[Federal Register Volume 69, Number 31 (Tuesday, February 17, 2004)]
[Notices]
[Pages 7489-7490]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-3332]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Request for Testing of Integration of the Hospital CAHPS 
(HCAHPS[reg]) Instrument Prior to the National Implementation

AGENCY: Agency for Healthcare Research and Quality (AHRQ), DDHS.

ACTION: Notice of request.

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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is 
inviting hospitals, vendors, and other interested parties to 
voluntarily test a revised 32-item Hospital CAHPS (HCAHPS[reg]) 
instrument prior to the national implementation. The purpose of this 
project is to provide another opportunity to the hospital industry to 
use the revised draft of the HCAHPS[reg] instrument and a chance to add 
items to the instrument, if desired, prior to the national 
implementation. It should be noted that, as a result of the additional 
testing (see FR, Vol. 68, No. 147 published on July 31, 2003 which can 
be accessed at http://www.access.gpo.gov/su_docs/fedreg/a030731c.html) 
the HCAHPS[reg] instrument may undergo some further refinement prior to 
finalization for the national implementation effort. In effect, this 
project provides an occasion to test items that vendors, hospitals, and 
others wish to add to the HCAHPS[reg] instrument and to evaluate the 
impact of integrating HCAHPS into the hospital's current instrument as 
well as to further evaluate the methods of data collection prior to 
national implementation of HCAHPS[reg].
    For the purposes of this project, up to forty (40) items may be 
added to the revised draft of HCAHPS[reg] and be tested, however, 
please be aware that the maximum number of items that may be added to 
the HCAHPS[reg] instrument for national implementation is currently 
thirty (30).
    After permission to use the instrument is granted by AHRQ, a site 
or sites may field the instrument until June 2004, with subsequent 
submission of requested analyses to AHRQ by August 2004 or earlier, if 
possible.
    For more information about this project or to download an 
application for authorization, please visit the CAHPS Survey User 
Network Web site at http://www.cahps-sun.org. The HCAHPS[reg] pre-
national implementation testing Web site will be active until April 15, 
2004.

DATES: Please submit requests on or before April 19, 2004.

ADDRESSES: Applications for permission to use the revised 32-item 
HCAHPS[reg] instrument, to add items, and field test the instrument may 
be submitted either in electronic format or via facsimile 
communication. Applications can be sent in letter form, preferably with 
an electronic file on a 3\1/2\ inch floppy disk as a standard word 
processing format or as an e-mail with an attachment. Responses should 
be submitted to:

Marybeth Farquhar, RN, MSN, Agency for Healthcare Research and Quality, 
Center for Quality Improvement and Patient Safety, 540 Gaither Road, 
Rockville, MD 20850, E-mail: [email protected].

    In order to facilitate handling of submissions, please include full 
information about the person requesting permission for testing: (a) 
Name, (b) title, (c) organization, (d) mailing address, (e) telephone 
and fax numbers, and (f) e-mail address.
    Other requested information includes: (a) List of the hospital in 
which HCAHPS[reg] will be used (including city and State); (b) sample 
size for each hospital; (c) intended mode of administration; (d) length 
of time after discharge the initial contact with the patient will be 
made; (e) name of vendor that will be administering the HCAHPS[reg] 
survey; (f) proposed dates for fielding; (g) whether items will be 
added to the HCAHPS[reg] survey and how many; and (h) a copy of the 
proposed questionnaire. (Again, please note: Items added to the 
HCAHPS[reg] survey will be limited to forty (40) for this testing 
project and can only be placed near the end of the HCAHPS[reg] items 
and just before the ``About You'' section of the questionnaire.) 
Electronic requests are encouraged. To help in the evaluation of the 
revised 32-item version of HCAHPS[reg], AHRQ and the Centers for 
Medicare & Medicaid Services (CMS) are asking participants to submit a 
brief summary of their experience with administering the HCAHPS[reg] 
survey, including sampling and survey data collection procedures. An 
analysis of the psychometrics of the instrument should also be 
provided. Analytic results should include:
     Participation (response) rates to the survey;
     Item missing data rates;
     Distribution of responses to each item;
     Intercorrelations among items;
     Correlations of items with composites (corrected 
for overlap where appropriate);
     Internal consistency reliability (Cronbach's 
alpha);
     Hospital-level reliability (if the survey is 
fielded with multiple hospitals); and,
     Correlations of items and composites with the 
global rating items and whether the respondent would recommend the 
hospital to family and friends (question 24).

FOR FURTHER INFORMATION CONTACT: Marybeth Farquhar, Center for Quality 
Improvement and Patient Safety, Agency for Healthcare Research and 
Quality, 540 Gaither Road, Rockville, MD 20850; Phone: (301) 427-1317; 
Fax: (301) 427-1341; e-mail: [email protected].

SUPPLEMENTARY INFORMATION:

Background

    The Agency for Healthcare Research and Quality (AHRQ) has been a 
leading proponent and supporter of the development of instruments for

[[Page 7490]]

measuring patient experiences within the health care system of the 
United States. As the research partner of the Centers for Medicare & 
Medicaid Services (CMS), AHRQ is charged with the development of a 
hospital patient experience of care instrument as well as the 
development of reporting strategies to maximize the utility of the 
survey results.
    The mutual goal of AHRQ and CMS is to develop a standardized 
instrument for use in the public reporting of patients' hospital 
experiences that is reliable and valid, freely accessible, and that 
will make comparative non-identifiable information on hospital 
patients' perspectives on care widely available. While there are many 
good survey tools available to hospitals, there is currently no 
nationally used or universally accepted survey instrument that allows 
comparisons across all hospitals. In response, and at the request of 
CMS, AHRQ and the CAHPS[reg] II Grantees developed an initial 
instrument with input from the various stakeholders in the industry. 
The initial draft of the HCAHPS[reg] instrument was tested as part of a 
CMS three-State pilot by hospitals in Arizona, Maryland, and New York. 
Based on an analysis of these data, the instrument was revised and 
shortened. The revised 32-item HCAHPS[reg] instrument is currently 
undergoing additional testing as specified in a Federal Register Notice 
published on July 31, 2003 (FR Vol. 68, No. 147, 44951-44953) which can 
be accessed at http://www.access.gpo.gov/su_docs/fedreg/a030731c.html. 
Based on the results of this additional testing by selected sites and 
public comments on the current instrument, further revisions to the 
HCAHPS[reg] instrument may be made.
    Once the HCAHPS[reg] instrument is finalized, it will be on the 
AHRQ and CMS websites for use by interested individuals and 
organizations. Plans have been made to make the HCAHPS instrument 
available to ``The Quality Initiative: A Public Resource on Hospital 
Performance,'' which is a public/private partnership that includes the 
major hospital associations, governments, consumer groups, measurement 
and accrediting bodies, and other stakeholders interested in reporting 
on hospital quality. In the first phase of the partnership (which has 
already begun), hospitals are voluntarily reporting the results of 
their performance on ten clinical quality measures for three medical 
conditions: acute myocardial infarction, heart failure, and pneumonia. 
HCAHPS[reg] reporting will comprise an additional and differently 
focused phase of quality of care measurement. For more information or 
to participate in the Quality Initiative, please visit http://www.aha.org under ``Quality and Patient Safety, Quality Initiative,'' 
or at http://www.fah.org, under ``Issue/Advisories,'' or at http://www.aamc.org by going to ``Government Affairs,'' ``Teaching Hospitals'' 
and then ``Quality.''

    Dated: February 9, 2004.
Carolyn M. Clancy,
Director.
[FR Doc. 04-3332 Filed 2-13-04; 8:45 am]
BILLING CODE 4160-90-M