[Federal Register Volume 84, Number 53 (Tuesday, March 19, 2019)]
[Notices]
[Pages 10083-10085]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-05144]


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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, HHS.

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) approve the proposed information collection 
project: ``Child Hospital Consumer Assessment of Healthcare Providers 
and Systems (Child HCAHPS) Survey Database.''
    This proposed information collection was previously published in 
the Federal Register on November 7th, 2018, and allowed 60 days for 
public comments. AHRQ received and responded to one substantive comment 
from a member of the public. The purpose of this notice is to allow an 
additional 30 days for public comment.

DATES: Comments on this notice must be received by April 18, 2019.

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 
email at [email protected] (attention: AHRQ's desk officer).

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports 
Clearance Officer, (301) 427-1477, or by email at 
[email protected].

SUPPLEMENTARY INFORMATION:

Proposed Project

Child Hospital Consumer Assessment of Healthcare Providers and Systems 
(Child HCAHPS) Survey Database

    In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3521, AHRQ invites the public to comment on this proposed information 
collection. The Child Hospital CAHPS Survey (Child HCAHPS) assesses the 
experiences of pediatric patients (less

[[Page 10084]]

than 18 years old) and their parents or guardians with inpatient care. 
It complements the Adult Hospital CAHPS Survey (Adult HCAHPS), which 
asks adult inpatients about their experiences. In contrast to the adult 
version of HCAHPS, there is no publicly available comprehensive 
database for Child HCAHPS that allows survey users to analyze and 
compare their survey results in order to assess their performance and 
identify opportunities for improvement. The proposed Child HCAHPS 
Database will fill this critical information gap by creating a 
voluntary database available to all Child HCAHPS users to support both 
quality improvement and research to enhance the patient-centeredness of 
care delivered to pediatric hospital patients.
    AHRQ supported the development of the Child HCAHPS survey by the 
Center of Excellence for Pediatric Quality Measurement at Boston 
Children's Hospital. The Child HCAHPS survey is currently used by 
approximately 300 hospitals. Hospitals using Child HCAHPS, including 
the 25 hospital members of the Pediatric Patient Experience 
Collaborative, have expressed strong interest in working with AHRQ to 
develop a database that can provide a centralized repository of data.
    Rationale for the information collection. Like the survey 
instrument itself and related toolkit materials to support survey 
implementation, aggregated Child HCAHPS Database results will be made 
publicly available on AHRQ's CAHPS website. Technical assistance will 
be provided by AHRQ through its contractor at no charge to hospitals to 
facilitate the access and use of these materials for quality 
improvement and research. Technical assistance will also be provided to 
support Child HCAHPS data submission.
    The Child HCAHPS Database will support AHRQ's goals of promoting 
improvements in the quality and patient-centeredness of health care in 
pediatric hospital settings. This research has the following goals:
    1. Improve care provided by individual hospitals and hospital 
systems.
    2. Offer several products and services, including providing survey 
results presented through an Online Reporting System, summary 
chartbooks, custom analyses, private reports and data for research 
purposes.
    3. Provides information to help identify strengths and areas with 
potential for improvement in patient care.
    This study is being conducted by AHRQ through its contractor, 
Westat, pursuant to AHRQ's statutory authority to conduct and support 
research on health care and on systems for the delivery of such care, 
including activities with respect to: the quality, effectiveness, 
efficiency, appropriateness and value of health care services; quality 
measurement and improvement; and health surveys and database 
development. 42 U.S.C 299a(a)(1), (2), and (8).

Method of Collection

    To achieve the goals of this project, the following activities and 
data collections that constitute information collection under the 
Paperwork Reduction Act (PRA) will be implemented:
    Submission Notifications and Instructions. Clear instructions and 
notifications are of paramount importance for successful submission of 
valid data, seamless report dissemination, and streamlined 
communication with survey vendors, hospitals, or other submitters. 
Procedures for data submission through the data submission platform 
will include the following:
     Registration with the submission website to obtain an 
account with a secure username and password: The point-of-contact 
(POC), often the hospital, completes a number of data submission steps 
and forms, beginning with the completion of the online registration 
form. The purpose of this form is to collect basic contact information 
about the organization and initiate the registration process;
     Submission of signed Data Use Agreements (DUAs) and survey 
questionnaires. The purpose of the data use agreement, completed by the 
participating hospital, is to state how data submitted by or on behalf 
of hospitals will be used and provides confidentiality assurances;
     Submission of hospital information form. The purpose of 
this form completed by the participating organization, is to collect 
background characteristics of the hospital; and
     Follow-up with submitters in the event of a rejected file, 
to assist in making corrections and resubmitting the file.
    With the approval and addition of the Child HCAHPS Database, data 
submitted will be used to produce three types of reporting products:
     Hospital Feedback Reports. Hospitals that submit data will 
have access to a customized report that presents findings for their 
individual submission along with results from the database overall. 
These ``private'' hospital feedback reports will display sortable 
results for each of the Child HCAHPS core composite measures and for 
each individual survey item that forms the composite measure.
     Child HCAHPS Chartbook. A summary-level Chartbook will be 
compiled to display top box and other proportional scores for the Child 
HCAHPS items and composite measures broken out by selected hospital 
characteristics (e.g., region, hospital size, ownership and 
affiliation, etc.).
     Online Reporting System. Aggregate results also will be 
made publicly available through an interactive, web-based system that 
allows users to view survey item and composite results (or build and 
download a custom report) in a variety of formats.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated burden hours for the respondents to 
participate in the database. The 302 POCs in Exhibit 1 are a 
combination of an estimated 300 hospitals that currently administer the 
Child HCAHPS survey and the two survey vendors assisting them.
    Each hospital will register online for submission. The online 
Registration form will require about 5 minutes to complete. Each 
submitter will also complete a hospital information form of information 
about each hospital such as the name of the hospital, hospital size, 
state, etc. The online hospital information form takes on average 5 
minutes to complete. The data use agreement will be completed by each 
of the 300 participating hospitals. Survey vendors do not sign or 
submit DUAs. The DUA requires about 3 minutes to sign and return by fax 
or mail. Each submitter, which in most cases will be the survey vendor 
performing the data collection, will provide a copy of their 
questionnaire and the survey data file in the required file format. 
Survey data files must conform to the data file layout specifications 
provide by the Child HCAHPS Database. Since the unit of analysis is at 
the hospital level, submitters will upload one data file per hospital. 
Once a data file is uploaded, the file will be automatically checked to 
ensure it conforms to the specifications and a data file status report 
will be produced and made available to the submitter. Submitters will 
review each report and will be expected to correct any errors in their 
data file and resubmit if necessary. It will take about one hour to 
submit the data for each hospital. The total burden is estimated to be 
365 hours annually.

[[Page 10085]]



                                  Exhibit 1--Estimated Annualized Burden Hours
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                                                     Number of       Number of
                    Form name                      respondents/    responses per     Hours per     Total burden
                                                       POCs             POC          response          hours
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Registration Form...............................             300               1            5/60              25
Hospital Information Form.......................             300               1            5/60              25
Data Use Agreement..............................             300               1            3/60              15
Data Files Submission...........................               2             150               1             300
                                                 ---------------------------------------------------------------
    Total.......................................             902              NA              NA             365
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    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to complete one submission process. The cost burden 
is estimated to be $16,722 annually.

                                   Exhibit 2--Estimated annualized cost burden
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                                                     Number of     Total burden   Average hourly    Total cost
                    Form name                       respondents        hours        wage rate *       burden
----------------------------------------------------------------------------------------------------------------
Registration Form...............................             300              25        53.69\a\          $1,342
Hospital Information Form.......................             300              25        \a\53.69           1,342
Data Use Agreement..............................             300              15        \b\94.25           1,414
Data Files Submission...........................               2             300       \c\ 42.08          12,624
                                                 ---------------------------------------------------------------
    Total.......................................             902             365              NA          16,722
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* National Compensation Survey: Occupational wages in the United States May 2017, ``U.S. Department of Labor,
  Bureau of Labor Statistics.''
(a) Based on the mean hourly wage for Medical and Health Services Managers (11-9111).
(b) Based on the mean hourly wage for Chief Executives (11-1011).
(c) Based on the mean hourly wages for Computer Programmer (15-1131).

Request for Comments

    In accordance with the Paperwork Reduction Act, 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's 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.

Gopal Khanna,
Director.
[FR Doc. 2019-05144 Filed 3-18-19; 8:45 am]
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