[Federal Register Volume 80, Number 55 (Monday, March 23, 2015)]
[Notices]
[Pages 15229-15231]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-06451]


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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.

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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: ``Nursing Home Survey on Patient Safety Culture Comparative 
Database.'' 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 May 22, 2015.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by email at 
<a href="/cdn-cgi/l/email-protection#a2c6cdd0cbd18ccec7c4c9cdd5cbd6d8e2e3eaf0f38ccacad18cc5cdd4"><span class="__cf_email__" data-cfemail="076368756e74296b62616c68706e737d47464f5556296f6f7429606871">[email protected]</span></a>.
    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 
<a href="/cdn-cgi/l/email-protection#62060d100b114c0e0704090d150b161822232a30334c0a0a114c050d14"><span class="__cf_email__" data-cfemail="2b4f4459425805474e4d40445c425f516b6a63797a05434358054c445d">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION:

Proposed Project

Nursing Home Survey on Patient Safety Culture Comparative Database

    Background on the Nursing Home Survey on Patient Safety Culture 
(Nursing Home SOPS). In 1999, the Institute of Medicine called for 
health care organizations to develop a ``culture of safety'' such that 
their workforce and processes focus on improving the reliability and 
safety of care for patients (IOM, 1999; To Err is Human: Building a 
Safer Health System). To respond to the need for tools to assess 
patient safety culture in health care, AHRQ developed and pilot tested 
the Nursing Home SOPS with OMB approval (OMB NO. 0935-0132; Approved 
July 5, 2007).
    The survey is designed to enable nursing homes to assess provider 
and staff opinions about patient safety issues, medical error, and 
error reporting and includes 42 items that measure 12 dimensions of 
patient safety culture. AHRQ made the survey publicly available along 
with a Survey User's Guide and other toolkit materials in November 2008 
on the AHRQ Web site (located at http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/nursing-home/index.html).
    The AHRQ Nursing Home SOPS Comparative Database consists of data 
from the AHRQ Nursing Home SOPS. Nursing homes in the U.S. are asked to 
voluntarily submit data from the survey to AHRQ through its contractor, 
Westat. The Nursing Home SOPS database (OMB NO. 0935-0195, last 
approved on June 12, 2012) was developed by AHRQ in 2011 in response to 
requests from nursing homes interested in knowing how their patient 
safety culture survey results compare to those of other nursing homes 
in their efforts to improve patient safety.
    Rationale for the information collection. The Nursing Home SOPS and 
the Comparative Database support AHRQ's goals of promoting improvements 
in the quality and safety of health care in nursing home settings. The 
survey, toolkit materials, and comparative database results are all 
made publicly available on AHRQ's Web site. Technical assistance is 
provided by AHRQ through its contractor at no charge to nursing homes 
to facilitate the use of these materials for nursing home patient 
safety and quality improvement.
    The goal of this project is to renew the Nursing Home SOPS 
Comparative Database. This database will:
    (1) Allow nursing homes to compare their patient safety culture 
survey results with those of other nursing homes,
    (2) Provide data to nursing homes to facilitate internal assessment 
and learning in the patient safety improvement process, and
    (3) Provide supplemental information to help nursing homes identify 
their strengths and areas with potential for improvement in patient 
safety culture.
    This study is being conducted by AHRQ through its contractor, 
Westat, pursuant to AHRQ's statutory authority to conduct and support 
research 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; quality 
measurement and improvement; and database development. 42 U.S.C. 
299a(a)(1), (2), and (8).

Method of Collection

    To achieve the goal of this project the following activities and 
data collections will be implemented:
    (1) Eligibility and Registration Form--The nursing home (or parent 
organization) point of contact (POC) completes a number of data 
submission steps and forms, beginning with the completion of an online 
eligibility and registration form. The purpose of this form is to 
determine the eligibility status and initiate the registration process 
for nursing homes seeking to voluntarily submit their Nursing Home

[[Page 15230]]

SOPS data to the Nursing Home SOPS Comparative Database.
    (2) Data Use Agreement--The purpose of the data use agreement, 
completed by the nursing home POC, is to state how data submitted by 
nursing homes will be used and provides confidentiality assurances.
    (3) Nursing Home Site Information Form--The purpose of the site 
information form is to obtain basic information about the 
characteristics of the nursing homes submitting their Nursing Home SOPS 
data to the Nursing Home SOPS Comparative Database (e.g., bed size, 
urbanicity, ownership, and geographic region). The nursing home POC 
completes the form.
    (4) Data Files Submission--The number of submissions to the 
database is likely to vary each year because nursing homes do not 
administer the survey and submit data every year. Data submission is 
typically handled by one POC who is either a corporate level health 
care manager for a Quality Improvement Organization (QIO), a survey 
vendor who contracts with a nursing home to collect their data, or a 
nursing home Director of Nursing or nurse manager. POCs submit data on 
behalf of 5 nursing homes, on average, because many nursing homes are 
part of a QIO or larger nursing home or health system that includes 
many nursing home sites, or the POC is a vendor that is submitting data 
for multiple nursing homes. POCs upload their data file(s), using the 
nursing home data file specifications, to ensure that users submit 
standardized and consistent data in the way variables are named, coded, 
and formatted.
    Survey data from the AHRQ Nursing Home SOPS are used to produce 
three types of products: (1) A Nursing Home SOPS Comparative Database 
Report that is produced periodically and made publicly available on the 
AHRQ Web site (see http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/nursing-home/2014/nhsurv14-ptI.pdf for the 
2014 report); (2) Individual Nursing Home Survey Feedback Reports that 
are confidential, customized reports produced for each nursing home 
that submits data to the database (the number of reports produced is 
based on the number of nursing homes submitting in any given calendar 
year); and (3) Research data sets of individual-level and nursing home-
level de-identified data to enable researchers to conduct analyses.
    Nursing homes are asked to voluntarily submit their Nursing Home 
SOPS survey data to the Comparative Database. The data are then cleaned 
and aggregated and used to produce a Comparative Database Report that 
displays averages, standard deviations, and percentile scores on the 
survey's 42 items and 12 patient safety culture dimensions, as well as 
displaying these results by nursing home characteristics (bed size, 
urbanicity, ownership, and Census Bureau Region, etc.) and respondent 
characteristics (work area/unit, staff position, and interaction with 
patients).
    Data submitted by nursing homes are also used to give each nursing 
home its own customized survey feedback report that presents the 
nursing home's results compared to the latest comparative database 
results. If a nursing home submits data more than once, its survey 
feedback report also presents trend data, comparing its previous and 
most recent data.
    Nursing homes use the Nursing Home SOPS, Comparative Database 
Reports and Individual Nursing Home Survey Feedback Reports for a 
number of purposes, to:
    <bullet> Raise staff awareness about patient safety.
    <bullet> Diagnose and assess the current status of patient safety 
culture in their nursing home.
    <bullet> Identify strengths and areas for patient safety culture 
improvement.
    <bullet> Examine trends in patient safety culture change over time.
    <bullet> Evaluate the cultural impact of patient safety initiatives 
and interventions.
    <bullet> Compare patient safety culture survey results with other 
nursing homes in their efforts to improve patient safety and health 
care quality.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in the database. An estimated 300 
POCs, each representing an average of 5 individual nursing homes each, 
will complete the database submission steps and forms annually. 
Completing the eligibility and registration form will take about 3 
minutes. Each POC will complete a data use agreement which takes about 
3 minutes to complete. The Nursing Home Site Information Form is 
completed by all POCs for each of their nursing homes (300 x 5 = 1,500 
forms in total) and is estimated to take 5 minutes to complete. The POC 
will submit data for all of the nursing homes he/she represents, which 
will take 1 hour on average. The total annual burden hours are 
estimated to be 455.
    The 300 respondents/POCs shown in Exhibit 1 are based on an 
estimate of nursing homes submitting data in the coming years, with the 
following assumptions:
    <bullet> 105 POCs for QIOs submitting on behalf of 10 nursing homes 
each
    <bullet> 18 POCs for vendors outside of QIOs submitting on behalf 
of 10 nursing homes each
    <bullet> 177 independent nursing homes submitting on their own 
behalf
    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to submit their data. The cost burden is estimated to 
be $20,839 annually.

                                  Exhibit 1--Estimated annualized burden hours
----------------------------------------------------------------------------------------------------------------
                                                     Number of       Number of
                    Form name                      respondents/    responses per     Hours per     Total burden
                                                       POCs             POC          response          hours
----------------------------------------------------------------------------------------------------------------
Eligibility/Registration Form...................             300               1            3/60              15
Data Use Agreement..............................             300               1            3/60              15
Nursing Home Site Information Form..............             300               5            5/60             125
Data Files Submission...........................             300               1               1             300
                                                 ---------------------------------------------------------------
    Total.......................................           1,200              NA              NA             455
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[[Page 15231]]


                                   Exhibit 2--Estimated annualized cost burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of                        Average
                    Form name                      respondents/    Total burden     hourly wage     Total cost
                                                       POCs            hours          rate *          burden
----------------------------------------------------------------------------------------------------------------
Eligibility/Registration Forms..................             300              15          $45.80            $687
Data Use Agreement..............................             300              15           45.80             687
Nursing Home Site Information Form..............             300             125           45.80           5,725
Data Files Submission...........................             300             300           45.80          13,740
                                                 ---------------------------------------------------------------
    Total.......................................           1,200             455              NA          20,839
----------------------------------------------------------------------------------------------------------------
* The wage rate in Exhibit 2 is based on May 2013 National Industry-Specific Occupational Employment and Wage
  Estimates, Bureau of Labor Statistics, U.S. Dept. of Labor. Mean hourly wages for nursing home POCs are
  located at http://www.bls.gov/oes/current/naics4_623100.htm and http://data.bls.gov/cgi-bin/print.pl/oes/current/naics2_62.htm. The hourly wage of $45.80 is the weighted mean of $47.97 (General and Operations
  Managers; N = 88), $40.07 (Medical and Health Services Managers; N = 89), $47.10 (General and Operations
  Managers; N =105) and $55.94 (Computer and Information Systems Managers; N = 18).

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 17, 2015.
Sharon B. Arnold,
Deputy Director, AHRQ.
[FR Doc. 2015-06451 Filed 3-20-15; 8:45 am]
 BILLING CODE 4160-90-P


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