[Federal Register Volume 86, Number 38 (Monday, March 1, 2021)]
[Notices]
[Pages 11919-11920]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-04190]


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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 the public's 
reporting burden. Public comments were previously requested via the 
Federal Register on November 19, 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): MOPS-HP.
    Type of Request: Regular submission, New Information Collection 
Request.
    Number of Respondents: 3,200.
    Average Hours per Response: 45 minutes.
    Burden Hours: 2,400.
    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 3,200 hospitals 
with the goal of producing four publicly available indices that measure 
key characteristics of these structured management practices. The 
proposed MOPS-HP will be collected for reference years 2020 and 2019. 
Content includes 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. This understanding is of increasing importance with the 
COVID-19 pandemic, where the overwhelming number of hospitalizations at 
varying points has stretched staff and resources to capacity. 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, 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. The Census Bureau 
conducted the MOPS in 2010 and 2015 with approximately 35,000 
manufacturing plants to measure management practices. These data show 
that management practices are strongly correlated with plant 
profitability and productivity. The WMS has collected

[[Page 11920]]

data on 20 basic management practices for approximately 2,000 hospitals 
in nine countries, including 307 in the U.S. Interviewers ask open-
ended questions and rate responses to indicate whether the management 
practices are more or less structured. Data from the WMS show large 
variations in these practices and their systematic relationship with 
clinical outcomes such as mortality rates from heart attacks.
    The COVID-19 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. 
In light of this, the Census Bureau has modified the survey proposal to 
collect data for reference years 2020 and 2019. This change seeks to 
directly measure management practices and protocols before and during 
the pandemic to gain a better understanding of how hospitals have had 
to adjust and pivot operations during this public health emergency. The 
Census Bureau has also 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.
    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 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 April 2021 and end in 
October 2021. Due to the nature of the respondents, this schedule may 
be impacted by the effects of 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 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.
     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. 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.
     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 
(BEA) 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 organizations; Not-
for-profit institutions.
    Frequency: One time.
    Respondent's Obligation: Mandatory.
    Legal Authority: The Census Bureau will conduct the MOPS-HP on a 
mandatory basis under authority of Title 13, United States Code, 
Sections 131, 182, 224, and 225.
    This information collection request may be viewed at 
www.reginfo.gov. Follow the instructions to view the 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. 2021-04190 Filed 2-26-21; 8:45 am]
BILLING CODE 3510-07-P