[Federal Register Volume 77, Number 232 (Monday, December 3, 2012)]
[Notices]
[Pages 71600-71601]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-29104]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-4169-NC]


Medicare Program; Request for Information To Aid in the Design 
and Development of a Survey Regarding Patient Experiences With 
Emergency Department Care

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Request for information.

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SUMMARY: This document is a request for information regarding consumer 
and patient experiences with emergency department care.

DATES: The information solicited in this notice must be received at the 
address provided below by February 1, 2013.

ADDRESSES: In responding to this solicitation, please reply via email 
to CMS [email protected] or by postal mail at Centers for Medicare 
and Medicaid Services, Attention: Sai Ma, Mailstop C1-14-18, 7500 
Security Boulevard, Baltimore, MD 21244-1850.

FOR FURTHER INFORMATION CONTACT: Sai Ma (410) 786-1479.

SUPPLEMENTARY INFORMATION: 

I. Background

    In accordance with section 3011 of the Affordable Care Act, the 
Department of Health and Human Services (HHS) developed the National 
Quality Strategy to create national aims and priorities to guide local, 
state, and national efforts to improve the quality of health care. This 
strategy established three aims supported by six priorities that focus 
on better care, healthy people/healthy communities, and affordable 
care.\1\ The six priorities include: (1) Making care safer by reducing 
harm caused by the delivery of care; (2) ensuring that each person and 
family are engaged as partners in their care; (3) promoting effective 
communication and coordination of care; (4) promoting the most 
effective prevention and treatment practices for the leading causes of 
mortality, starting with cardiovascular disease; (5) working with 
communities to promote wide use of best practices to enable healthy 
living; and (6) making quality care more affordable for individuals, 
families, employers, and governments by developing and spreading new 
health care delivery models Surveys focusing on the patient and 
caregiver experience, including those discussed later and the Emergency 
Department care survey under development, support the goals of the 
National Quality Strategy for providing better care.
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    \1\ Please see U.S. Department of Health and Human Services, 
Report to Congress, National Strategy for Quality Improvement in 
Health Care, (March 2011), available at http://www.healthcare.gov/law/resources/reports/nationalqualitystrategy032011.pdf.
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    The Centers for Medicare & Medicaid Services (CMS) has already 
implemented patient experience surveys for health and drug plans, 
inpatient hospitals, and home health agencies. While CMS and the Agency 
for Healthcare Research and Quality (AHRQ) have developed additional 
Consumer Assessment of Healthcare Providers and Systems (CAHPS[supreg]) 
surveys for in-center hemodialysis facilities, nursing homes, and 
clinician and group practices, none of these surveys address consumers' 
and patients' experiences with emergency department services. A 
patient's experience in an emergency department is an essential 
component of their overall healthcare experience in a hospital, and we 
believe that a patient survey evaluating such care will further support 
the HHS's goals and priorities.
    The target population for the emergency department patient 
experience of care survey is consumers/patients and caregivers of 
patients who received emergency department care. The emergency 
department is a unique environment within the health care system, 
bridging the world of outpatient and inpatient care. This makes 
existing patient experience instruments designed for either outpatient 
care or inpatient care only partially relevant for capturing patient 
experiences (for example, none of the existing surveys addresses 
patients' experience regarding transitions from emergency room to 
inpatient care). Having a rigorous, well-designed emergency department 
survey will allow us to understand patients' perspectives on their 
experiences in emergency departments and how such experiences change 
over time. This information will ultimately be used to help improve the 
quality of care patients receive in emergency departments.
    We are in the process of reviewing potential topic areas, as well 
as publicly available instruments and measures, for the purpose of 
developing a consumer and patient experience survey that will enable 
objective comparisons of emergency department experiences across the 
country. The principal focus is to develop a survey for consumers and 
patients 18 years of age and older. However, we are also interested in 
how a survey could also be developed for pediatric patients.

II. Solicitation of Information

    We are soliciting the submission of suggested topic areas (such as 
``communication with providers,'' ``pain control'' or ``waiting time'') 
as well as publicly available instruments for capturing patient 
experiences with emergency department care. We are interested in 
instruments and items that can measure quality of care from the 
patient's and caregiver's perspective, including pediatric patients, 
and track changes over time.

[[Page 71601]]

    We are looking for suggested topic areas and publicly available 
instruments in which--(1) The source of information is from consumers 
and patients who directly received care at an emergency department or 
caregivers who were directly involved in the care (for example, parents 
of young children); and (2) patients or caregivers identified the 
information as important to them in evaluating emergency department 
care (for example, wait time, medical staff and physician 
communication). Existing instruments that have been tested, have a high 
degree of reliability and validity, and evidence of wide use is 
preferred.
    The following information would be especially helpful in any 
comments responding to this request for information:
     A brief cover letter summarizing the information requested 
above for submitted instruments and topic areas, respectively, and how 
the submission will help fulfill the intent of the patient experiences 
survey;
     (Optional) Information about the person submitting the 
material for the purposes of follow up questions about the submission 
which includes the following:
    ++ Name.
    ++ Title.
    ++ Organization.
    ++ Mailing address.
    ++ Telephone number.
    ++ Email address.
    ++ Indication that the topic area or instrument is publicly 
available.
     When submitting topic areas, we encourage including to the 
extent available the following information:
    ++ Detailed descriptions of the suggested topic area(s) and 
specific purpose(s).
    ++ Relevant peer-reviewed journal articles or full citations.
     When submitting publicly available instruments or survey 
questions, we encourage including to the extent available the following 
information:
    ++ Name of the instrument.
    ++ Copies of the full instrument in all available languages.
    ++ Topic areas included in the instrument.
    ++ Measures derived from the instrument. Instrument reliability 
(internal consistency, test-retest, etc) and validity (content, 
construct, criterion-related).
    ++ Results of cognitive testing.
    ++ Results of field testing.
    ++ Current use of the instrument (who is using it, what it is being 
used for, what population it is being used with, how instrument 
findings are reported, and by whom the findings are used).
    ++ Relevant peer-reviewed journal articles or full citations.
    ++ CAHPS[supreg] trademark status.
    ++ Survey administration instructions.
    ++ Data analysis instructions.
    ++ Guidelines for reporting survey data.
    We are developing this survey and plan to submit it to AHRQ for 
recognition as a Consumer Assessment of Healthcare Providers and 
Systems (CAHPS[supreg]) survey. The survey will be developed in 
accordance with CAHPS[supreg] Survey Design Principles and 
implementation instructions will be based on those for CAHPS[supreg] 
instruments (https://www.cahps.AHRQ.gov/About-CAHPS/Principles.aspx).

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: October 2, 2012.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2012-29104 Filed 11-30-12; 8:45 am]
BILLING CODE 4120-01-P