Collection of Information for AHRQ's Hospital Survey on Patient Safety Culture Comparative Database

Forms and Documents

Document Name	Status
Form Attachment D Data Files Submission Form and Instruction	Modified
Form Form # 3 Hospital Information Form Form and Instruction	Modified
Form Form # 2 Data Use Agreement Form and Instruction	Modified
Form Form # 1 Eligibility/Registration Form and Data Submission Form and Instruction	Modified
Attachment G - Example Screenshots of Hospital SOPS Data Submission Web Site - 3-1-22.docx Supplementary Document	2022-08-29
Attachment F - Databases TEP List.docx Supplementary Document	2022-08-29
Attachment E - Survey Data File Specifications - 3-1-22.pdf Supplementary Document	2022-08-29
Supporting Statement Part B -- HSOPS DB Renewal_3-3-2022.docx Supporting Statement B	2022-08-29
Supporting Statement Part A -- HSOPS DB Renewal_3-3-2022 with AHRQ info (002).docx Supporting Statement A	2022-09-12

IC Document Collections

IC ID	Document Title	Status
236390	Data Files Submission Form and Instruction	Modified
191670	Hospital Information Form Form and Instruction	Modified
191668	Data Use Agreement Form and Instruction	Modified
191667	Eligibility/Registration Form and Data Submission Form and Instruction	Modified

ICR Details

OMB Control No: 0935-0162	ICR Reference No: 202208-0935-002
Status: Received in OIRA	Previous ICR Reference No: 201906-0935-003
Agency/Subagency: HHS/AHRQ	Agency Tracking No: 20206
Title: Collection of Information for AHRQ's Hospital Survey on Patient Safety Culture Comparative Database
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/13/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,040	0
Time Burden (Hours)	459	0
Cost Burden (Dollars)	0	0

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Abstract: The Hospital Survey on Patient Safety Culture (Hospital SOPS) is designed to enable hospitals to assess provider and staff perspectives about patient safety issues, medical error, and error reporting. The Hospital SOPS includes 42 items that measure 12 composites of patient safety culture. AHRQ first made the Hospital SOPS publicly available, along with a Survey User’s Guide and other toolkit materials, in November, 2004, on the AHRQ web site. The Hospital SOPS Database consists of data from the AHRQ Hospital Survey on Patient Safety Culture and may include reportable, non-required supplemental items. Hospitals in the U.S. can voluntarily submit data from the survey to AHRQ, through its contractor, Westat. The Hospital SOPS Database (OMB NO. 0935-0162, last approved on August 21, 2019) was developed by AHRQ in 2006 in response to requests from hospitals interested in tracking their own survey results. Those organizations submitting data receive a feedback report, as well as a report of the aggregated de-identified findings of the other hospitals submitting data. These reports are used to assist hospital staff in their efforts to improve patient safety culture in their organizations. Rationale for the information collection. The Hospital SOPS and the Hospital SOPS Database support AHRQ’s goals of promoting improvements in the quality and safety of health care in hospital settings. The survey, toolkit materials, and database results are all made publicly available on AHRQ’s website. Technical assistance is provided by AHRQ through its contractor at no charge to hospitals, to facilitate the use of these materials for hospital patient safety and quality improvement. This database will: 1) present results from hospitals that voluntarily submit their data, 2) provide data to hospitals to facilitate internal assessment and learning in the patient safety improvement process, and 3) provide supplemental information to help hospitals identify their strengths and areas with potential for improvement in patient safety culture.

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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:
	87 FR 33795	06/03/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 53749	09/01/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Data Files Submission	Attachment D	Data Files Submission
Data Use Agreement	Form # 2	Attachment B: Hospital Data Use Agreement
Eligibility/Registration Form and Data Submission	Form # 1	Attachment A: Hospital Eligibility and Registration Form
Hospital Information Form	Form # 3	Attachment C: Hospital Site Information Form

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ICR Summary of Burden

	Total Request	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	2,040	0	0	0	0	2,040
Annual Time Burden (Hours)	459	0	0	0	0	459
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $200,000

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 09/13/2022

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