[Federal Register Volume 73, Number 237 (Tuesday, December 9, 2008)]
[Notices]
[Pages 74723-74724]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-28902]


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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.
    This proposed information collection was previously published in 
the Federal Register on September 19th, 2008 and allowed 60 days for 
public comment. One comment was received. This notice differs from the 
previous notice in that the number of respondents was increased by 150 
respondents and the burden hours were reduced by 1,488 hours. The 
purpose of this notice is to allow an additional 30 days for public 
comment.

DATES: Comments on this notice must be received by January 8, 2009.

ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk 
Officer by fax at (202) 395-6974 (attention: AHRQs 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 the AHRQ 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:

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 
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, provider specialty mix, 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 400 outpatient medical offices will be 
identified and recruited. The goal is for the sample to be 
proportionately distributed with regard to three practice 
characteristics: Office size (number of physicians and employed staff); 
provider specialty mix (single- vs multi-specialty); and extent to 
which electronic health information tools are used. 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 paper-based

[[Page 74724]]

(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, 
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 
than an average of 10 persons (about 3 physicians and 7 staff) in each 
of the approximately 400 medical offices will respond to the survey, 
resulting in a maximum of 4000 responses (approximately 1,200 
physicians and 2,800 staff). The Medical Office Survey on Patient 
Safety (MO-SOPS) and 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 participating medical 
offices. Standard techniques such as using a cover letter of support 
from the medical office, reminder postcards, and distribution of a 
second survey will be used to achieve the target response rate.
    The MO-SOPS survey and Office Characteristics survey each require 
approximately 15 minutes to complete. All staff will be asked to 
complete the MO-SOPS, however only the office manager will need to 
complete the Office Characteristics Survey. Additionally, the Post-
Survey Evaluation, which will take an estimated 15 minutes to complete, 
will be distributed to all respondents electronically. It is estimated 
that the total annualized respondent burden for completing the surveys 
will be 2,100 hours.

                                  Exhibit 1--Estimated Annualized Burden Hours
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                                                                     Number of
                   Survey name                       Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
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MO-SOPS Survey..................................             400              10           15/60           1,000
Office Characteristics Survey...................             400               1           15/60             100
Post-Survey Evaluation..........................             400              10           15/60           1,000
                                                 ---------------------------------------------------------------
    Total.......................................           1,200              na              na           2,100
----------------------------------------------------------------------------------------------------------------

    Exhibit 2 shows the estimated annualized cost burden based on the 
respondent's time to participate in this project. Based on the burden 
hours and hourly rates of physicians and staff, the total annualized 
cost burden is estimated at $58,662.

                                   Exhibit 2--Estimated Annualized Cost Burden
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                                                     Number of     Total burden   Average hourly    Total cost
                   Survey name                      respondents        hours        wage rate *       burden
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MO-SOPS Survey..................................             400           1,000          $27.44         $27,440
Office Characteristics Survey...................             400             100           37.82           3,782
Post-Survey Evaluation..........................             400           1,000           27.44          27,440
                                                 ---------------------------------------------------------------
    Total.......................................           1,200           2,100             n/a          58,662
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* 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: December 1, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8-28902 Filed 12-8-08; 8:45 am]
BILLING CODE 4160-90-M