Inital Screening Round 2 (Cognitive Interviews)

Application to Use Burden/Hours from Generic PRA Clearance for

Consumer Research on Public Reporting of Hospital Quality Measures

Information Collection #1
June 13, 2011

Division of Consumer Assessment & Plan Performance (DCAPP)
Centers for Medicare & Medicaid Services (CMS)

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A. Background
One of the primary missions of the Centers for Medicare & Medicaid Services (CMS) is to
improve the quality and efficiency of care in the Fee-for-Service (FFS) program, by publicly
reporting of quality of care information on the Hospital Compare website. This vehicle also
serves to provide Medicare beneficiaries and other consumers with the type of data needed to
make informed decisions about which hospitals to use for their care. Insuring that consumers
understand the data as intended, interpret them correctly, and make accurate inferences about
their significance and implications helps the Agency to fulfill its mission.
As noted in the Supporting Statement to our generic, or “umbrella,” request for information
collection, CMS proposes to conduct two types of activities related to Consumer Research on
Public Reporting of Hospital Quality Measures:
1. Formative research to explore how to best organize quality, safety, and efficiency
information on the Hospital Compare website, using focus groups with consumers
(patients and informal caregivers)
2. Iterative rounds of research to elicit specific feedback on ways of displaying new
measures to be added to Hospital Compare
a. Round 1: intensive individual interviews probing understanding of mock
displays and eliciting feedback about them from
i. consumers (patients and their informal family caregivers)
ii. health care providers (physicians who refer patients to hospitals or
inform them about hospital quality).
b. Round 2: intensive individual interviews probing understanding of revised
displays (based on input from round 1) and eliciting feedback about them
from
i. consumers (patients and their informal family caregivers)
ii. health care providers
Thiscurrent Information Collection Request (ICR) addresses the first round of the second
activity outlined above, as it relates to consumer respondents (section 2.a.i, highlighted in
boldface above). A second request, submitted along with this one, focuses on physician
respondents (2.a.ii.). ICRs for the other activities outlined above will be submitted at a later
date.

B. Description of Information Collection

The Information Collection requested here will serve to provide individual feedback from
hospital patient consumers and informal family caregiver consumers about 3 new types of
measures: Hospital Acquired Condition rates, Healthcare Associated Infections (Central
Line-Associated Blood Stream Infections), and two measures of timely transfer of
Emergency Department patients to admitted status. The research team will conduct
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individual interviews with 6 to 8 hospital patient consumers, ranging in age from 40 to 70
years of age, and with 6 to 8 informal family caregiver consumers, ranging in age from 18 to
70 years of age, for a total of 14 consumer interviews. The stimulus materials will include
explanatory text and draft displays of measure data, rates and benchmarks.
Interviewers will look for misinterpretations, unintended reactions or confusion, and what
changes to the display or language might improve them. The goal of gathering such
individual feedback about the mock-ups will be to determine how to best integrate the new
information into the existing website using the display devices similar to those used for
extant measures, but presenting the information clearly and in such a way that consumers
could draw accurate and useful inferences from the data. Recommendations will be made to
internal clients responsible for reporting of quality metrics to the public and to those
responsible for maintaining the Hospital Compare website.
We will work with established, reliable market research firms to enlist the necessary
participants, providing them tailored screeners for the recruitment process. We have attached
a recruitment screener that includes a detailed script along with specific criteria to use when
contacting potential participants. The script includes screening questions designed to target
the specific audience required for this research, including such criteria as gender, age, race
and ethnicity, and level of education. Our screening tool also takes into account certain
exclusion criteria, screening out, for example, individuals who work in the health care
industry, to avoid response bias.
For this information collection request, the following data collection tools are attached:
1) Recruitment screening forms to be used by the research facilities to match the
participant pool to the recruitment goals of the research team (Attachment A);
2) A semi-structured guide for interviews with patient consumers and informal family
caregivers (Attachments B);
3) Mock ups (Attachment C); and
4) Consent form (Attachment D)
C. Deviations from Generic Request
OMB currently approves incentive of up to $45/hour. As the individual interviews will entail
at least 1 ½ hours of intensive cognitive work, CMS requests permission to provide subjects
$67.50 for their participation. Lower remuneration may alter the subject pool in ways that
could bias the results.
D. Burden Hour Deduction
This is a new collection of information. From the total of 186.64 burden hours in the original
generic request, 3.33 hours are requested for screening of consumers using the hospital
patient consumer screener and the informal family caregiver consumer screener. An
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additional 42 hours are requested for interviews with 14 consumers. Hence, the deduction
from the original requested burden hours is 45.33 hours.
E. Timeline
The current IC request is for use in June/July 2011, so that recommendations may be made to
internal clients by the end of July 2011 for website language and display design.
The following attachments are provided for this information collection:
Attachment A – Screening forms
Attachment B – Intensive Individual interview guide
Attachment C – Testing Materials/Mockups
Attachment D – Consent form

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