Attachment G -- 60 Day FRN

70648

Federal Register / Vol. 73, No. 226 / Friday, November 21, 2008 / Notices

IP marketplace? How will they affect
innovation and competition?
7. How does uncertainty regarding the
validity and scope of patents affect the
operation of the IP marketplace? Does
the current system adequately fulfill the
notice function of patents? How does
uncertainty influence the operation of
the IP marketplace? What are the
sources of uncertainty that affect the
value of patents and the operation of the
IP marketplace? What could be done to
address them?
8. How transparent is the current IP
marketplace? Can it be made more
transparent? Is that desirable?
9. During the past five years, what
new learning has furthered the
understanding of the patent system and
the IP marketplace?
By direction of the Commission.
Donald S. Clark,
Secretary.
[FR Doc. E8–27673 Filed 11–20–08: 8:45 am]
[BILLING CODE 6750–01–S]

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.

dwashington3 on PRODPC61 with NOTICES

AGENCY:

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:
‘‘Reducing Waste and Inefficiency
through Process Redesign: Lean/Toyota
Production System (TPS)
Implementation.’’ 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 (insert date 60 days after
date of publication).
ADDRESSES: Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by
email at [email protected].
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

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Clearance Officer, (301) 427–1477, or by
email at [email protected]..
SUPPLEMENTARY INFORMATION:
Proposed Project
‘‘Reducing Waste and Inefficiency
through Process Redesign: Lean/Toyota
Production System (TPS)
Implementation’’ 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).
Method of Collection
At least four research locations (i.e.,
hospitals or other health settings) will
be selected to create eight case study
reports. Four of the studies will employ
a retrospective analytics perspective,
while four will employ a prospective
analytics perspective. At each location,
implementation of Lean/TPS in two
departments will be studied: One
department with an essentially linear
process (clinical laboratory, radiology,
or ED) and one department with an
essentially non-linear process
(cardiology, GI, or med/surg unit). A

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linear department is one in which the
process is essentially uniform and
predictable for most or all services
delivered. A non-linear department is
one in which the process is much less
uniform and predictable. If there is more
than one Lean/TPS project in the
selected department, we will
purposively select a project that appears
to have the most information for others
about the processes and outcomes of
Lean/TPS implementation.
Qualitative data will be collected
directly from the four locations selected
for this study. The collection will be
accomplished using interviews
telephone and in-person), collection of
documentation, and digital diaries for
the four prospective studies. The
‘‘digital diary’’ is a data collection
method using a diary entry guide and a
digital recorder to describe key aspects
of the implementation process. The total
number of in-person interviews to be
conducted across the four locations is
100; the total number of telephone
interviews is 36. The in-person
interviews will be conducted through a
multi-day visit to each site. The number
of digital diary submissions will depend
on the number and duration of the
Lean/TPS project within in each
department.
Estimated Annual Respondent Burden
Exhibit I shows the estimated
annualized burden hours. A total of 25
in-person interviews will be conducted
with the administrative and clinical
personnel from each of the four
participating health care facilities. The
estimated time per response is 1.0 hour
for a total of 100 burden hours.
Additionally, a total of 9 telephone
interviews will be conducted with each
facility. The estimated time per
response is 30 minutes, for a total of 18
burden hours. The digital diaries will be
completed once a month for eight
months by two personnel from each
facility, and will require about 30
minutes each per month for a total of 32
hours. Finally, administrative staff from
each site will be asked to provide
training materials, reports on Lean/TPS
implementation, and/or any other
documentation or existing data from
previous or current Lean/TPS projects
implemented. We anticipate this task
will simply consist of forwarding emails
and or photocopying and sending
documents to the project team one time
throughout the course of the project and
will take about four hours per facility or
16 hours total. The total estimated
burden is 166 hours. Exhibit 2 shows
the estimated annualized cost burden
for the respondents’ time to provide the
requested data. The hourly rate of

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70649

Federal Register / Vol. 73, No. 226 / Friday, November 21, 2008 / Notices
$35.07 is an average of the
administrative personnel hourly wage of

$14.53 and the clinical personnel hourly
wage of $62.52 for physicians and

$28.15 for registered nurses. The total
cost burden is about $5,492.

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

Data collection

Number of
responses
per
respondent

Hours per
response

Total
burden
hours

In-person interviews .........................................................................................................
Telephone interviews .......................................................................................................
Digital Diaries ...................................................................................................................
Collection of documentation ............................................................................................

4
4
4
4

25
9
16
1

1.0
30/60
30/60
4

100
18
32
16

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

16

....................

....................

166

Total
burden
hours

Average
hourly wage
rate *

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents

Data collection

Total cost
burden

In-person interviews .........................................................................................................
Telephone interviews .......................................................................................................
Digital Diaries ...................................................................................................................
Collection of documentation ............................................................................................

4
4
4
4

100
18
32
16

$35.07
35.07
35.07
14.53

$3,507
631
1,122
232

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

16

....................

....................

5,492

* Based upon the average hourly wages of administrative support personnel, physicians, and registered nurses, National Compensation Survey; Occupational Wages in the United States 2005, U.S. Department of Labor, Bureau of Labor Statistics.

Estimated Annual Costs to the Federal
Government

comments will become a matter of
public record.

The total cost to the Federal
Government for this project is $415,000,
with an average annual cost of $207,500.
This figure includes the cost of data
collection, data analysis, reporting, and
government oversight of the contract.

Dated: November 6, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8–27521 Filed 11–20–08; 8:45 am]

dwashington3 on PRODPC61 with NOTICES

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’s 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. All

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BILLING CODE 4160–90–M

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:

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:
‘‘Conducting Measurement Activities in
Support of the AHRQ Health IT
Initiative.’’ 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

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Register on September 19th, 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 December 10, 2008.
ADDRESSES: Written comments should
be submitted to: AHRQ’s OMB Desk
Officer by fax at (202) 395–6974
(attention: AHRQV’s desk officer) or by
e-mail at OIRA_submissionomb.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 the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at [email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
Conducting Measurement Activities in
Support of the AHRQ Health IT
Initiative
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.

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