The Re-engineered Visit for Primary Care (AHRQ REV)

Forms and Documents

Document Name	Status
Form 7 Community Agency Interview Guide Form and Instruction	New
Form 6 Patient Interview Guide Form and Instruction	New
Form 5 Work Flow Mapping Follow-Up Interview Guide Form and Instruction	New
Form 4 Work Flow Mapping Group Interview Guide Form and Instruction	New
Form 3 Workflow mapping preliminary interview Form and Instruction	New
Form 2 Primary care site patient characteristics survey Form and Instruction	New
Form 1 Primary care site organizational characteristics survey; Attachment G Form and Instruction	New
Project REV OMB Package Supporting Statement A.04.20.17.fine.docx Supporting Statement A	2017-05-10
Response 1.docx Supplementary Document	2017-05-09
Attachment M Community Agency Interview Guide JSI_093016.AHRQ.fine.version.docx Supplementary Document	2017-05-09
Attachment F Primary Care Site OverviewAHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document	2017-05-09
Attachment E Fielding Data Collection and Analysis Methods AHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document	2017-05-09
Attachment D Summary of Common Data Collection Instruments AHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document	2017-05-09
Attachment C Pilot Methods AHRQ.REV.JSI.11.2016.fine.version.doc Supplementary Document	2017-05-09
Attachment B Contract Staff Consultant and TEP Lists AHRQ.REV.JSI.11.2016.fine.version..doc Supplementary Document	2017-05-09

IC Document Collections

IC ID	Document Title	Status
226747	Community Agency Interview Guide Form and Instruction	New
226746	Patient Interview Guide Form and Instruction	New
226745	Work Flow Mapping Follow-Up Interview Guide Form and Instruction	New
226744	Work Flow Mapping Group Interview Guide Form and Instruction	New
226743	Workflow mapping preliminary interview Form and Instruction	New
226742	Primary care site patient characteristics survey Form and Instruction	New
226741	Primary care site organizational characteristics survey; Attachment G Form and Instruction	New

ICR Details

OMB Control No: 0935-0237	ICR Reference No: 201704-0935-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: The Re-engineered Visit for Primary Care (AHRQ REV)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/25/2017
	Date Received in OIRA: 05/10/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	36 Months From Approved
Responses	387	0	0
Time Burden (Hours)	325	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This project, The Re-engineered Visit for Primary Care (AHRQ REV), directly addresses the agency’s goal to conduct research to enhance the quality of health care and reduce avoidable readmissions, which are a major indicator of poor quality and patient safety. Research from AHRQ’s Healthcare Cost and Utilization Project (HCUP) indicates that in 2011 there were approximately 3.3 million adult hospital readmissions in the United States. Adults covered by Medicare have the highest readmission rate (17.2 per 100 admissions), followed by adults covered by Medicaid (14.6 per 100 admissions) and privately insured adults (8.7 per 100 admissions). High rates of readmissions are a major patient safety problem and are associated with a range of adverse events, such as prescribing errors and misdiagnoses of conditions in the hospital and ambulatory care settings. Collectively these readmissions are associated with $41.3 billion in annual hospital costs, many of which potentially could be avoided. . In recent years, payer and provider efforts to reduce readmissions have proliferated. Many of these national programs have been informed or guided by evidence-based research, toolkits and guides, such as AHRQ’s RED (Re-Engineered Discharge), STAAR (STate Action on Avoidable Readmission), AHRQ’s Project BOOST (Better Outcomes by Optimizing Safe Transitions), the Hospital Guide to Reducing Medicaid Readmissions, and Eric Coleman’s Care Transitions Intervention. These efforts have largely focused on enhancing practices occurring within the hospital setting, including the discharge process transitions among providers and between settings of care. While many of these efforts have recognized the critical role of primary care in managing care transitions, they have not had an explicit focus on enhancing primary care with the aim of reducing avoidable readmissions. Evidence-based guidance to reduce readmissions and improve patient safety are comparatively lacking for the primary care setting. This gap in the literature is becoming more pronounced as primary care is increasingly serving as the key integrator across the health system as part of payment and delivery system reforms. This research project aims to address the important and unfulfilled need to improve patient safety and reduce avoidable readmissions within the primary care context. AHRQ’s goals in supporting this 30-month project are to build on the knowledge base from the inpatient settings, add to the expanding evidence base on preventing readmissions by focusing on the primary care setting, and provide insight on the components and themes that should be part of a re-engineered visit in primary care. This work will ultimately inform an effective intervention that can be tested in a diverse set of primary care clinics. To meet AHRQ’s goals and objectives, the agency awarded a task order to John Snow, Inc. (JSI) to conduct qualitative research using quality improvement to investigate the primary care-based transitional care workflow from the primary care staff, patient, and community agency perspective. This research has the following goals: 1. Analyze current processes in the primary care visit associated with hospital discharge; and 2. Identify components of the re-engineered visit.

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Authorizing Statute(s): US Code: 42 USC Sec.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:
	82 FR 10487	02/13/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 20892	05/04/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 7

IC Title	Form No.	Form Name
Primary care site patient characteristics survey	2	Attachment H: Primary Care Site Patient Characteristics Survey
Primary care site organizational characteristics survey; Attachment G	1	Attachment G: Primary Care Site Organizational Characteristics Survey
Workflow mapping preliminary interview	3	Attachment I: Work Flow Mapping Preliminary Interview Guide
Work Flow Mapping Group Interview Guide	4	Attachment J: Work Flow Mapping Group Interview Guide
Work Flow Mapping Follow-Up Interview Guide	5	Attachment K: Work Flow Mapping Follow-Up Interview Guide
Patient Interview Guide	6	Attachment L: Patient Interview Guide
Community Agency Interview Guide	7	Attachment M: Community Agency Interview Guide

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ICR Summary 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	387	0	0	387	0	0
Annual Time Burden (Hours)	325	0	0	325	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: This is a new data collection ICR.

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Annual Cost to Federal Government: $42,064

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 05/10/2017

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