Federal Register / Vol. 78, No. 17 / Friday, January 25, 2013 / Notices 5459
control’’ or ‘‘non-pain symptom respondents to ensure that they DATES: The information solicited in this management,’’ as well as publicly understand the questionnaire.) notice must be received at the address available instruments for capturing ++ Results of field testing. provided below by March 26, 2013. family members’ or friends’ experiences ++ Current use of the instrument (who ADDRESSES: In responding to this with hospice care. We are interested in is using it, what it is being used for, solicitation, please reply via email to instruments and items that can measure what population it is being used with, [email protected] or by quality of care from the family member/ how instrument findings are reported, postal mail at Centers for Medicare and friend’s perspective, including all and by whom the findings are used). Medicaid Services, Attention: Memuna potential hospice settings (for example, ++ Relevant peer-reviewed journal Ifederah, Mailstop C1–25–05, 7500 home, nursing home, hospital, and free- articles or full citations. Security Boulevard, Baltimore, MD ® standing hospice) and instruments that ++ CAHPS trademark status. 21244–1850. track changes over time. ++ National Quality Forum (NQF) FOR FURTHER INFORMATION CONTACT: We are looking for suggested topic endorsement status. Memuna Ifederah, (410) 768–6849 or areas and publicly available instruments ++ Survey administration instructions. Caren Ginsberg (410) 786–0713. in which the information was identified ++ Data analysis instructions. SUPPLEMENTARY INFORMATION: by family members/friends as important ++ Guidelines for reporting survey data. to them in evaluating hospice care. CMS is developing this survey and I. Background Existing instruments are preferred if plans to submit it to AHRQ for In accordance with section 3011 of they have been tested, have a high recognition as a Consumer Assessment the Affordable Care Act, the Department degree of reliability and validity, and of Healthcare Providers and Systems of Health and Human Services (HHS) report evidence of wide use. (CAHPS®) survey. The survey will be ® developed the National Quality Strategy The following information would be developed in accordance with CAHPS to create national aims and priorities to especially helpful in any comments Survey Design Principles and guide local, state, and national efforts to responding to this request for implementation instructions will be ® improve the quality of health care. The information: based on those for CAHPS instruments National Quality Strategy established • A brief cover letter summarizing the (https://www.cahps.AHRQ.gov/About- three aims supported by six priorities. information requested for submitted CAHPS/Principles.aspx). The 3 aims are as follows: instruments and topic areas, (Catalog of Federal Domestic Assistance • Better Care: Improve the overall respectively, and how the submission Program No. 93.773, Medicare—Hospital quality, by making health care more will help fulfill the intent of the survey. Insurance; and Program No. 93.774, patient-centered, reliable, accessible, • (Optional) Information about the Medicare—Supplementary Medical and safe. person submitting the material for the Insurance Program) • Healthy People/Healthy purposes of follow up questions about Dated: December 5, 2012. Communities: Improve the health of the the submission which includes the Marilyn Tavenner, U.S. population by supporting proven following: Acting Administrator, Centers for Medicare interventions to address behavioral, ++ Name. & Medicaid Services. social, and environmental determinants ++ Title. [FR Doc. 2013–01299 Filed 1–24–13; 8:45 am] of health in addition to delivering ++ Organization. BILLING CODE 4120–01–P higher quality care. ++ Mailing address. • Affordable Care: Reduce the cost of ++ Telephone number. quality health care for individuals, ++ Email address. DEPARTMENT OF HEALTH AND families, employers, and government.1 ++ Indication that the instrument is HUMAN SERVICES The six priorities are: ‘‘(1) Making publicly available. care safer by reducing harm caused by • When submitting topic areas, we Centers for Medicare & Medicaid the delivery of care; (2) ensuring that encourage including to the extent Services each person and family are engaged as available the following information: partners in their care; (3) promoting ++ Detailed descriptions of the [CMS–4171–NC] effective communication and suggested topic area(s) and specific coordination of care; (4) promoting the purpose(s). Medicare Program; Request for Information To Aid in the Design and most effective prevention and treatment ++ Relevant peer-reviewed journal practices for the leading causes of articles or full citations. Development of a Survey Regarding Patient Experiences With Hospital mortality, starting with cardiovascular • When submitting publicly available Outpatient Surgery Departments/ disease; (5) working with communities instruments or survey questions, we Ambulatory Surgery Centers and to promote wide use of best practices to encourage including to the extent Patient-Reported Outcomes From enable health living; and (6) making available the following information: Surgeries and Procedures Performed quality care more affordable for ++ Name of the instrument. in These Settings individuals, families, employers and ++ Copies of the full instrument in all governments by developing and available languages. AGENCY: Centers for Medicare & spreading new health care delivery ++ Topic areas included in the Medicaid Services (CMS), HHS. models’’. instrument. ACTION: Request for information. Surveys focusing on the patient ++ Measures derived from the experience as well as the Hospital instrument. SUMMARY: This document is a request for Outpatient Surgery Department/ ++ Instrument reliability (internal information regarding hospital consistency, test-retest, etc) and outpatient surgery departments (HOSDs) 1 Please see U.S. Department of Health and validity (content, construct, criterion- and ambulatory surgery centers (ASCs), Human Services, Report to Congress, National Strategy for Quality Improvement in Health Care, related). as well as patient-reported outcomes (March 2011), available at http:// ++ Results of cognitive testing (one-on- from surgeries or other procedures www.healthcare.gov/law/resources/reports/ one testing with a small number of performed in these settings. nationalqualitystrategy032011.pdf.
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Ambulatory Surgery Patient Experience II. Solicitation of Information and measures that have been tested and of Care Survey now under development This document solicits input for have a high degree of reliability and support the National Quality Strategy of developing this new patient experience validity, and for which there is evidence better care and the priorities of— survey, including the following: of wide use. This request for information solicits • Ensuring that each person and • Relevant topic areas such as input from consumers, researchers, family are engaged as partners in their communication between patients and vendors, health plans, HOSDs, ASCs, care (priority #2); and health care providers; access to care; customer service; provision of pre- and surgeons, advocacy organizations, • Promoting effective communication community-based providers, and other and coordination of care (priority #3). post-surgical care information; access to follow-up care; care coordination; stakeholders and interested parties. This Since 1995, the Agency for Healthcare patient preferences; environment; and call for topic areas, publicly available Research and Quality (AHRQ) and its safety. surveys, questions, and measures is Consumer Assessment of Healthcare • Publicly available surveys, survey occurring now because of the multi- ® Providers and Systems (CAHPS ) questions, and measures indicating— (1) phased survey development and testing Consortium, in partnership with the patient experience and/or level of process necessary to produce a Centers for Medicare & Medicaid patient satisfaction with experience in standardized instrument. The target Services (CMS), has developed HOSDs/ASCs; and (2) patient-reported population for the survey is adults standardized CAHPS® Surveys and outcomes from surgeries or other (defined in CAHPS surveys as 18 years tools for a variety of populations to procedures (for example, colonoscopies, old and older) who recently have had collect data on patient’s experiences endoscopies) performed in HOSDs and surgery or other procedures, such as a with and ratings of care. CMS and ASCs. These surveys, survey questions, colonoscopy or endoscopy, in a surgical AHRQ have developed CAHPS® surveys and measures should measure and outpatient setting. CMS is developing this survey and for in-center hemodialysis facilities, assess quality of care and patient- plans to submit it to AHRQ for nursing homes, and clinician and group reported outcomes from the patient’s recognition as a CAHPS® survey. The practices. CMS has already perspective, and track changes over survey will be developed in accordance implemented CAHPS® surveys for time. with CAHPS® Survey Design Principles health and drug plans, hospitals, and We are interested in suggestions for topic areas, and publicly available and implementation instructions will be home health agencies. based on those for CAHPS® instruments We are developing a standardized surveys, questions or measures that address the following specifically for (https://www.cahps.AHRQ.gov/About- Hospital Outpatient Surgical outpatient surgery: CAHPS/Principles.aspx). Department/Ambulatory Surgical Center We are asking respondents to include • Issues that are that are highly (HOSD/ASC) Experience of Care Survey the following in their submissions: relevant to DHHS and CMS, because to evaluate the care received in these • A brief cover letter summarizing the they support DHHS’s and CMS’s efforts facilities from the patient’s perspective. information requested above for ® for improved quality and efficiency of submitted topic areas, surveys, Two related CAHPS surveys exist; care and are included in or facilitate however, they do not collect questions, and measures, and how the alignment with other CMS programs. submission will help fulfill the intent of information specific to the patient • Identification of gaps in the quality experience of care in HOSD/ASC the patient experiences survey. of care delivered in outpatient surgical • (Optional) Information about the facilities. In 2006, CMS began departments. ® person submitting the material for implementing the Hospital CAHPS • Measures of surgical care (HCAHPS) Survey, which collects data purposes of follow-up questions about coordination and related care the submission, including the following: on hospital inpatients experiences with coordination activities. and ratings of hospital inpatient care. • Identification and assessment of ++ Name. The HCAHPS Survey includes neither ++ Title. patient-reported outcomes, such as pain, ++ Organization. patients who receive outpatient surgical nausea and vomiting, deep vein care from hospital-based outpatient ++ Mailing address. thrombosis, infection, pneumonia, and ++ Telephone number. surgical departments, nor patients who urinary retention. ++ Email address. received such care from freestanding We are looking for suggested topic ++ Indication that the topic area or ® ASCs. The Surgical Care CAHPS areas, as well as any publicly available instrument is publicly available. Survey, developed by the American surveys, questions and measures in • When submitting topic areas, College of Surgeons (ACS) and the which—(1) the source of information is respondents should include to the Surgical Quality Alliance (SQA) focuses from patients who directly received care extent available the following on both inpatient and outpatient at HOSDs or ASCs; and (2) patients information: surgeries and includes questions related identified the topic areas such as those ++ Detailed descriptions of the to the patient’s experience before, listed above as important to them in suggested topic area(s) and specific during, and after surgery. However, this evaluating HOSD or ASC care (for purpose(s). survey focuses on the care provided by example, wait time and medical staff ++ Sample questions, in all available the physician rather than the facility. and physician communication). We are languages. Hospital outpatient surgery departments seeking topic areas, surveys, questions ++ Relevant peer-reviewed journal and ASCs will be the unit of analysis for and measures that are applicable across articles or full citations. this HOSD/ASC survey instrument. The outpatient surgical settings (for ++ Name of the instrument. Hospital Outpatient Surgery example, freestanding settings, hospital ++ Copies of the full instrument in all Department/Ambulatory Surgery Center based settings, for-profit settings; not- available languages. Patient Experience of Care Survey will for-profit settings; rural settings; urban ++ Topic areas included in the survey. be used to help consumers make settings; multi-specialty and single- ++ Measures derived from the survey. informed choices about providers as specialty surgery departments/centers). ++ Survey reliability (internal well as improving the quality of care. We prefer existing surveys, questions, consistency, test-retest, etc.) and
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validity (content, construct, criterion- Medicare—Supplementary Medical Description related). Insurance Program) 42 U.S.C. 612 (Section 412 of the ++ Results of cognitive testing (one-on- Dated: December 13, 2012. Social Security Act) requires each one testing with a small number of Marilyn Tavenner, Indian Tribe that elects to administer respondents to ensure that they Acting Administrator, Centers for Medicare and operate a TANF program to submit understand the questionnaire). & Medicaid Services. a TANF Tribal Plan. The TANF Tribal ++ Results of field testing. [FR Doc. 2013–01300 Filed 1–24–13; 8:45 am] Plan is a mandatory statement ++ Current use of the instrument (who BILLING CODE 4120–01–P submitted to the Secretary by the Indian is using it, what it is being used for, Tribe, which consists of an outline of what population it is being used with, how the Indian Tribes TANF program how instrument findings are reported, DEPARTMENT OF HEALTH AND will be administered and operated. It is and by whom the findings are used). HUMAN SERVICES used by the Secretary to determine ++ Relevant peer-review journal articles Administration for Children and whether the plan is approvable and to or full citations. determine that the Indian Tribe is ® Families ++ CAHPS trademark status. eligible to receive a TANF assistance ++ Survey administration instructions. Proposed Information Collection grant. It is also made available to the ++ Data analysis instructions. Activity; Comment Request public. ++ Guidelines for reporting survey data. Proposed Projects Respondents (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Title: Guidance for Tribal TANF. Indian Tribes applying to operate a Insurance; and Program No. 93.774, OMB No.: 0970–0157. TANF program.
ANNUAL BURDEN ESTIMATES
Number of Average Instrument Number of responses per burden hours Total Burden respondents respondent per response hours
Request for State Data Needed to Determine the Amount of a Tribal Family Assistance Grant ...... 23 1 68 1564
Estimated Total Annual Burden the quality, utility, and clarity of the Description: The information Hours: 1564. information to be collected; and (d) collected by the Project Impact In compliance with the requirements ways to minimize the burden of the Assessment Survey is needed for two of Section 506(c)(2)(A) of the Paperwork collection of information on main reasons: (1) To collect crucial Reduction Act of 1995, the respondents, including through the use information required to report on the Administration for Children and of automated collection techniques or Administration for Native Americans’ Families is soliciting public comment other forms of information technology. (ANA) established Government on the specific aspects of the Consideration will be given to Performance and Results Act (GPRA) information collection described above. comments and suggestions submitted measures, and (2) to properly abide by Copies of the proposed collection of within 60 days of this publication. ANA’s congressionally-mandated information can be obtained and statute (42 United States Code 2991 et Robert Sargis, comments may be forwarded by writing seq.) found within the Native American to the Administration for Children and Reports Clearance Officer. Programs Act of 1974, as amended, Families, Office of Planning, Research [FR Doc. 2013–01450 Filed 1–24–13; 8:45 am] which states that ANA will evaluate and Evaluation, 370 L’Enfant BILLING CODE 4184–01–P projects assisted through ANA grant Promenade, SW., Washington, DC dollars ‘‘including evaluations that 20447, Attn: ACF Reports Clearance describe and measure the impact of Officer. Email address: DEPARTMENT OF HEALTH AND such projects, their effectiveness in [email protected]. All requests HUMAN SERVICES achieving stated goals, their impact on should be identified by the title of the related programs, and their structure Administration for Children and information collection. and mechanisms for delivery of Families The Department specifically requests services.’’ The information collected comments on: (a) Whether the proposed Proposed Information Collection with this survey will fulfill ANA’s collection of information is necessary Activity; Comment Request statutory requirement and will also for the proper performance of the serve as an important planning and functions of the agency, including Proposed Projects performance tool for ANA. whether the information shall have Respondents: Tribal Governments, practical utility; (b) the accuracy of the Title: ANA Project Impact Assessment Native American nonprofit agency’s estimate of the burden of the Survey. organizations, and Tribal Colleges and proposed collection of information; (c) OMB No.: 0970–0379 Universities.
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