[Federal Register Volume 73, Number 112 (Tuesday, June 10, 2008)]
[Notices]
[Pages 32712-32714]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-12768]


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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, ``Reducing Healthcare Associated Infections (HAI): Improving 
patient safety through implementing multidisciplinary training.'' In 
accordance with the Paperwork Reduction Act of 1995, 44 U.S.C. 
3506(c)(2)(A), AHRQ invites the public to comment on this proposed 
information collection.
    This proposed information collection was previously published in 
the Federal Register on April 3rd, 2008 and allowed 60 days for public 
comment. No comments were received. The purpose of this notice is to 
allow an additional 30 days for public comment.

DATES: Comments on this notice must be received by July 10, 2008.

ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk 
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by 
e-mail at [email protected] (attention: AHRQ's desk 
officer).
    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, or by e-mail at 
[email protected].

SUPPLEMENTARY INFORMATION: 

[[Page 32713]]

Proposed Project

``Reducing Healthcare Associated Infections (HAI): Improving patient 
safety through implementing multi-disciplinary training''

    The goal of the HAI project is to identify factors associated with 
the implementation of training that can assist hospitals in 
successfully reducing and sustaining the reduction of infections 
associated with the process of care. The project is being carried out 
pursuant to AHRQ's statutory mandates under 42 U.S.C. 299b(b) and 
299(b)(1)(G) to disseminate research findings to community settings for 
practice improvement and to support research on determinants of 
practitioner use and development of best practices. The findings from 
the HAI project will be shared publicly to assist other healthcare 
organizations in their efforts to improve infection safety.
    For the HAI project, AHRQ will use the Accelerating Change and 
Transformation in Organizations and Networks (ACTION) which is a 
program of task order contracts to support field-based partnerships for 
conducting applied research. In order to understand the challenges of 
infection prevention and patient safety at the point of care, AHRQ has 
funded five ACTION partnerships, each of which has experience with 
implementing interventions and tools to improve the processes of care 
and the safety and quality of healthcare delivery. These ACTION 
partnerships will be working collaboratively with 34 hospitals, ranging 
from large academic teaching hospitals to community hospitals, in 11 
states. At each of these hospitals, multi-disciplinary teams will 
implement clinician training that uses AHRQ-supported evidence-based 
tools to improve infection safety. Through the HAI project, these 
hospitals will focus on barriers and challenges to implementing 
infection prevention training and how to sustain lessons learned in 
order to help other hospitals achieve success.
    The project involves six activities: (1) Implement training focused 
on mitigating infections, particularly with respect to blood stream 
infections (BSI), central line insertions, ventilator associated 
pneumonia (VAP) and chest tube insertions; (2) catalogue infection 
rates before and after the training; (3) analyze the opinions of 
hospital staff about their hospital's infection prevention and patient 
safety activities; (4) analyze the trainees' evaluation of the 
infection prevention and patient safety training and materials; (5) 
determine the impact of the implementation of infection prevention 
training and the hospitals' participation in the HAI project on their 
ability to mitigate and sustain infection safety improvements; and, (6) 
make publicly available case studies focusing on the hospitals' 
experiences of the training and their success with infection reduction 
and sustainability.
    In order to support the healthcare organizations and hospitals, 
AHRQ will be issuing a contract to coordinate the assessment aspects of 
the HAI program. The objective of the HAI assessment contract is to 
facilitate the collection of infection information across the HAI 
project hospitals including providing technical assistance and support 
for the administration of the common data collection instruments. In 
addition, the assessment contractor will assist AHRQ in sharing the 
lessons learned about the successes, barriers, and challenges in 
implementing and sustaining infection safety interventions and tools. 
Each of the 34 participating hospitals will be responsible for securing 
clearance from their own Institutional Review Boards for their 
activities as part of the HAI project, including administration of the 
proposed data collection instruments. The data collection will be 
conducted in accordance with the Health Insurance Portability and 
Accountability Act (HIPAA) Privacy Rule, 45 CFR Parts 160 and 164, and 
with the Protection of Human Subjects regulations, 45 CFR Part 46. 
Identifiable data for provider organizations and individuals will only 
be used for the above-stated purposes and will be kept confidential.

Methods of Collection

    The infection prevention training will be implemented at 34 
hospitals over a 6 month period at the end of 2008 through 2009. The 
data collection instruments will be administered at each hospital 
before, during and after the training. Respondents include both medical 
and administrative personnel. These instruments will be a key input to 
AHRQ understanding the challenges and barriers to implementing training 
and improving infection safety. The proposed paper-based data 
collection instruments are:

Pre-Training Infection Prevention and Safety Assessment;
Post-Training Infection Prevention and Safety Assessment;
Baseline Infection Rates Summary; Follow-up Infection Rates Summary; 
Infection Prevention and Patient Safety Activities Catalogue; Training 
Evaluation.
    In addition to the 34 hospitals which will implement the training 
and fully participate in the HAI project, there will be a control group 
consisting of 102 rural hospitals. At each of the control group 
hospitals, an infection prevention staff member will complete the Post-
Training Infection Prevention and Safety Assessment, Follow-up 
Infection Rate Summary, and the Infection Prevention and Patient Safety 
Activities Catalogue. In addition to providing a baseline measure, the 
control group hospitals will provide additional insights on the 
challenges of and barriers to infection prevention and patient safety 
at rural hospitals.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated burden hours to the respondents for 
providing all of the data needed to meet the study's objectives. For 
both the Pre-Training and Post-Training Infection Prevention and Safety 
Assessment instruments, the number of respondents is based on an 
estimate of 20 respondents at each of the 34 implementation hospitals. 
In addition, one respondent at each of the 102 hospitals in the control 
group will complete the Post-Training instrument. For both the Baseline 
and Follow-up Infection Rate Summary instrument, the number of 
respondents is based on an estimate of one respondent at each of the 34 
implementation hospitals. In addition, one respondent at each of the 
102 control group hospitals will complete the Follow-Up instrument. For 
the Infection Prevention and Patient Safety Activity Catalogue, the 
number of respondents is based on an estimate of 1 respondent at each 
of the 34 implementation hospitals and the 102 control group hospitals. 
Finally, the number of respondents for the Training Evaluation 
instrument is based on an estimate of 25 respondents at each of the 34 
implementation hospitals.
    Exhibit 2 shows the estimated annualized cost burden for the 
respondents' time to participate in this project. There will be no cost 
burden to the respondent other than that associated with their time to 
provide the required data. There will be no additional costs for 
capital equipment, software, computer services, etc.

[[Page 32714]]



                                  Exhibit 1.--Estimated Annualized Burden Hours
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                                                                     Number of
           Data collection instrument                Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
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Pre-Training Infection Prevention and Safety                  34              20           30/60             340
 Assessment.....................................
Post-Training Infection Prevention and Safety                136            5.75           45/60             587
 Assessment.....................................
Baseline Infection Rate Summary.................              34               1           30/60              17
Follow-up Infection Rate Summary................             136               1           40/60              91
Infection Prevention and Patient Safety Activity             136               1            1.00             136
 Catalogue......................................
Training Evaluation.............................              34              25           10/60             141
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    Total.......................................             136              na              na           1,312
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                                  Exhibit 2.--Estimated Annualized Cost Burden
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                                                     Number of
           Data collection instrument               respondents    Total burden   Average hourly    Total cost
                                                      (hours)         rate\*\       wage burden
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Pre-Training Infection Prevention and Safety                  34             340          $41.75         $14,195
 Assessment.....................................
Post-Training Infection Prevention and Safety                136             587           41.75          24,507
 Assessment.....................................
Baseline Infection Rate Summary.................              34              17           28.99             493
Follow-up Infection Rate Summary................             136              91           28.99           2,638
Infection Prevention and Patient Safety Activity             136             136           39.02           5,307
 Catalogue......................................
Training Evaluation.............................              34             141           49.04           6,915
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    Total.......................................             136           1,312              na          54,055
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\*\ Based on the planned respondents, the average hourly rates are the average of the mean hourly wage estimates
  for the following occupational groups: epidemiologists, healthcare support aides, medical and health services
  managers, pharmacists, physicians, physician assistants, registered nurses, and respiratory therapists. The
  wage estimates are derived from the National Occupational Employment and Wage Estimates, Bureau of Labor
  Statistics, May 2006.

Estimated Annual Costs to the Federal Government

    This data collection effort is one aspect of a larger effort 
focused on reducing healthcare associated infections, The cost of 
developing the data collection instruments by a one-time statistical 
support task order is $25,000. The costs of implementing the data 
collection instruments and analyzing and publishing the results are 
$108,650 annually. Finally, the estimated costs for federal staff time 
for supporting the common data collection efforts are $24,000 annually. 
Thus, the estimated annual cost to the federal government is $145,150.

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, quality improvement and 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: May 30, 2008.
Carolyn M. Clancy,
Director.
 [FR Doc. E8-12768 Filed 6-9-08; 8:45 am]
BILLING CODE 4160-90-M