Attachment F -- 60 Day Federal Register Notice

Attachment F -- 60 Day Federal Register Notice.pdf

Reducing Healthcare Associated Infections (HAI): Improving patient safety through implementing multi-disciplinary interventions

Attachment F -- 60 Day Federal Register Notice

OMB: 0935-0144

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18284

Federal Register / Vol. 73, No. 65 / Thursday, April 3, 2008 / Notices

system in participating emergency
departments.
Method of Collection
Survey: An equal-probability sample
of 507 ED professionals from the
database AHRQ maintains of
individuals and organizations that
requested a copy of the ESI tools will be
contacted to participate in the survey.
Where a phone number has been
provided, we will do a reverse
telephone number search to identify the
mailing address of the requester and
conduct a mail survey with telephone
follow-up. For those who have provided
an e-mail address, we will send a link
to a Web survey. Telephone and e-mail

prompts will be sent after two weeks to
those who have not yet completed the
questionnaire, followed by two
additional reminders sent three weeks
apart. The expected response rate of 80
percent will result in 405 respondents to
the survey with approximately 70% ED
nurses, 20% ED medical and health
services managers, and 10% ED
physicians.
Focus Groups: Focus groups will be
conducted to gauge ED managers’ and
clinicians’ awareness of the ESI tool as
well as AHRQ’s role in ED surge
planning and preparation. To the extent
that we are able to identify a subgroup
of ED representatives who are aware of
the ESI tool but have chosen not to

utilize it in their emergency
departments, focus groups may also be
useful to gather information on why
these organizations opted not to employ
the ESI. In order to facilitate
communication among focus group
participants and ensure that responses
address the key issues identified in the
focus group guide, we will limit
participation in each focus group
meeting to between six and eight
individuals. A total of four focus group
meetings will be held, including two
meetings each with ED medical
directors, ED triage nurses, and ED
medical and health services managers.
Estimated Annual Respondent Burden

EXHIBIT 1.—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

Data collection effort

Number of
responses per
respondent

Hours per
response

Total burden
hours

ED professionals survey ..................................................................................
ED professionals focus groups ........................................................................

405
32

1
1

20/60
1.5

135
48

Total ..........................................................................................................

437

na

na

183

EXHIBIT 2.—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents

Data collection effort

Total burden
hours

Average
hourly wage
rate*

Total cost
burden

ED professionals survey ..................................................................................
ED professionals focus groups ........................................................................

405
32

135
48

$33.70
36.62

$4,549.50
1,757.76

Total ..........................................................................................................

437

183

na

6,307.26

*Total

cost burden for the survey is based upon the weighted average of 13 physicians at $58.76/hr, 95 nurses at $29.10/hr, and 27 medical
and health services managers at $37.82/hr. Total cost burden for the focus groups is based on the weighted average of 6 ED physicians at
$58.76/hr, 21 nurses at $29.10/hr, and 21 medical and health services managers at $37.82/hr. National Compensation Survey: Occupational
wages in the United States 2006, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’

This information collection will not
impose a cost burden on respondents
beyond that associated with their time
to provide the required data. There will
be no additional costs for capital
equipment, software, computer services,
etc.
Estimated Annual Costs to the Federal
Government

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Developing and implementing the
survey—$183,305.
Developing and conducting focus
groups—$69,669.
Analyzing the data and report
production—$26,172.
Associated personnel costs—$17,073.
The total cost to the government for
this activity is estimated to be $296,219.
Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
comments on AHRQ’s information
collection are requested with regard to

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any of the following: (a) Whether the
proposed collection of information is
necessary for the proper performance of
AHRQ 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.

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All comments will become a matter of
public record.
Dated: March 25, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8–6757 Filed 4–2–08; 8:45 am]
BILLING CODE 4160–90–M

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for HeaIthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, Department of Health and
Human Services.

AGENCY:

ACTION:

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Notice.

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Federal Register / Vol. 73, No. 65 / Thursday, April 3, 2008 / Notices

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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.
DATES: Comments on this notice must be
received by June 2, 2008.
ADDRESSES: Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@ahrq.hhs.gov.
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:

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 fieldbased 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

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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, multidisciplinary teams will implement
clinician training that uses AHRQsupported 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 (V AP) 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

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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 PostTraining 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 PreTraining 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

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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.

EXHIBIT 1. ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

Data collection instrument

Number of
responses per
respondent

Hours per
response

Total burden
hours

Pre-Training Infection Prevention and Safety Assessment .............................
Post-Training Infection Prevention and Safety Assessment ...........................
Baseline Infection Rate Summary ...................................................................
Follow-up Infection Rate Summary .................................................................
Infection Prevention and Patient Safety Activity Catalogue ............................
Training Evaluation ..........................................................................................

34
136
34
136
136
34

20
5.75
1
1
1
25

30/60
45/60
30/60
40/60
1.00
10/60

340
587
17
91
136
141

Total ..........................................................................................................

136

na

na

1,312

EXHIBIT 2.—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents

Data collection instrument

Total burden
hours

Average
hourly wage
rate*

Total cost
burden

Pre-Training Infection Prevention and Safety Assessment .............................
Post-Training Infection Prevention and Safety Assessment ...........................
Baseline Infection Rate Summary ...................................................................
Follow-up Infection Rate Summary .................................................................
Infection Prevention and Patient Safety Activity Catalogue
Training Evaluation ..........................................................................................

34
136
34
136
136
34

340
587
17
91
136
141

$41.75
41.75
28.99
28.99
39.02
49.04

$14,195
24,507
493
2,638
5,307
6,915

Total ..........................................................................................................

136

1,312

na

54,055

* Based on the planned respondents, the average hourly rates are the average of the mean hourly wage estimates for the following occupational groups: Epidemiologists, health care 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
onetime 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.

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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

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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: March 25, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8–6761 Filed 4–2–08; 8:45 am]
BILLING CODE 4160–90–M

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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30 Day–08–07BO]

Agency Forms Undergoing Paperwork
Reduction Act Review
The Centers for Disease Control and
Prevention (CDC) publishes a list of
information collection requests under
review by the Office of Management and
Budget (OMB) in compliance with the
Paperwork Reduction Act (44 U.S.C.
Chapter 35). To request a copy of these
requests, call the CDC Reports Clearance
Officer at (404) 639–5960 or send an
e-mail to omb@cdc.gov. Send written
comments to CDC Desk Officer, Office of
Management and Budget, Washington,
DC 20503 or by fax to (202) 395–6974.
Written comments should be received
within 30 days of this notice.
Proposed Project
State of Pennsylvania Fire and Life
Safety Public Education Survey—New—

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