[Federal Register Volume 72, Number 9 (Tuesday, January 16, 2007)]
[Notices]
[Pages 1723-1725]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-108]


=======================================================================
-----------------------------------------------------------------------

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.

-----------------------------------------------------------------------

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: ``Improving Quality of Care in Long Term Care.'' 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 February 15, 2007.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, 540 Gaither Road, Room 5036, 
Rockville, MD 20850.
    Copies of the proposed collection plans, data collection 
instruments, and specific details on the estimated burden can be 
obtained from AHRQ's Reports Clearance Officer.

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ, Reports 
Clearance Officer, (301) 427-1477.

SUPPLEMENTARY INFORMATION:

Proposed Project

Improving Quality of Care in Long Term Care

    The proposed project will design, implement, and evaluate an 
intervention program to prevent injurious falls in assisted living 
facilities. The project involves four major activities: (1) Adapting a 
multifaceted, evidence-based falls prevention program to a protocol 
tailored to the assisted living environment; (2) implementing the pilot 
protocol and collecting clinical and process data pre- and post-
intervention; (3) evaluating the results of the intervention; and (4) 
widely disseminating the protocol (revised as needed based on the 
evaluation), training materials, and research findings.
    The project design is a multi-component falls intervention program

[[Page 1724]]

that will include medication review, resident assessment, environmental 
modification, and exercise. Its goal will be to reduce risk factors for 
falls, as well as fall and fracture rates, among residents of assisted 
living facilities. The project will adapt existing evidence-based falls 
prevention interventions to the assisted living setting, and collect 
data to track the progress and impact of the intervention program. Data 
collection for the falls intervention project will be approved by the 
University of North Carolina--Chapel Hill and Research Triangle 
Institute (RTI) International Institutional Review Boards. It will be 
conducted in accordance with the Health Insurance Portability and 
Accountability Act (HIPAA) Privacy rule and with the Protection of 
Human Research Subjects regulations, 45 CFR part 46. In addition, the 
identifiable data collected in this study about provider organizations 
and individuals will only be used for the above-stated purposes and 
will be kept confidential.

Methods of Collection

    The evaluation will use several methods to examine the efficacy of 
the intervention, including record review, in-person surveys, and in-
depth interviews. Data for this process evaluation of the 
implementation of the intervention will be collected at 6 and 12 months 
at the facility-level (e.g., fall and fracture rates, intervention 
adoption) and the resident-level (e.g., risk factors for falls, 
adherence to intervention regimens).
    The quantitative data will be collected using a series of 
questionnaires to collect information about the facility, its staff, 
and the participating residents. The information about residents' 
cognitive, medical, and functional status, and risk for falls will be 
collected using resident medication records and charts, performance 
based physical assessments, and standard measures of activities of 
daily living and cognition.
    The in-depth interviews of residents and staff will use both open-
ended questions and items with categorical response options to 
facilitate analysis. Items will include the degree to which the 
facility has changed its practice; the degree to which residents accept 
and adhere to the intervention; facilitators for and obstacles to 
implementation; report of staff and resident satisfaction; reactions 
and experiences related to the use of volunteers; and lessons learned. 
These data will be gathered through 60-minute interviews with facility 
staff including administrators and clinical personnel, and 30 to 40 
minute interviews with residents. The research staff will interview up 
to four staff at each intervention site and up to four residents at 
each site.

Estimated Annual Respondent Burden

    The table below indicates the estimated time and cost burden to the 
respondents for obtaining all of the data needed to meet the study's 
objectives. There will be no cost burden to the respondent other than 
the cost burden associated with their time to provide the required 
data. There will be no additional costs for capital equipment, 
software, computer services, etc.
    Time required to analyze the data and prepare it for reporting and 
publication is not included in these estimates.

                                                          Table 1.--Estimated Respondent Burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                              Number of
                                                            responses per
                                              Number of      respondent         Estimated time per       Estimated total  Average hourly  Estimated cost
            Type of respondent               respondents    (baseline, 6            respondent           burden  (hours)       rate        burden to the
                                                            months and 12                                                                   respondent
                                                               months)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Direct Caregiver Staff...................              20              30  0.10 hours (6 minutes)......             60             $9.00         $540
Facility Staff...........................             260               1  .067 hours (4 minutes)......             17.3            9.00          155.70
Facility Administrator...................               4               3  0.25 hours (15 minutes).....              3             25              75
Facility Residents.......................             200               3  0.583 hours (35 minutes)....            350              0               0
    Total................................  ..............  ..............  ............................            430    ..............          770.70
--------------------------------------------------------------------------------------------------------------------------------------------------------

Estimated Annual Costs to the Federal Government

    The total estimated one-time cost of this intervention 
implementation and related data collection to the federal government is 
$199,600. This funding will be used to support the cost of implementing 
the intervention, salary and fringe benefits for the research team to 
conduct the survey interview and in-depth interviews, costs for members 
of the research team to travel to each site, and the incentives paid to 
facilities for participation in the intervention. The project proposes 
to work with assisted living facilities with which the research team 
already has established relationships and familiarity and will attempt 
to minimize burden to the assisted living facility staff by being 
flexible to schedules and requirements of care practices within the 
facilities.

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 ocsts) 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

[[Page 1725]]

comments will become a matter of public record.

    Dated: January 4, 2007.
Carolyn M. Clancy,
Director.
[FR Doc. 07-108 Filed 1-12-07; 8:45 am]
BILLING CODE 4160-90-M