[Federal Register Volume 73, Number 183 (Friday, September 19, 2008)]
[Notices]
[Pages 54402-54403]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-21822]


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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, Department of 
Health and Human Services.

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) allow the proposed information collection 
project: ``Establishing Benchmarks for the Medical Office Survey on 
Patient Safety.'' In accordance with the Paperwork Reduction Act of 
1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A)), AHRQ invites the 
public to comment on this proposed information collection.

DATES: Comments on this notice must be received by November 18, 2008.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by e-mail at 
<a href="/cdn-cgi/l/email-protection#82e6edf0ebf1aceee7e4e9edf5ebf6f8c2e3eaf0f3aceaeaf1ace5edf4"><span class="__cf_email__" data-cfemail="197d766b706a37757c7f72766e706d635978716b683771716a377e766f">[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 e-mail at 
<a href="/cdn-cgi/l/email-protection#5a3e3528332974363f3c31352d332e201a3b32282b74323229743d352c"><span class="__cf_email__" data-cfemail="2e4a415c475d00424b48454159475a546e4f465c5f0046465d00494158">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION:

Proposed Project

    ``Establishing Benchmarks for the Medical Office Survey on Patient 
Safety''.
    The ambulatory Medical Office Survey on Patient Safety (SOPS), an 
adapted version of AHRQ's Hospital Survey on Patient Safety Culture 
(HSOPSC), was developed in 2005 to measure specific components of 
patient safety culture in the ambulatory setting. A pilot study (OMB 
<greek-i>0935-0131) assessed and refined the psychometric properties of 
specific survey items, and a final version of SOPS is now ready for 
public dissemination. However, in order for the survey to be most 
useful to ambulatory medical offices in identifying areas of relative 
strength and weakness in patient safety culture, reliable benchmarks to 
which a practice's responses can be compared need to be established.
    AHRQ has determined, through discussions with potential end-users 
of SOPS, including leaders of physician and other provider groups, that 
an ambulatory practice is unlikely to have confidence in SOPS 
benchmarks unless the benchmarking data are based on responses derived 
from offices with similar characteristics. Office characteristics 
thought to have a potential effect on SOPS responses include practice 
size, location, provider specialty, and use of electronic information 
technology. A separate survey to collect information about these 
practice characteristics has been developed and was tested and refined 
as part of the pilot study.
    In order to establish SOPS benchmarks that can be tailored with 
respect to specific practice-related characteristics, survey responses 
from a large sample of practices stratified by these characteristics 
are required. AHRQ therefore intends to recruit and administer SOPS to 
ambulatory medical offices that have been selected on the basis of 
practice characteristics. In addition, AHRQ intends to collect from 
these practices evaluative information about administrative barriers 
and facilitators to survey participation as well as a description of 
how the office used (or plans to use) the survey results to enhance 
patient safety culture. These data will inform future efforts by AHRQ 
to maximize the use of SOPS and the utility/value of survey results to 
ambulatory practices across the country.
    This project is being conducted pursuant to AHRQ's statutory 
mandates to (1) promote health care quality improvement by conducting 
and supporting research that develops and presents scientific evidence 
regarding all aspects of health care, including methods for measuring 
quality and strategies for improving quality (42 U.S.C. 299(b)(1)(F)) 
and (2) conduct and support research on health care and on systems for 
the delivery of such care, including activities with respect to quality 
measurement and improvement (42 U.S.C. 299a(a)(2)).

Methods of Collection

    A purposive sample of 350 outpatient medical offices will be 
identified and recruited. The goal is for the sample to be 
proportionately distributed with regard to six practice 
characteristics: geographical location of offices; office size (number 
of physicians and employed staff); provider specialty; type of practice 
ownership; extent to which electronic information tools are used; and 
demographics of patients being served. All physicians and employed 
staff in the practices will be asked to complete the SOPS. 
Additionally, one office manager for the practice will be asked to 
complete the Office Characteristics Survey. Since higher response rates 
have been demonstrated when paperbased (compared to electronic) surveys 
are administered to busy ambulatory clinicians, SOPS will be 
administered in paper form. Standard non-response follow-up techniques 
such as reminder postcards and distribution of a second survey will be 
used. Additionally, all respondents will subsequently be asked to 
complete a web-based evaluation assessing barriers and facilitators to 
survey completion,

[[Page 54403]]

and the intended use(s) of survey data. Individuals and organizations 
contacted will be assured of the confidentiality of their replies under 
42 U.S.C. 924(c).

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated burden hours for the medical offices' 
time to participate in this one-time data collection. It is anticipated 
that an average of 20 persons (about 6 physicians and 14 staff) in each 
of the 350 medical offices will respond to the survey, resulting in 
7000 responses (approximately 2,000 physicians and 5,000 staff). The 
Survey on Patient Safety and the Post-Survey Evaluation will be 
completed by both physicians and staff, while the Office 
Characteristics Survey will be completed by the office manager at each 
of the 350 participating medical offices. Each survey will require 
approximately 15 minutes to complete. The total annualized burden for 
the medical offices to participate in this project is estimated to be 
3,588 hours.
    Exhibit 2 shows the estimated cost burden to participate in this 
project. The total annualized cost burden, based on the burden hours 
and hourly rates of the physicians and staff, is estimated at $99,368.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                   Survey name                       Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Survey on Patient Safety (SOPS).................             350              20           15/60           1,750
Office Characteristics Survey...................             350               1           15/60              88
Post-Survey Evaluation..........................             350              20           15/60           1,750
                                                 ---------------------------------------------------------------
    Total.......................................           1,050              na              na           3,588
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                                   Exhibit 2--Estimated Annualized Cost Burden
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                                                                                      Average
                   Survey name                       Number of     Total burden     hourly wage     Total cost
                                                    respondents        hours          rate *          burden
----------------------------------------------------------------------------------------------------------------
Survey on Patient Safety (SOPS).................             350           1,750          $27.44         $48,020
Office Characteristics Survey...................             350              88           37.82           3,328
Post-Survey Evaluation..........................             350           1,750           27.44          48,020
                                                 ---------------------------------------------------------------
    Total.......................................           1,050           3,588              na          99,368
----------------------------------------------------------------------------------------------------------------
* For the SOPS and Post-Survey Evaluation the wage rate is the national average wage for ``healthcare
  practitioner and technical occupations.'' For the Office Characteristics Survey the hourly wage is the
  national average wage for ``medical and health services managers.'' National Compensation Survey: Occupational
  Wages in the United States 2006, U.S. Department of Labor, Bureau of Labor Statistics.

Estimated Annual Costs to the Federal Government

    The total cost to the Government for conducting this research will 
be approximately $340,000. This estimate includes the costs of medical 
office identification and recruitment; data collection and aggregation; 
shipping, inputting and cleaning of data; analysis and report writing.

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 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: September 9, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8-21822 Filed 9-18-08; 8:45 am]
BILLING CODE 4160-90-M


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