Pilot Test of Hospital CAHPS Survey

ICR 200303-0938-003

OMB: 0938-0891

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
8722 Migrated
ICR Details
0938-0891 200303-0938-003
Historical Active
HHS/CMS
Pilot Test of Hospital CAHPS Survey
New collection (Request for a new OMB Control Number)   No
Emergency 03/21/2003
Approved with change 05/09/2003
Retrieve Notice of Action (NOA) 03/12/2003
Consistent with the following terms of clearance this information collection request is approved as a pilot study for purposes of obtaining data that will be useful in refining the HCAHPS survey instrument and assessing its psychometric properties. AHRQ/CMS have determined that they will not use or publish the substantive findings from this collection. Additionally, during OMB's discussions with AHRQ/CMS, they have agreed to send copies of all reports from this investigation to OMB and will brief OMB when the results of the psychometric testing are available. AHRQ/CMS have also agreed that they will consult with OMB to determine whether the results of the pilot adequately support further implementation of this survey process or if additional pilot testing is needed. AHRQ/CMS have further agreed that they will consult with OMB about any additional collections related to this survey instrument and involving any other collaborators to inform OMB about these activities and to determine whether they are subject to formal OMB review under the PRA. AHRQ/CMS have also agreed that, before proposing research with any outside collaborators, they will publish a Federal Register Notice offering any interested organization the opportunity to participate in developmental research on the HCAHPS instrument; this notice will include a) a statement of the areas where AHRQ/ CMS are particularly interested in doing further research; b) a request that interested organizations submit a brief statement of their intests and capabilities; c) a list of any terms and conditions of participation (e.g., timelines, sharing of all data collected with AHRQ/CMS; and d) a list of certain criteria that AHRQ/CMS will use to select potential collaborators. Finally, AHRQ/CMS have agreed that, in providing information to OMB about collaborations with outside groups, they will provide an 83-C with the number of responses and burden hours as a cover memo and a discussion of the project that includes a description of the entity with whom the agencies are collaborating, what is being tested, the project's research design and information about the number and characteristics of respondents.
  Inventory as of this Action Requested Previously Approved
11/30/2003 11/30/2003
16,500 0 0
5,500 0 0
0 0 0

CMS has requested a hospital survey as a way of providing comparison information for consumers who need to select a hospital and as a way of encouraging accountability of hospital for the care they provide. With a standardized instrument consumers will be able to make "apples to apples" comparisons among hospitals allow hospitals and hospital chains to self compare, and provide state oversight officials with useful data. A standardized instrument, developed under the CAHPS umbrella will produce a reliable and valid instrument that any organizations can use at no cost to obtain patient....

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IC Title Form No. Form Name
Pilot Test of Hospital CAHPS Survey CMS-10083

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16,500 0 0 16,500 0 0
Annual Time Burden (Hours) 5,500 0 0 5,500 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/12/2003


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