2900-0701_justification_Part_B1 FY12_FINAL 2-10-2012

Bereaved Family Member Satisfaction Survey

VA Form 10-21081(NR)

2900-0701

B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS

1. Provide a numerical estimate of the potential respondent universe and describe any sampling or other respondent selection method to be used. Data on the number of entities (e.g., households or persons) in the universe and the corresponding sample are to be provided in tabular format for the universe as a whole and for each strata. Indicate expected response rates. If this has been conducted previously include actual response rates achieved.

Surveys will be attempted for all inpatient deaths during each year of this project. The table below shows data for fiscal years 2010 and 2011. During each of these years approximately 20,000 eligible inpatient deaths occurred throughout the VA system. We were able to achieve a 57% response rate which yielded approximately 11,500 completed surveys per year. Beginning in fiscal year 2012, we are transitioning from a predominantly phone survey (with about 10% of responses coming from mailed surveys) to a predominantly mailed out survey. Based on several years of data from mailed outpatient satisfaction surveys, we estimate a response rate of 50%. Thus, in future years we anticipate an estimated potential respondent universe of 22,000 per year and the total of approximately 11,000 completed surveys per year.

Historical Universe of potential respondents, response rates, and completed surveys (FY2010, 2011)

	Universe*	QTRs	Annual total	Response Rate	Completed surveys
2010	5,500/QTR	4	19,877	57%	11,330†
2011	5,500/QTR	4	20,832	57%	11,874†

Projected Universe of potential respondents, response rates, and completed surveys (FY2012, 2013, 2014)

	Universe*	QTRs	Annual total	Response Rate	Completed surveys
2012	5,500/QTR	4	22,000*	50%	11,000∆
2013	5,500/QTR	4	22,000*	50%	11,000∆
2014	5,500/QTR	4	22,000*	50%	11,000∆

*based on average per quarter

†actual number of completed surveys

∆ projected number of completed surveys

2. Describe the procedures for the collection of information, including:

• Statistical methodology for stratification and sample selection

• Estimation procedure

• Degree of accuracy needed

• Unusual problems requiring specialized sampling procedures

• Any use of less frequent than annual data collection to reduce burden

The Bereaved Family Survey is collected one time approximately 6 weeks following the Veteran’s death. As such, no sampling procedure will be required. Responses to the survey will be entered by VA employees, contractors or appropriately trained volunteers into a secure, central data repository. Through the use of the data repository at the Philadelphia VAMC Center for Health Equity Research and Promotion, facilities across the country can enter and retrieve information via a secure web server. The survey data is stored within the VA firewall, with password protected access in a manner similar to accessing patient information across the VA system.

3. Describe methods to maximize response rate and to deal with issues of non-response. The accuracy and reliability of information collected must be shown to be adequate for intended uses. For collections based on sampling, a special justification must be provided for any collection that will not yield “reliable” data that can be generalized to the universe studied.

The Bereaved Family Survey is sent to the identified Next of Kin (NOK) listed in the deceased Veterans medical records 3-6 weeks after death. To maximize response rate, a follow-up call is conducted 14 days after initial mailing to inquire if NOK received the survey and to ask them to complete it. If the NOK prefers to complete the interview over the phone, the caller will conduct the interview. The effect of non-response bias was examined by creating a model to predict the likelihood of response based on patient and family characteristics; then this model was used to apply weights that were equivalent to the inverse of the probability of response for that individual. The results indicate that although non-response bias is a theoretical concern, it does not appear to have a significant effect on the facility-level results of this survey (Casarett D, Smith D, Breslin S et al. Does nonresponse bias the results of retrospective surveys of end-of-life care? J Am Geriatrc Soc 2010; 58: 2381-2386)

4. Describe any tests of procedures or methods to be undertaken. Testing is encouraged as an effective means of refining collections to minimize burden and improve utility. Tests must be approved if they call for answers to identical questions of 10 or more individuals.

The bereaved family survey and its administration procedures have been intensively studied over the past several years. We do not anticipate major changes in either the administration procedure or the survey itself. One reason to minimize any additional changes is to allow for comparison of results over time. The survey has been in use for the past two years and as part of the Network Directors Performance Plan. Refining the survey to minimize burden can only be achieved by reducing the number of questions asked. Due to the survey’s use as a performance measure, any deletions of the questions will result in data that are not comparable year to year.

5. Provide the name and telephone number of individuals consulted on statistical aspects of the design and the name of the agency unit, contractor(s), grantee(s), or other person(s) who will actually collect and/or analyze the information for the agency.

Mary Ersek,

PROMISE (Performance Reporting and Outcomes Measurement to Improve the Standard of care at End-of-life) Center

Philadelphia Veterans Affairs Medical Center

3800 Woodland Avenue, Annex

Philadelphia, PA 19104

Tel: 215.823.5800, ext. 7940

Fax: 215.222.2590

Email: [email protected]

Preferred Email: [email protected]

Associate Director, John A. Hartford Center of Geriatric Nursing Excellence

Associate Professor

University of Pennsylvania School of Nursing

418 Curie Blvd., Room 329

Philadelphia, PA 19104-4217

Tel: 215.746.3563

Fax: 215.573.7507