SUBMISSION OF INFORMATION COLLECTION UNDER THE
Request for Approval under AHRQ’s Generic Clearance “Questionnaire and Data Collection Testing, Evaluation, and Research for the AHRQ” (OMB Control Number: 0935-0124)
DATE OF REQUEST: April 10, 2017
SUB AGENCY (I/C): HHS/AHRQ
TITLE: Identifying, Assessing, and Balancing Competing Risks of Multiple Hospital-Acquired Conditions (HACs).
GENERIC CLEARANCE UNDER OMB#: 0935-0124 EXP. DATE: 07/31/2018
Section
5001(c) of the Deficit Reduction Act of 2005 requires the Secretary
of Health and Human Services to identify hospital acquired
conditions (HACs) that: (a) are high cost or high volume or both,
(b) result in the assignment of a case to a diagnosis related group
(DRG) that has a higher payment when present as a secondary
diagnosis, and (c) could reasonably have been prevented through the
application of evidence-based guidelines. The Centers for Medicare
and Medicaid Services identified 11 categories of HACs that include
hospital acquired pressure ulcers (HAPUs), patient falls during a
hospital stay, and catheter associated urinary tract infections
(CAUTIs). HACs often result in longer hospital stays and increased
health care costs. For example, AHRQ has estimated that on average a
CAUTI increases hospitalization costs by $1,000, a fall increases
costs by $7,234 and a HAPU increases cost by $17,000.1 Although
overall rates of HACs are estimated to have decreased by 21% from
2010 to 2015, improvements have plateaued since 2013.2 In
addition, whereas CAUTIs is one of the three HACs with the largest
improvement (33% reduction), falls and HAPUs are two of the three
HACs with the smallest improvement (15% and 10%, respectively) from
2010 to 2015.2
These
three HACs – CAUTIs, falls, and HAPUs – are
interrelated, nursing-sensitive conditions and interventions to
prevent each individual HAC may have potential inter-actions and
trade-offs such that an intervention designed to reduce the risk of
one HAC (e.g., in-dwelling urinary catheter [IUC] removal to reduce
CAUTIs) may increase the risk of others (e.g., falls and/or HAPU
through impacts on mobility and skin moisture). As a result,
patients at risk for CAUTI, falls, and HAPU are subject to multiple,
often conflicting prevention strategies, leaving frontline
clinicians with challenging clinical decisions to make to promote
overall patient safety. To date, there are no tools that clinicians
can use in managing these competing risks in an inpatient setting
despite the need for such a tool to improve patient safety and its
relevance to health care costs from the perspective of health
systems and payers.
This
project is an aggregate of three information collection requests to
develop a toolkit to meet this need using an iterative participatory
toolkit design framework. The data collection activity has the
following goals:
Engage clinicians and
hospital/health system administrators to identify informative and
practical ways to communicate information to these users of a tool
that takes patient-specific information, calculates predicted
values of the likelihood of each HAC based on a clinical decision,
and displays these values in a way that communicates competing
risks of each HAC; and
Pilot test the tool through
a series of on-site usability tests of multiple visual display
prototypes for two to four patient care delivery scenarios that
depict likely outcomes using examples of high risk patients to
validate and refine the tool’s risk dashboard information and
visual designs.
TOTAL ANNUAL BURDEN APPROVED: 2967 Hours Per year
BURDEN USED TO DATE: 43 hours.
BURDEN THIS REQUEST: 36 hours (Information Needs Identification Focus Groups ).
FEDERAL COST: The estimated annual cost to the Federal government is $772_____.
IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?
______YES ______ NO _____x_ N/A
OBLIGATION TO RESPOND:
___x___ VOLUNTARY
______ REQUIRED TO OBTAIN OR RETAIN BENEFITS
______ MANDATORY
HOW WILL THIS SURVEY BE OFFERED?
__ ___ WEB SITE
__ ___ TELEPHONE INTERVIEW
__ ___ MAIL RESPONSE [email]
__x__ IN PERSON INTERVIEW
_____ OTHER: ___________________________________
CONTACT INFORMATION:
NAME: _Noel Eldridge______________________________
TELEPHONE NUMBER: 301.427.1156________________
EMAIL ADDRESS: _[email protected] ________________
File Type | application/msword |
File Title | Generic Clearance Form - 04/28/2008 |
Subject | Generic Clearance Form - 04/28/2008 |
Author | OD/USER |
Last Modified By | Windows User |
File Modified | 2017-04-14 |
File Created | 2017-04-14 |