Mini Part A for fourth IC_11_15_11

Application to Use Burden/Hours from Generic PRA Clearance for

Consumer Research on Public Reporting of Hospital Quality Measures

Information Collection #4
December 15, 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 family 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
This current Information Collection Request (ICR) addresses the first activity outlined above,
as it relates to consumer/informal family caregiver respondents (section 1, highlighted in
boldface above).

B. Description of Information Collection

The Information Collection requested here will serve to provide feedback from informal
family caregivers of hospital patients about a new way of introducing and organizing the
patient perspectives, patient safety, clinical quality, outcome and efficiency measures on
Hospital Compare.
The research team will conduct focus groups with 20 informal family caregiver consumers,
ranging in age from 18 to 70 years of age. The stimulus materials will include explanatory
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text and charts that introduce, group and organize measures of patient perspectives, clinical
quality, outcomes and efficiency.
CMS proposes to conduct a round of formative research to explore consumers’ perceptions,
knowledge and understanding of the various measurement topic represented on Hospital
Compare and to also explore options for effectively integrating the new information into the
website, through an organizational scheme based on plain-language versions of the categories
of measures found in the IOM’s six aims and in the more recent National Quality Strategy.
The research team will conduct the exploratory research using focus groups. Focus groups
are an effective tool for eliciting individuals’ perspectives and examining the differences in
their opinions and reactions. Focus groups will allow the research team to get multiple points
of view at one time, and stimulate discussion regarding perceptions and attitudes around the
topics, and explore options for language, organization, display, and navigation through group
discussion and brainstorming.
Specifically, the research team conducted a series of focus group discussions with informal
family caregiver consumers. The informal family caregiver consumer participants will range
in age from 18 to 70 years of age and help care for persons who have had a mix of hospital
experiences.
.
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 Focus Group moderator’s guide for discussions with 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 $40/hour. CMS will adhere to this limit for
research participant incentives.

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D. Burden Hour Deduction
This is an existing collection of information. From the total of 186.64 burden hours in the
original generic request, 45.33 hours will have been used by the time of the current IC,
leaving 141.31 hours. CMS requests 5 minutes per 40 potential respondents (3.32 hours) to
screen potential respondents and up to 90 minutes per 20 respondents (30 hours) to conduct
the focus groups. Hence, the deduction from the original requested burden hours is 33.332
hours.
E. Timeline
The current IC request is for use in December 2011 and January 2012 so that
recommendations may be made to internal clients by the end of March 2012 for website redesign and release by September 2012.
As noted above, the following attachments are provided for this information collection:
Attachment A – Screening forms for Informal Family Caregiver Consumers
Attachment B – Focus Group moderator’s guide
Attachment C – Testing Materials/Mockups/Handouts:
Six Aims for Improvement
Quality Measures IOM Table
Safety Categories--plain language definitions
HAC Displays
HAI Displays
Timeliness Measures
Attachment D – Consent form

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