[Federal Register Volume 87, Number 82 (Thursday, April 28, 2022)]
[Notices]
[Pages 25271-25273]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-09026]


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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: ``TeamSTEPPS[supreg] Stakeholder Surveys for AHRQ's ACTION III 
Diagnostic Safety Capacity Building Contract Task.'' This proposed 
information collection was previously published in the Federal Register 
on February 9th, 2022 and 60 days for public comment. AHRQ did not 
receive substantive comments from members of the public during this 
period. The purpose of this notice is to allow an additional 30 days 
for public comment.

DATES: Comments on this notice must be received by May 31, 2022.

ADDRESSES: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports 
Clearance Officer, (301) 427-1477, or by email at 
<a href="/cdn-cgi/l/email-protection#563239243f25783a33303d39213f222c16171e0407783e3e2578313920"><span class="__cf_email__" data-cfemail="a4c0cbd6cdd78ac8c1c2cfcbd3cdd0dee4e5ecf6f58accccd78ac3cbd2">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION: 

Proposed Project

TeamSTEPPS[supreg] Stakeholder Surveys for AHRQ's ACTION III Diagnostic 
Safety Capacity Building Contract Task 3

    AHRQ awarded a contract to the MedStar Health Research Institute 
(MHRI) in 2019 and received OMB fast track clearance (OMB control 
number 0935-0179, expiration date of 11/30/23), to provide program 
support and expertise related to improving diagnostic safety and 
quality across five distinct contract tasks. Task 3 of the contract is 
to develop, pilot test and promote a TeamSTEPPS[supreg] Course to 
improve communication among providers related to diagnosis. 
TeamSTEPPS[supreg] to Improve Diagnosis provides communication 
strategies, including methods to improve intra-professional 
communication and communication during the referral process and to 
practice mutual support and situation monitoring during the diagnostic 
process. TeamSTEPPS[supreg] to Improve Diagnosis includes an 
educational module for leaders on strategies to facilitate improved 
communication with and among providers related to diagnosis. This 
module also includes a Team Assessment Tool for Improving Diagnosis 
(the ``Team Assessment Tool'').
    The Team Assessment Tool is an instrument developed as a method of 
self-assessment, with the goal of helping teams reflect on their 
current diagnostic and teamwork practices. In addition, it orients them 
to the repertoire of tools available within the TeamSTEPPS for 
Improving Diagnosis course that are available to support improvement 
efforts. The Team Assessment Tool asks participants to complete self-
assessment ratings as a mechanism to identify strengths and 
opportunities for improvement in unit-based teamwork. The unit level 
aggregate results of the assessments help unit leaders identify 
priorities for training via use of course modules and specific 
interventions with their diagnostic improvement teams.
    AHRQ would like to further develop this Team Assessment Tool into a 
measurement instrument, expanding on its intended use as an educational 
activity and formative assessment. The opportunity to provide evidence 
(via publication in peer reviewed journals) that the tool is both valid 
and reliable will strengthen its acceptance in the care delivery 
community and provide a scientifically sound method for teams to assess 
changes in performance overtime. The Team Assessment Tool requires 
psychometric testing in order to ensure validity and reliability.
    Psychometrics is the construction and validation of measurement 
instruments and assessing if these instruments are reliable (have 
consistency in measurement) and valid (have accuracy in measurement). 
Reliability and validity indicate how well a method,

[[Page 25272]]

technique, test, or instrument is truly measuring what it intends to 
measure.
    The contractor has conducted precursor psychometric testing on the 
Team Assessment Tool, which included the following: (1) Item wording 
and scale refinement, (2) Project Team Subject Matter Expert content 
review, (3) Non-Project Team Subject Matter Expert review, (4) End-user 
feedback, and (5) Instrument refinement. This work puts the reliability 
and validity of the indicators of the instrument at an optimal starting 
point for full psychometric testing.
    Full psychometric testing of this instrument means the scaling must 
be evaluated extensively, which will require a sample of at least 359 
individual care team members (physicians, nurses, ancillary staff, 
etc.,) from diverse clinical settings to participate in a 15-minute, 
anonymous, online survey distributed via a shared electronic survey 
link. Individual care team members will be recruited from across 9 
health systems or care settings. The survey will ask participants to 
read through and complete the questions; participants will not be privy 
to the results of the survey.
    The contractor will examine this sample of results via analyses to 
determine the stability of the instrument and its indicators, ensuring 
parallel measurements, homogeneity among indicators, concurrent, 
convergent, and discriminant validity, latent constructs of the tool, 
the extent to which measures of the same concept correlate and diverge, 
and the degree of that correlation in evaluating the instrument's 
ability to discriminate between different groups with various levels 
and familiarity with safety culture. It is important to note the 
responses on the surveys are not being evaluated, but rather the 
consistency with which the questions are answered is being evaluated 
(i.e., determining whether the questions are being interpreted the same 
by all the users), despite diverse healthcare settings and varying 
levels of experience and familiarity with TeamSTEPPS. The combination 
of these psychometric methods will allow for internal and external 
validity and reliability to be assessed, to create a psychometrically 
sound instrument vetted for potential widespread adoption.
    The Team Assessment Tool instrument will undergo remote usability 
testing of a survey to refine questions. To execute this task, the 
contractor has assembled an interprofessional team to execute any or 
all of the following methods for generating reliability and validity 
evidence that would be applicable to this specific tool: (1) Parallel 
forms reliability, (2) internal consistency reliability, (3) inter-
rater reliability, (4) content validity, and (5) construct validity, 
using a multitrait-multimethod matrix and/or known groups testing.
    This information collection has the following goal:
    1. To determine the stability of the Team Assessment Tool 
instrument and its indicators in improving communication to reduce 
diagnostic errors, by quantitatively examining the correlation among 
responses of each indicator.
    This study is being conducted by AHRQ through its contractor, 
MedStar Health Research Institute, 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 
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 goal of this project the following information 
collection instruments will be completed using individual surveys:
    (1) Setting Demographics Survey: Prior to testing of the 
instrument, each health system will take a brief survey to describe the 
characteristics of the sites engaged in pilot testing (e.g., size, 
diagnostic team member role diversity, and familiarity with patient 
safety and quality improvement activities).
    (2) TeamSTEPPS[supreg] Team Assessment Tool for Improving 
Diagnosis: This is collected from individual survey respondents, who 
are diverse staff members in a diagnostic team. The consistency with 
which the questions are interpreted and answered among respondents will 
be evaluated to determine the stability among indicators on the 
instrument.
    AHRQ will use the information collected through this Information 
Collection Request to assess and enhance the feasibility of adopting a 
course to improve communication among providers related to diagnosis. 
AHRQs' ability to publicly share a Team Assessment Tool that has been 
scientifically validated is expected to be of great interest to the 
health care community and important in helping organizations prioritize 
improvement efforts.

Estimated Annual Respondent Burden

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Setting Demographics Survey.....................               9               1            0.25            2.25
TeamSTEPPS[supreg] Team Assessment Tool for                  350               1            0.25            87.5
 Improving Diagnosis............................
                                                 ---------------------------------------------------------------
    Total.......................................             359  ..............  ..............           89.75
----------------------------------------------------------------------------------------------------------------


                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                    Form name                        Number of     Total burden     hourly wage     Total cost
                                                    respondents        hours           rate           burden
----------------------------------------------------------------------------------------------------------------
Setting Demographics Survey.....................               9            2.25      \a\ $57.12         $128.52
TeamSTEPPS[supreg] Team Assessment Tool for                  265           66.25      \b\ 103.06       $6,827.73
 Improving Diagnosis............................
TeamSTEPPS[supreg] Team Assessment Tool for                   85           21.25       \c\ 15.50         $329.38
 Improving Diagnosis............................
                                                 ---------------------------------------------------------------
    Total.......................................             359           89.75  ..............        7,285.63
----------------------------------------------------------------------------------------------------------------
\a\ Based on the mean wages for Medical and Health Services Managers (Code 11-9111).

[[Page 25273]]

 
\b\ Based on the mean wages for Family Medicine Physicians (Code 29-1215).
\c\ Based on the mean wages for HC Support Occupations (Code 31-0000).
Occupational Employment Statistics, May 2020 National Occupational Employment and Wage Estimates United States,
  U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.

Request for Comments

    In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3520, 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's 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 22, 2022.
Marquita Cullom,
Associate Director.
[FR Doc. 2022-09026 Filed 4-27-22; 8:45 am]
BILLING CODE 4160-90-P


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