Disease Control and 

Prevention (CDC) publishes a list of 

information collection requests under 

review by the Office of Management and 

Budget (OMB) in compliance with the 

Paperwork Reduction Act (44 U.S.C. 

Chapter 35). To request a copy of these 

requests, call the CDC Reports Clearance 

Officer at (404) 639–7570 or send an 

email to omb@cdc.gov. Send written 

comments to CDC Desk Officer, Office of 

Management and Budget, Washington, 

DC 20503 or by fax to (202) 395–5806. 

Written comments should be received 

within 30 days of this notice. 

Proposed Project 

DELTA FOCUS Program Evaluation— 

New—National Center for Injury 

Prevention and Control (NCIPC), 

Centers for Disease Control and 

Prevention (CDC). 

Background and Brief Description 

Intimate Partner Violence (IPV) is a 

serious, preventable public health 

problem that affects millions of 

Americans and results in serious 

consequences for victims, families, and 

communities. IPV occurs between two 

people in a close relationship. The term 

‘‘intimate partner’’ describes physical, 

sexual, or psychological harm by a 

current or former partner or spouse. IPV 

can impact health in many ways, 

including long-term health problems, 

emotional impacts, and links to negative 

health behaviors. IPV exists along a 

continuum from a single episode of 

violence to ongoing battering; many 

victims do not report IPV to police, 

friends, or family. 

The purpose of the DELTA FOCUS 

(Domestic Violence Prevention 

Enhancement and Leadership Through 

Alliances, Focusing on Outcomes for 

Communities United with States) 

program is to promote the prevention of 

IPV through the implementation and 

evaluation of strategies that create a 

foundation for the development of 

practice-based evidence. By 

emphasizing primary prevention, this 

program will support comprehensive 

and coordinated approaches to IPV 

prevention. Each state domestic 

violence coalition is required to identify 

and fund one to two well-organized, 

broad-based, active local coalitions 

(referred to as coordinated community 

responses or CCRs) that are already 

engaging in, or are at capacity to engage 

in, IPV primary prevention strategies 

affecting the structural determinants of 

health at the societal and/or community 

levels of the social ecological model. 

State Domestic Violence Coalitions 

(SDVCs) must facilitate and support 

local-level implementation and hire 

empowerment evaluators to support the 

evaluation of IPV prevention strategies 

by the CCRs. SDVCs must also 

implement and with their 

empowerment evaluators, evaluate 

state-level IPV prevention strategies. 

CDC seeks OMB approval for one year 

to collect information electronically 

from awardees, their CCRs and their 

empowerment evaluators. Data will be 

collected in year one and analyzed and 

disseminated in years two and three. A 

reinstatement request will be made to 

collect data in the fourth year of the 

program. Information will be collected 

using the DELTA FOCUS Program 

Evaluation Survey (referred to as DF 

Survey). The DF survey will collect 

information about SDVCs satisfaction 

with CDC efforts to support them; 

process, program and strategy 

implementation factors that affect their 

ability to meet the requirements of the 

funding opportunity announcement; 

prevention knowledge and use of the 

public health approach; and 

sustainability of prevention activities 

and successes. 

The DF Survey will be completed by 

10 SDVC executive directors, 10 SDVC 

project coordinators, 19 CCR project 

coordinators, and 10 SDVC 

empowerment evaluators and take a 

maximum of 1 hour to complete. The 

total estimated annualized burden is 49 

hours. 

There are no costs to respondents 

other than their time. 


emcdonald on DSK67QTVN1PROD with NOTICES