Updating and Expanding the AHRQ Quality Indicators Toolkit for Hospitals

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form #4 AHRQ QI Data Collection Tool	Form and Instruction	Removed	Available
Form Form - 3 Toolkit usability protocol (includes informed consent statement)	Form and Instruction	Modified	Available
Form Old - Form #3 Old - Usability Testing Protocol	Form and Instruction	Modified	Available
Form Form - 2 Quarterly update protocol (includes informed consent statement)	Form and Instruction	Modified	Available
Form Old - Form #2 Old - Quarterly Update Protocol	Form and Instruction	Modified	Available
Form Form 1 Pre-post interview protocol	Form and Instruction	Modified	Available
Form Old - Form #1 Old - Pre/Post-Test Interview Protocol	Form and Instruction	Modified	Available
Attachment H -- Recruitment Letter.docx	Supplementary Document	Uploaded 2014-09-09	Available
Attachment A --- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document	Uploaded 2014-08-15	Available
Attachment G -- RAND Human Subjects Protection Committee (IRB) Exemption Notice.pdf	Supplementary Document	Uploaded 2014-08-14	Available
Attachment F -- Informed consent form for pre-post interview.docx	Supplementary Document	Uploaded 2014-08-14	Available
Supporting Statement Part B FINAL.docx	Supporting Statement B	Uploaded 2014-08-14	Available
Supporting Statement Part A Final 9.09.2014.docx	Supporting Statement A	Uploaded 2014-09-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192333	AHRQ QI Data Collection Tool	Form and Instruction	Removed	AHRQ QI Data Collection Tool
192332	Usability Testing Protocol	Form and Instruction	Modified	Toolkit usability protocol (includes informed consent statement)
192332	Usability Testing Protocol	Form and Instruction	Modified	Old - Usability Testing Protocol
192331	Quarterly Update Protocol	Form and Instruction	Modified	Quarterly update protocol (includes informed consent statement)
192331	Quarterly Update Protocol	Form and Instruction	Modified	Old - Quarterly Update Protocol
192330	Pre/Post-Test Interview Protocol	Form and Instruction	Modified	Pre-post interview protocol
192330	Pre/Post-Test Interview Protocol	Form and Instruction	Modified	Old - Pre/Post-Test Interview Protocol

ICR Details

OMB Control No: 0935-0164	ICR Reference No: 201408-0935-001
Status: Historical Active	Previous ICR Reference No: 201003-0935-001
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Updating and Expanding the AHRQ Quality Indicators Toolkit for Hospitals
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/30/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/19/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved
Responses	240	0	0
Time Burden (Hours)	240	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: An important part of AHRQ's mission is to disseminate information and tools that can support improvement in quality and safety in the U.S. health care community. This proposed information collection supports that part of AHRQ's mission by developing and evaluating a toolkit that will enable hospitals to effectively use AHRQ's Quality Indicators (QIs). AHRQ has developed sets of QIs that can be used by the Agency and others to document quality and safety conditions at U.S. hospitals. Two sets of QIs will be used in this proposed toolkit: the Inpatient Quality Indicators (IQIs) and the Patient Safety Indicators (PSIs). The IQIs contain measures of volume, mortality, and utilization for common medical conditions and major surgical procedures. The PSIs are a set of measures to screen for potentially preventable adverse events that patients may experience during hospitalization. These QIs have been previously developed and evaluated by AHRQ, and are in use at a number of hospitals throughout the country. The QIs and supportive documentation on how to work with them are posted on AHRQ's Web site at www.qualityindicators.ahrq.gov. Many of the QIs have been endorsed by the National Quality Forum through its consensus review process.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 26964	05/12/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 45194	08/04/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
AHRQ QI Data Collection Tool	Form #4	AHRQ QI Data Collection Tool
Pre/Post-Test Interview Protocol	Old - Form #1, Form 1	Old - Pre/Post-Test Interview Protocol ,   Pre-post interview protocol
Quarterly Update Protocol	Old - Form #2, Form - 2	Old - Quarterly Update Protocol ,   Quarterly update protocol (includes informed consent statement)
Usability Testing Protocol	Form - 3, Old - Form #3	Old - Usability Testing Protocol ,   Toolkit usability protocol (includes informed consent statement)

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ICR Summary of Burden

table that charts list of burden

	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	240	0	0	240	0	0
Annual Time Burden (Hours)	240	0	0	240	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Since the release of the Toolkit in 2012, the QIs have been updated and expanded, best practices have advanced, and many hospitals have improved their understanding of their quality improvement needs as well as increased their familiarity with the use of the Toolkit.

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Annual Cost to Federal Government: $105,554

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/19/2014

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