[Federal Register: June 10, 2008 (Volume 73, Number 112)]
[Notices]
[Page 32712-32714]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr10jn08-50]
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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, ``Reducing Healthcare Associated Infections (HAI): Improving
patient safety through implementing multidisciplinary training.'' In
accordance with the Paperwork Reduction Act of 1995, 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 April 3rd, 2008 and allowed 60 days for public
comment. No comments were received. The purpose of this notice is to
allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by July 10, 2008.
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
e-mail at OIRA_submission@omb.eop.gov (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 AHRQ's Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by e-mail at
doris.lefkowitz@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
[[Page 32713]]
Proposed Project
``Reducing Healthcare Associated Infections (HAI): Improving patient
safety through implementing multi-disciplinary training''
The goal of the HAI project is to identify factors associated with
the implementation of training that can assist hospitals in
successfully reducing and sustaining the reduction of infections
associated with the process of care. The project is being carried out
pursuant to AHRQ's statutory mandates under 42 U.S.C. 299b(b) and
299(b)(1)(G) to disseminate research findings to community settings for
practice improvement and to support research on determinants of
practitioner use and development of best practices. The findings from
the HAI project will be shared publicly to assist other healthcare
organizations in their efforts to improve infection safety.
For the HAI project, AHRQ will use the Accelerating Change and
Transformation in Organizations and Networks (ACTION) which is a
program of task order contracts to support field-based partnerships for
conducting applied research. In order to understand the challenges of
infection prevention and patient safety at the point of care, AHRQ has
funded five ACTION partnerships, each of which has experience with
implementing interventions and tools to improve the processes of care
and the safety and quality of healthcare delivery. These ACTION
partnerships will be working collaboratively with 34 hospitals, ranging
from large academic teaching hospitals to community hospitals, in 11
states. At each of these hospitals, multi-disciplinary teams will
implement clinician training that uses AHRQ-supported evidence-based
tools to improve infection safety. Through the HAI project, these
hospitals will focus on barriers and challenges to implementing
infection prevention training and how to sustain lessons learned in
order to help other hospitals achieve success.
The project involves six activities: (1) Implement training focused
on mitigating infections, particularly with respect to blood stream
infections (BSI), central line insertions, ventilator associated
pneumonia (VAP) and chest tube insertions; (2) catalogue infection
rates before and after the training; (3) analyze the opinions of
hospital staff about their hospital's infection prevention and patient
safety activities; (4) analyze the trainees' evaluation of the
infection prevention and patient safety training and materials; (5)
determine the impact of the implementation of infection prevention
training and the hospitals' participation in the HAI project on their
ability to mitigate and sustain infection safety improvements; and, (6)
make publicly available case studies focusing on the hospitals'
experiences of the training and their success with infection reduction
and sustainability.
In order to support the healthcare organizations and hospitals,
AHRQ will be issuing a contract to coordinate the assessment aspects of
the HAI program. The objective of the HAI assessment contract is to
facilitate the collection of infection information across the HAI
project hospitals including providing technical assistance and support
for the administration of the common data collection instruments. In
addition, the assessment contractor will assist AHRQ in sharing the
lessons learned about the successes, barriers, and challenges in
implementing and sustaining infection safety interventions and tools.
Each of the 34 participating hospitals will be responsible for securing
clearance from their own Institutional Review Boards for their
activities as part of the HAI project, including administration of the
proposed data collection instruments. The data collection will be
conducted in accordance with the Health Insurance Portability and
Accountability Act (HIPAA) Privacy Rule, 45 CFR Parts 160 and 164, and
with the Protection of Human Subjects regulations, 45 CFR Part 46.
Identifiable data for provider organizations and individuals will only
be used for the above-stated purposes and will be kept confidential.
Methods of Collection
The infection prevention training will be implemented at 34
hospitals over a 6 month period at the end of 2008 through 2009. The
data collection instruments will be administered at each hospital
before, during and after the training. Respondents include both medical
and administrative personnel. These instruments will be a key input to
AHRQ understanding the challenges and barriers to implementing training
and improving infection safety. The proposed paper-based data
collection instruments are:
Pre-Training Infection Prevention and Safety Assessment;
Post-Training Infection Prevention and Safety Assessment;
Baseline Infection Rates Summary; Follow-up Infection Rates Summary;
Infection Prevention and Patient Safety Activities Catalogue; Training
Evaluation.
In addition to the 34 hospitals which will implement the training
and fully participate in the HAI project, there will be a control group
consisting of 102 rural hospitals. At each of the control group
hospitals, an infection prevention staff member will complete the Post-
Training Infection Prevention and Safety Assessment, Follow-up
Infection Rate Summary, and the Infection Prevention and Patient Safety
Activities Catalogue. In addition to providing a baseline measure, the
control group hospitals will provide additional insights on the
challenges of and barriers to infection prevention and patient safety
at rural hospitals.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated burden hours to the respondents for
providing all of the data needed to meet the study's objectives. For
both the Pre-Training and Post-Training Infection Prevention and Safety
Assessment instruments, the number of respondents is based on an
estimate of 20 respondents at each of the 34 implementation hospitals.
In addition, one respondent at each of the 102 hospitals in the control
group will complete the Post-Training instrument. For both the Baseline
and Follow-up Infection Rate Summary instrument, the number of
respondents is based on an estimate of one respondent at each of the 34
implementation hospitals. In addition, one respondent at each of the
102 control group hospitals will complete the Follow-Up instrument. For
the Infection Prevention and Patient Safety Activity Catalogue, the
number of respondents is based on an estimate of 1 respondent at each
of the 34 implementation hospitals and the 102 control group hospitals.
Finally, the number of respondents for the Training Evaluation
instrument is based on an estimate of 25 respondents at each of the 34
implementation hospitals.
Exhibit 2 shows the estimated annualized cost burden for the
respondents' time to participate in this project. There will be no cost
burden to the respondent other than that associated with their time to
provide the required data. There will be no additional costs for
capital equipment, software, computer services, etc.
[[Page 32714]]
Exhibit 1.--Estimated Annualized Burden Hours
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Number of
Data collection instrument Number of responses per Hours per Total burden
respondents respondent response hours
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Pre-Training Infection Prevention and Safety 34 20 30/60 340
Assessment.....................................
Post-Training Infection Prevention and Safety 136 5.75 45/60 587
Assessment.....................................
Baseline Infection Rate Summary................. 34 1 30/60 17
Follow-up Infection Rate Summary................ 136 1 40/60 91
Infection Prevention and Patient Safety Activity 136 1 1.00 136
Catalogue......................................
Training Evaluation............................. 34 25 10/60 141
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Total....................................... 136 na na 1,312
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Exhibit 2.--Estimated Annualized Cost Burden
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Number of
Data collection instrument respondents Total burden Average hourly Total cost
(hours) rate\*\ wage burden
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Pre-Training Infection Prevention and Safety 34 340 $41.75 $14,195
Assessment.....................................
Post-Training Infection Prevention and Safety 136 587 41.75 24,507
Assessment.....................................
Baseline Infection Rate Summary................. 34 17 28.99 493
Follow-up Infection Rate Summary................ 136 91 28.99 2,638
Infection Prevention and Patient Safety Activity 136 136 39.02 5,307
Catalogue......................................
Training Evaluation............................. 34 141 49.04 6,915
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Total....................................... 136 1,312 na 54,055
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\*\ Based on the planned respondents, the average hourly rates are the average of the mean hourly wage estimates
for the following occupational groups: epidemiologists, healthcare support aides, medical and health services
managers, pharmacists, physicians, physician assistants, registered nurses, and respiratory therapists. The
wage estimates are derived from the National Occupational Employment and Wage Estimates, Bureau of Labor
Statistics, May 2006.
Estimated Annual Costs to the Federal Government
This data collection effort is one aspect of a larger effort
focused on reducing healthcare associated infections, The cost of
developing the data collection instruments by a one-time statistical
support task order is $25,000. The costs of implementing the data
collection instruments and analyzing and publishing the results are
$108,650 annually. Finally, the estimated costs for federal staff time
for supporting the common data collection efforts are $24,000 annually.
Thus, the estimated annual cost to the federal government is $145,150.
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, quality improvement and 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: May 30, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8-12768 Filed 6-9-08; 8:45 am]
BILLING CODE 4160-90-M