[Federal Register Volume 85, Number 129 (Monday, July 6, 2020)]
[Notices]
[Pages 40200-40202]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-14414]


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DEPARTMENT OF COMMERCE

Census Bureau


Agency Information Collection Activities; Submission to the 
Office of Management and Budget (OMB) for Review and Approval; Comment 
Request; Management and Organizational Practices Survey-Hospitals

    The Department of Commerce will submit the following information 
collection request to the Office of Management and Budget (OMB) for 
review and clearance in accordance with the Paperwork Reduction Act of 
1995, on or after the date of publication of this notice. We invite the 
general public and other Federal agencies to comment on proposed, and 
continuing information collections, which helps us assess the impact of 
our information collection requirements and minimize

[[Page 40201]]

the public's reporting burden. Public comments were previously 
requested via the Federal Register on January 27, 2020 during a 60-day 
comment period. This notice allows for an additional 30 days for public 
comments.
    Agency: U.S. Census Bureau.
    Title: Management and Organizational Practices Survey-Hospitals.
    OMB Control Number: 0607-XXXX.
    Form Number(s): MP-2000.
    Type of Request: Regular submission, New Information Collection 
Request.
    Number of Respondents: 4,500
    Average Hours Per Response: 45 minutes.
    Burden Hours: 3,375.
    Needs and Uses: The Census Bureau proposes conducting the 
Management and Organizational Practices Survey-Hospitals (MOPS-HP) in 
order to provide critical information on the health sector to our many 
stakeholders in support of our mission to serve as ``the leading source 
of quality data about the nation's people and economy.'' The MOPS-HP 
will collect information on the use of structured management practices 
from Chief Nursing Officers (CNOs) at approximately 4,500 hospitals 
with the goal of producing four publicly-available indices that measure 
key characteristics of these structured management practices. The 
proposed MOPS-HP will ask about performance monitoring, goals, staff 
management, the use of standardized clinical protocols, and medical 
record documentation. Some questions are adapted from the Management 
and Organizational Practices Survey (MOPS) (OMB Approval Number 0607-
0963), conducted in the manufacturing sector, allowing for inter-
sectoral comparisons.
    The MOPS-HP will provide a deeper understanding of the business 
processes which impact an increasingly important sector of the economy; 
total national health expenditures represented almost 18 percent of 
U.S. gross domestic product in 2017 (National Center for Health 
Statistics). The MOPS-HP will provide a nationally representative 
sample, enabling stakeholders to understand the role of structured 
management practices in financial and clinical outcomes in U.S. 
hospitals. In much the same way that the MOPS allowed for the 
measurement of the importance of these structured management practices 
for productivity and growth in the manufacturing sector,\1\ the MOPS-HP 
will inform our understanding of hospitals. Questions developed and 
tested for the MOPS-HP instrument are adapted from the 2015 MOPS and 
the 2009 World Management Survey's (WMS) healthcare instrument.\2\ \3\ 
The Census Bureau conducted the MOPS in 2010 and 2015 with 
approximately 35,000 manufacturing plants to measure management 
practices.\4\ \5\ These data show that management practices are 
strongly correlated with plant profitability and productivity.\6\ The 
WMS has collected data on 20 basic management practices for 
approximately 2,000 hospitals in nine countries, including 307 in the 
U.S.\7\ Interviewers ask open-ended questions and rate responses to 
indicate whether the management practices are more or less 
structured.\8\ \9\ Data from the WMS show large variations in these 
practices and their systematic relationship with clinical outcomes such 
as mortality rates from heart attacks.\10\
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    \1\ Bloom, N., E. Brynjolfsson, L. Foster, R. Jarmin, M. 
Patnaik, I. Saporta Eksten and J. Van Reenen. 2019. ``What Drives 
Differences in Management Practices?'' American Economic Review.
    \2\ 2015 MOPS' Questionnaire https://www.census.gov/programs-surveys/mops/technical-documentation/questionnaires.html and an 
overview https://www.census.gov/programs-surveys/mops.html.
    \3\ WMS' 2009 instrument for healthcare https://worldmanagementsurvey.org/survey-data/methodology/ and academic 
research papers https://worldmanagementsurvey.org/academic-research/healthcare/.
    \4\ Throughout this document, any reference to the ``MOPS'' 
refers to the surveys conducted for the manufacturing sector, while 
the hospital survey will always be denoted as the ``MOPS-HP.''
    \5\ Buffington, C., L. Foster, R. Jarmin, and S. Ohlmacher. 
2017. ``The Management and Organizational Practices Survey (MOPS): 
An Overview.'' Journal of Economic and Social Measurement, 42(1), 1-
26.
    \6\ Bloom, N., E. Brynjolfsson, L. Foster, R. Jarmin, M. 
Patnaik, I. Saporta Eksten and J. Van Reenen. 2019. ``What Drives 
Differences in Management Practices?'' American Economic Review.
    \7\ Bloom, N., R. Lemos, R. Sadun and J. Van Reenen. 2019. 
``Healthy Business? Managerial Education and Management in 
Healthcare.'' Review of Economics and Statistics, forthcoming.
    \8\ Bloom, N. and J. Van Reenen. 2007. ``Measuring and 
Explaining Management Practices Across Firms and Countries.'' The 
Quarterly Journal of Economics 122(4): 1351-1408.
    \9\ Bloom, N., R. Lemos, R. Sadun, D. Scur and J. Van Reenen. 
2014. ``The New Empirical Economics of Management.'' Journal of the 
European Economics Association.
    \10\ Bloom, N., R. Lemos, R. Sadun and J. Van Reenen. 2019. 
``Healthy Business? Managerial Education and Management in 
Healthcare.'' Review of Economics and Statistics, forthcoming.
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    The current pandemic highlights the relevance of hospital 
management practices, especially as they relate to hospitals' ability 
to respond to shocks to their organization and the health care system. 
The Census Bureau has included two questions in the MOPS-HP content to 
help improve measurement of hospital preparedness. These questions will 
provide information on two elements of responsiveness, hospitals' 
coordinated deployment of frontline clinical workers and hospitals' 
ability to quickly respond to needed changes in standardized clinical 
protocols. In an effort to limit respondent burden while adding this 
content, adjustments were made to keep the total number of questions 
and estimated burden per response unchanged. Because the content 
changes were developed in response to the current pandemic, they were 
made after the pre-submission notice for the MOPS-HP was published in 
the Federal Register.
    The MOPS-HP will be a supplement to the Service Annual Survey (SAS) 
and will utilize a subset of its mail-out sample. Its sample will 
consist of hospital locations for enterprises classified under General 
Medical and Surgical Hospitals (NAICS 6221) and sampled in the SAS. The 
survey will be mailed separately from the 2019 SAS and collected 
electronically through the Census Bureau's Centurion online reporting 
system. Respondents will be sent an initial letter with instructions 
detailing how to log into the instrument and report their information. 
These letters will be addressed to the location's Chief Nursing Officer 
(CNO). Collection is scheduled to begin in November 2020 and end in 
June 2021. Due to the nature of the respondents, this schedule may be 
impacted by the effects of the Coronavirus (COVID-19). The Census 
Bureau is monitoring the ongoing situation and will adjust dates as 
necessary as the collection start date approaches as we do not want to 
add burden to an overly burdened sector of the economy.
    The Census Bureau will produce a publicly-available press release 
to describe the survey and discuss the results. The Census Bureau will 
also write at least one research paper describing the MOPS-HP 
collection, processing, and data findings. Conditional on quality, the 
Census Bureau will construct and publish in a research paper indices of 
management practices, which can be used in tabulations and empirical 
analyses for potential use by the public, clinicians, hospitals, and 
researchers. These indices as well as microdata will be available to 
approved Federal Statistical Research Data Centers (FSRDC) users and 
will provide benefits to other Federal agencies and the public.
    Examining factors that impact clinical and financial outcomes is 
essential to understanding the health care industry, which makes up a 
large portion of the U.S. economy. The MOPS-HP will provide unique 
national-level estimates on management and organizational practices in 
hospitals that could

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improve our understanding of the hospital industry:
     The Centers for Medicare and Medicaid Services' Hospital 
Compare data or the Hospital Consumer Assessment of Healthcare 
Providers and Systems (HCAHPS) survey could be used in conjunction with 
the MOPS-HP to determine whether hospitals with more structured 
management practices have higher overall patient ratings and are more 
likely to be recommended.\11\
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    \11\ More structured management practices are associated with 
more rather than less frequent reviews of performance, communication 
with all levels of staff and not just senior staff, and promotions 
based on performance and ability and not just tenure. See Question 
2.c. in the Supporting Statement B for more details on measuring 
whether management practices are more or less structured.
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     The National Hospital Care Survey from the National Center 
for Health Statistics could be used in combination with the MOPS-HP's 
index to evaluate how management practices relate to hospital 
utilization and patient care.
     Data from the Surveys on Patient Safety Culture-Hospital 
Survey from the Agency for Healthcare Research and Quality could be 
used to study whether hospitals with more structured management 
practices have fewer patient safety events.
     Policymakers could use the data to understand how 
management and organizational practices are evolving in hospitals, 
which can help understand changes in the industry.\12\ The Census 
Bureau plans to use the data collected from the MOPS-HP's questions on 
medical record documentation to construct an index measuring the 
management of multiple objectives--clinical and financial--that would 
inform policymakers concerned with both aspects of hospital 
performance. By examining any links between the survey's measures of 
management practices and clinical outcomes, the survey may help to 
inform policymakers and to encourage practices that are beneficial to 
patients and our population as a whole.
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    \12\ By collecting data for both 2019 and 2014, the MOPS-HP will 
help measure the evolution of management practices in hospitals over 
this five-year period.
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    The Census Bureau plans to use the data collected from the MOPS-
HP's questions on medical record documentation to consruct an index 
measuring the management of multiple objectives--clinical and 
financial--that would perform policymakers concerned with both aspects 
of hospital performance. By examining any links between the survey's 
measures of management practices and clinical outcomes, the survey may 
help to inform policymakers and to encourage practices that are 
beneficial to patients and our population as a whole.
     Hospital administrators could utilize planned public 
indices to benchmark their own practices, and subsequently make 
decisions or set policies to improve their financial and clinical 
outcomes.
     The MOPS-HP data could be used in combination with the 
Census Bureau's collected data on hospital finances, including revenues 
and expenses, to improve our understanding on how management practices 
may impact financial performance.
     In a letter of support, the Bureau of Economic Analysis 
expressed their interest in the MOPS-HP and noted that it will help aid 
their mission to promote `` `. . . a better understanding of the U.S. 
economy . . .' '' The letter states that the MOPS-HP will ``fill a 
critical gap in our current understanding of how management systems 
affect patient health outcomes and healthcare expenditures.''
    Affected Public: Business or other for-profit; State, local or 
Tribal government.
    Frequency: One time.
    Respondent's Obligation: Mandatory.
    Legal Authority: Title 13, United States Code, Sections 131 and 
182.
    This information collection request may be viewed at 
www.reginfo.gov. Follow the instructions to view Department of Commerce 
collections currently under review by OMB.
    Written comments and recommendations for the proposed information 
collection should be submitted within 30 days of the publication of 
this notice on the following website www.reginfo.gov/public/do/PRAMain. 
Find this particular information collection by selecting ``Currently 
under 30-day Review--Open for Public Comments'' or by using the search 
function and entering the title of the collection.

Sheleen Dumas,
Department PRA Clearance Officer,Office of the Chief Information 
Officer,Commerce Department.
[FR Doc. 2020-14414 Filed 7-2-20; 8:45 am]
BILLING CODE 3510-07-P