Agency Information Collection Activities: Proposed Data Collection; Comment Request

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) approve the proposed information collection  project: ``Pilot Test of the Proposed Pharmacy Survey on Patient Safety Culture.'' In accordance with the Paperwork Reduction Act, 44 U.S.C.3501-3521, A1-IRQ invites the public to comment on this proposed information collection.

DATES: Comments on this notice must be received by May 10, 2011.

ADDRESSES: Written comments should be submitted to: 

Doris Lefkowitz, Reports Clearance Officer, AHRQ, by e-mail 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 the AHRQ 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

Pilot Test of the Proposed Pharmacy Survey on Patient 
Safety Culture

    As the baby boomer population ages, the general U.S. population 
continues to grow, and as drug therapies for the treatment of chronic 
diseases become more efficacious, the expected increase in the number 
of prescriptions and demand for pharmaceutical products is likely to 
increase the potential for medication errors in community/retail 
pharmacies. In 2007, there were about 56,000 community/retail 
pharmacies, including about 22,000 traditional chain pharmacy 
companies, nearly 17,000 independent drug stores, about 9,300 
supermarket pharmacies, and about 7,700 mass merchant pharmacies. 
Numerous reports substantiate the presence of medication errors in 
pharmacies. For example, one national observational study of 
prescription dispensing accuracy and safety in 50 pharmacies in the 
U.S. found a rate of about 4 errors per day in a pharmacy filling 250 
prescriptions daily. This error rate translates to an estimated 51.5 
million errors occurring during the filling of 3 billion prescriptions 
each year.

    Given the widespread impact of pharmacies on patient safety, the 
new Pharmacy Survey on Patient Safety Culture (Pharmacy SOPS) will 
measure pharmacy staff perceptions about what is important in their 
organization and what attitudes and behaviors related to patient safety 
are supported, rewarded, and expected. The survey will help community/
retail pharmacies to identify and discuss strengths and weaknesses of 
patient safety culture within their individual pharmacies. They can 
then use that knowledge to develop appropriate action plans to improve 
their practices and their culture of patient safety. This survey is 
designed for use in community/retail pharmacies, which includes chain 
drugstores (e.g., Walgreens and CVS), supermarket pharmacies, 
independently owned pharmacies, and mass merchant pharmacies (e.g., 
Wal-Mart, Costco, Target), not for use in hospital pharmacies.

    This research has the following goals:
    (1) Cognitively test and modify as necessary the Pharmacy Survey              on Patient Safety Culture Questionnaire;
    (2) Pretest and modify the questionnaire as necessary;
    (3) Make the final questionnaire available to the public.

    This study is being conducted by AHRQ through its contractor, 
Westat, pursuant to AHRQ's statutory authority to conduct and support 
research on healthcare and on systems for the delivery of such care, 
including activities with respect to the quality, effectiveness, 
efficiency, appropriateness and value of healthcare services and with 
respect to quality measurement and improvement. 42 U.S.C. 299a(a)(1) 
and (2).

Full Federal Register Announcement

AHRQ News And Numbers: Approximately Five Percent Of Seniors Report One Or More Cognitive Disorders

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Slightly over over 5 percent of the nearly 39 million Americans age 65 and older in 2007 reported one or more cognitive disorders, such as senility or dementia, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

Seniors age 85 and older were the most likely to have reported one or more cognitive disorders (18.4 percent), compared to seniors ages 75 to 84 (6 percent) and seniors ages 65 to 74 (1.1 percent).

AHRQ found that for elderly Americans age 65 and older in 2007:

- Seniors with less than a high school education were more likely to have reported one or more cognitive disorders than seniors that were high school graduates (8.6 percent and 4.9 percent, respectively) or seniors with more than a high school education (2.7 percent ).

- Nearly 8 percent of poor seniors reported one or more cognitive disorders compared to 4.1 percent of middle and high income seniors reporting such a condition.

- Nearly 11 percent of seniors who had both Medicare and another type of supplemental public insurance reported one or more cognitive disorders, compared to 5 percent of seniors with Medicare only and 4.1 percent of seniors with Medicare and supplemental private insurance.

- Average annual health care expense for seniors reporting one or more cognitive disorders totaled $15,549 a year, compared to $9,019 for seniors not reporting any cognitive disorders.

AHRQ, which is part of the U.S. Department of Health and Human Services, improves the quality, safety, efficiency, and effectiveness of health care for all Americans. The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey (MEPS), a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid. For more information, go to: Person Characteristics of the Elderly Reporting One or More Cognitive Disorders, 2007 .

Source:
AHRQ News and Numbers

AoA November Newsletter

Table of Contents

Top Story

November Is National Family Caregivers Month

AoA News

AoA’s National Family Caregiver Support Program Celebrates 10 Years

November is National Alzheimer’s Disease Awareness Month

Message from Assistant Secretary Kathy Greenlee on Veterans Day 2010

AoA Recognizes Native American Heritage Month

Population Data on Older American Indian Adults Featured in AoA’s November
Widget

Eldercare Locator Takes on a New Look for a Rapidly Aging Population

2010-2011 Influenza Campaign

Other HHS News

Medicare Open Enrollment

AHRQ Launches New Website for Men

Hospitalizations for Medication and Illicit Drug-related Conditions on the Rise
among Americans Ages 45 and Older

More News

Scholarship Opportunity for Graduate Students

NCOA to Sponsor Webinar on Vision and Aging

Additional National Observances in November

USPSTF Expands Osteoporosis Guidelines from MedPage Today

By Todd Neale, Staff Writer, MedPage Today

Postmenopausal women of any age with a 10-year fracture risk equal to or greater than that of a 65-year-old woman and no other osteoporosis risk factors should be screened for the disease, according to draft guidelines from the U.S. Preventive Services Task Force (USPSTF).

The 2002 USPSTF guidelines recommended routine screening only for women ages 65 and older, as well as women ages 60 to 64 with an increased risk for osteoporotic fractures. The current guidelines contain no recommendation for or against screening in younger women.

An additional change from the 2002 guidelines is a mention of men, albeit only to say that evidence is insufficient to assess the balance of benefits and harms of screening in older men. The updated guidance is still in draft form and will be available on the Agency for Healthcare Research and Quality's website for four weeks to receive public comments. After consideration of feedback, the final recommendations will be released.
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Medical News: Metabolic Meds Top Medicare Drug Spending - in Geriatrics, Medicare from MedPage Today

By Kristina Fiore, Staff Writer, MedPage Today

Metabolic drugs -- namely cholesterol and diabetes meds -- account for the greatest Medicare prescription expenses, researchers say.

The drugs cost Medicare $18.6 billion in 2007, the latest year for which figures were available.

That's about a quarter (23%) of the nearly $82 billion spent on medications for the elderly, Anita Soni, PhD, of the Agency for Healthcare Research and Quality (AHRQ) reported in a statistical brief.

The top five drug categories -- of 17 broad therapeutic areas -- totaled spending in excess of $54 billion, or about 66% of total medication expenditures for Medicare beneficiaries.

The four other drug classes were:

* Cardiovascular drugs: $15 billion
* Central nervous system drugs: $8 billion
* Gastrointestinal drugs: $7 billion
* Hormones: $5 billion

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US Task Force Leads the way on Prevention Recommendations

by Kim Krisberg

For more than 25 years, the U.S. Preventive Services Task Force has been a pioneer in the fields of prevention and primary care, examining the evidence and using strict criteria to make recommendations that are often the gold standard for clinical preventive services.

First convened in 1984 by the U.S. Public Health Service and now sponsored by the Agency for Healthcare Research and Quality, the task force has a reputation for being fiercely diligent about sticking to the evidence — a characteristic that has garnered acclaim, respect and, most recently, national controversy. Most people outside of health, medical and policy circles probably knew little, if anything, about the U.S. Preventive Services Task Force until November, when the group released recommendations against routine mammography for women ages 40 to 49, recommending that such screening begin at age 50.
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Medicare Pays Almost Half of Rural Hospital Stays

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Newswise — Medicare patients accounted for almost half of all stays (45 percent) at rural hospitals in 2007, while the percentage of Medicare beneficiaries who were admitted to urban hospitals was considerably lower (35 percent) , according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

The federal agency’s analysis also found that in 2007:

• About 25 percent of rural hospital patients were covered by private health insurance v. 36 percent of urban hospital patients. One-fifth of patients in both rural and urban hospitals had Medicaid and about 5 percent were uninsured.
• Half of the nation’s 2,000 rural hospitals had fewer than 50 beds compared with only one-fifth of urban hospitals.
• The top five illnesses among the two-thirds of rural residents who were hospitalized in rural facilities were: pneumonia (267,000 stays); congestive heart failure (166,000 stays); chronic obstructive lung disease (146,000 stays); chest pain (110,000); and fluid and electrolyte disorders, primarily dehydration and fluid overload (106,000 stays).
• The top five illnesses among the one-thirds of rural residents who were admitted to urban hospitals were hardening of the arteries (108,000 stays; osteoarthritis (79,000 stays); back disorders (75,000 stays); medical device, implant or graft complications (61,000 stays); and heart attack (61,000 stays).

This AHRQ News and Numbers is based on data in Inpatient Stays in Rural Hospitals, 2007 (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb85.pdf). The report uses statistics from the 2007 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.

10% of seniors' ED visits related to falls ... American Medical News

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Falls continue to be a serious problem for elderly patients. Seniors who hurt themselves in falls made more than 2.1 million emergency department visits in 2006, according to a report released in October by the Agency for Healthcare Research and Quality.
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Complete AHRQ Report

Common Formats for Patient Safety Data Collection and Event Reporting

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The Patient Safety Act (at 42 U.S.C. 299b–23) authorizes the collection of this information in a standardized manner, as explained in the related Patient Safety and Quality Improvement Final Rule, 42 CFR part 3(Patient Safety Rule), published in the Federal Register on November 21, 2008: 73 FR 70731–70814. As authorized by the Secretary of HHS, AHRQ coordinates the development of a set of common definitions and reporting formats (Common Formats) that allow healthcare providers to voluntarily collect and submit standardized information regarding patient safety events. The initial release of the formats,Version 0.1 Beta, was announced in thevFederal Register on August 29, 2008: 73 FR 50974–50976. The purpose of this notice is to announce the availability of the expanded and enhanced Common Formats Version 1.0 and the process for their continued development and refinement.

DATES: Ongoing public input.

ADDRESSES: The Common Formats can be accessed electronically at the following HHS Web site: http://www.pso.ahrq.gov/index.html.

FOR FURTHER INFORMATION CONTACT:
Susan Grinder, Center for Quality Improvement and Patient Safety, AHRQ,
540 Gaither Road, Rockville, MD 20850;
Telephone (toll free): (866) 403–3697;
Telephone (local): (301) 427–1111; TTY
(toll free): (866) 438–7231; TTY (local):
(301) 427–1130;
E-mail: pso@ahrq.hhs.gov.
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AHRQ Hospital Survey on Patient Safety Culture

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Request for comment on the collection of information for Agency for Healthcare Research and Quality’s(AHRQ) Hospital Survey on Patient Safety Culture Comparative Database.
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Medical Expenditure Panel Survey

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) approve the proposed information collection project: ``Medical Expenditure Panel Survey (MEPS) Household Component and the MEPS Medical Provider Component through 2012.'' In accordance with the Paperwork Reduction Act of 1995, Public Law 104-13 (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 May 6th 2009 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 August 13, 2009.

CAHPS Field Test of Proposed Health Information Technology Questions and Methodology

This study, funded through cooperative agreements with RAND and Harvard, is being conducted pursuant to AHRQ’s statutory authority to conduct research and evaluations on health care and systems for the delivery of such care, including activities with respect to (1) the quality, effectiveness, efficiency, appropriateness and value of health care services and (2) health care technologies, facilities and equipment. See 42 U.S.C. 299a(a)(1) and (5). This study is a one-time field test to be conducted in calendar year 2009. The field test to be conducted under this request will be done for the following purposes: a. Analysis of revised item wording— Assess candidate wordings for survey items b. Mode Analysis—Evaluate the equivalence of items administered by mail, telephone, and internet; compare the characteristics and responses of respondents who complete the survey by different modes of administration. c. Case mix adjustment analysis— Evaluate variables that need to be considered for case mix adjustment of scores. d. Psychometric Analysis-Provide information for the revision and shortening of questionnaires based on the assessment of the reliability and validity of survey items and composites. The end result will be a data collection related to the assessment of patients’ perspective on how well health information technology is being used by health care professionals. The field testing will ensure that the future data collection yields high quality data and to ensure a minimization of respondent burden, increase agency efficiency, and improve responsiveness to the public. The survey items will be added to currently available CAHPS® surveys and will provide a venue to clinicians and practitioners to verify the quality of their services.

AHRQ Health Services Research Demonstration and Dissemination Grants

-Support improvements in health outcomes. Drawing from literature on variations in clinical practice and associated outcomes, the documented increase in the prevalence of chronic disease, and growing interest in the impact of different delivery modalities and financing arrangements on the outcomes of care, AHRQ seeks to support research to understand and improve decision-making at all levels of the health care system, the outcomes of health care, and, in particular, what works, for whom, when, and at what cost. -Strengthen quality measurement and improvement. AHRQ is interested in a broad array of research topics, including studies to develop valid and reliable measures of the process and outcomes of care, causation and prevention of errors in health care, strategies for incorporating quality measures into programs of quality improvement, and dissemination and implementation of validated quality improvement mechanisms. -Identify strategies to improve access, foster appropriate use, and reduce unnecessary expenditures. This area focuses on issues pertaining to the types of health care services Americans use, the cost of these services and sources of payment, determinants of access to care, and whether particular approaches to health care delivery and financing, or characteristics of the health care market, alter behaviors in ways that improve access and promote cost-effective use of health care resources. Eligible Applicants County governments Native American tribal governments (Federally recognized) Public housing authorities/Indian housing authorities Public and State controlled institutions of higher education State governments Independent school districts Special district governments City or township governments Native American tribal organizations (other than Federally recognized tribal governments) Private institutions of higher education

Final Rule: Patient Safety and Quality Improvement

The Secretary of Health and Human Services is adopting rules to implement certain aspects of the Patient Safety and Quality Improvement Act of 2005, Pub. L. 109-41, 42 U.S.C. 299b-21--b-26 (Patient Safety Act). The final rule establishes a framework by which hospitals, doctors, and other health care providers may voluntarily report information to Patient Safety Organizations (PSOs), on a privileged and confidential basis, for the aggregation and analysis of patient safety events. The final rule outlines the requirements that entities must meet to become PSOs and the processes by which the Secretary will review and accept certifications and list PSOs. It also describes the privilege and confidentiality protections for the information that is assembled and developed by providers and PSOs, the exceptions to these privilege and confidentiality protections, and the procedures for the imposition of civil money penalties for the knowing or reckless impermissible disclosure of patient safety work product. DATES: The final rule is effective on January 19, 2009.

AHRQ Health IT Proposed Project

AHRQ-supported research has helped to demonstrate the potential of health IT to enhance health care quality and patient safety. As the lead federal research agency on the quality, safety, efficiency, and effectiveness of health care in America, AHRQ plays a central role in efforts to increase the adoption of health IT. Consistent with its mission, AHRQ proposes to develop measures of four indicators of performance of its health IT portfolio, namely: 1. Reduction in medication errors due to adoption of electronic prescribing systems; 2. The number of persons who can access their medication information online; 3. The number of clinicians who can electronically access evidence-based prevention or treatment information; and 4. The number of clinician organizations who have adopted evidence-based decision support technologies. While secondary data are available to calculate measures 1, 3 and 4 described above, no national data exist for measure 2. Thus, this proposed information collection relates to measure 2: The number of persons who can access their medication information online.

``Reducing Waste and Inefficiency through Process Redesign: Lean/Toyota Production System (TPS) Implementation''

Proposed Project AHRQ, through its contractor, American Institutes for Research (AIR), proposes to investigate the contribution of Lean/TPS to reducing waste in health care delivery systems. Lean is a process-redesign methodology adopted from Toyota Production Systems. The goal of Lean/TPS is to empower front-line staff to apply continuous quality improvement methods to reduce waste and enhance value in workflows and operations (Spear, S. Fixing healthcare from the inside, today. Harvard Business Rev., 2005 83(9), 78-91). AHRQ is interested in assessing and disseminating promising techniques and methodologies for redesigning health care processes to reduce waste and enhance efficiency. Using a purposive sample of health care organizations and projects, AHRQ will describe and assess the ways in which Lean/TPS has been implemented and the related challenges and solutions experienced. The sample will vary in community and market characteristics, type of service (e.g., inpatient/outpatient), and delivery system characteristics (e.g., relationship between physicians and hospitals, ownership). AHRQ plans to disseminate the lessons learned from this project on the implementation of Lean/TPS to health care delivery systems. This project is being conducted pursuant to AHRQ's statutory authority to conduct and support research on health care and on systems for the delivery of such care, including activities with respect to: The quality, effectiveness, efficiency, appropriateness and value of health care services; quality measurement and improvement; and health care costs, productivity, organization, and market forces. 42 U.S.C. 299a(a)(1), (2), and (6).

``The AHRQ Data Inventory'' Proposed Project

The Agency for Healthcare Research and Quality (AHRQ) is interested in determining the availability of regularly collected administrative and other data collection initiatives about outpatient health service utilization. AHRQ seeks to better understand issues in developing data collection initiatives, redundancies in these initiatives, uses of available data, gaps in available information, similarities across data projects, and areas for possible collaboration and coordination. AHRQ's initial focus is on those data sets that would inform healthcare providers, policymakers, and consumers about outpatient health service utilization and episodes of care. The primary purpose of this information collection is to comprehensively document outpatient health care data collection initiatives in the 50 states, the District of Columbia, and other geographic units. Information being collected about the data sets is not readily available to the public. In-depth information about the data sets will provide guidance to AHRQ on the potential synergy across such initiatives and suggest how the information can inform Federal, State, and local health care policymakers, clinicians, and consumers. Information collected during the interviews will comprehensively document outpatient health care data collection initiatives.

How to Become a Patient Safety Organization

Interim Guidance Availability AHRQ and OCR are announcing the availability of the guidance entitled ``Implementing the Patient Safety and Quality Improvement Act of 2005 Including How to Become a Patient Safety Organization.'' The Interim Guidance document explains how the Department of Health and Human Services (HHS) will begin implementing the Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), how an entity can become a Patient Safety Organization (PSO), and how information may be protected as Patient Safety Work Product (PSWP) in the interim period prior to the promulgation of a final regulation. To access the Interim Guidance, visit AHRQ's PSO Web site at http://www.pso.ahrq.gov. DATES: The Interim Guidance is effective immediately with the publication of this notice. The Interim Guidance will remain effective until the effective date of the final regulation, which is expected to be promulgated before the end of 2008.

Meeting of the National Advisory Council for Healthcare Research and Quality

Notice of public meeting to be held on Friday, November 7, 2008, from 9 a.m. to 3 p.m. The Council is composed of members of the public, appointed by the Secretary, and Federal ex-officio members. Agenda On Friday, November 7, the Council meeting will convene at 9 a.m., with the call to order by the Council Chair and approval of previous Council minutes. The AHRQ director will present her update on current research, programs, and initiatives. The agenda will include a discussion on Patient-centered Health Care and Cost Effective Health Care by the Council. The final agenda will be available on the AHRQ Web site at http://www.ahrq.gov no later than November 3, 2008.

Hospital Adverse Event Reporting

This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project: ``National Study of the Hospital Adverse Event Reporting Follow-Up Survey.'' In accordance with the Paperwork Reduction Act of 1995, 44 U.S.C. 3506()(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 July 24th, 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. Changes were made to this 30 day notice to account for the electronic patient records review which were not accounted for in the 60 day notice.