Child HCAHPS Database_OMB Statement B 1 16 26

SUPPORTING STATEMENT

Part B

Agency for Healthcare Research and Quality’s (AHRQ)

Consumer Assessment of Healthcare Providers and Systems Child Hospital (Child HCAHPS) Survey Database

January 2026

Reinstatement with change of a previously approved ICR

OMB No. 0935-0243

Agency of Healthcare Research and Quality (AHRQ)

Contents

1. Description of Respondent Universe 3

2. Information Collection Procedures 4

3. Methods to Maximize Response Rates 6

4. Tests of Procedures 7

5. Statistical Consultants 7

Supporting Statement B

Child HCAHPS Survey Database

1. Description of Respondent Universe

The AHRQ Consumer Assessment of Healthcare Providers and Systems Child Hospital Survey (Child HCAHPS) Database will serve as a central repository of survey results submitted by users of the Child HCAHPS survey. Through its contractor, AHRQ will house the Child HCAHPS database. Because the database will be comprised of data that are voluntarily submitted by many, but not likely all hospitals that have administered the survey, the database will therefore not be representative of all children’s hospitals or of all hospitals using the Child HCAHPS survey.

The Center of Excellence for Pediatric Quality Measurement at Boston Children’s Hospital developed the Child HCAHPS Survey with funding provided by the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) through the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality Measures Program (PQMP). The survey was submitted to AHRQ and CMS in February 2014.

The Child HCAHPS Survey questions ask parents or guardians to report on their own and on their child’s experiences with different aspects of their child’s inpatient hospital care. Many of the questions are combined into composite measures that address the same aspect of care or service to arrive at a broader assessment; examples of these composite measures include communication with doctors and nurses, communication about medicines, preparation for discharge; attention to safety and comfort, and the hospital environment. The Child HCAHPS Survey comprises a total of 18 measures, including 10 composite measures, 6 single-item measures, and 2 overall rating measures.

Case-Mix Adjustment. Case-mix refers to respondent health status and other socio-demographic characteristics that have been shown to affect composite and rating item scores of hospitals. Characteristics used to case-mix adjust Child HCAHPS hospital scores, where applicable, will be determined by best practices using the Child HCAHPS survey.

Testing for Statistical Differences. The individual private hospital feedback reports will be used to test for statistically significant differences between top box scores and ratings of individual hospitals for each CAHPS measure and the average or mean top box score of all hospitals in the Child HCAHPS Database using the t-test. A significance level of 0.05 or less is considered statistically significant. The mean scores will be adjusted for case-mix differences before the statistical tests are applied. Hospital scores will be denoted to show if they are significantly higher than the overall top box mean, significantly lower than the overall top box mean or not significant different than the overall top box mean.

2. Information Collection Procedures

Information collection for the AHRQ Child HCAHPS Database will occur in an annual data collection cycle that began in 2021. Information collection procedures for submitting and processing data are shown in Figure 1.

Figure 1. Child HCAHPS Database Data Submission

Step 1: Call for Data Submission. Announcements about the opening of data submission are disseminated through various sources. AHRQ’s electronic newsletter and communications target approximately 160,000 subscribers. In addition, the AHRQ CAHPS News and Events listserv targets approximately 84,000 subscribers. Reminder announcements will be sent two weeks after the initial call for data submission. In addition, the AHRQ CAHPS Web site posts public information about the yearly timeline and instructions for data submission. Through these efforts, children’s hospitals and hospitals with pediatric units will be made aware of and invited to submit their survey data voluntarily to the database. As the administrator of the database and under contract with AHRQ, the contractor provides free technical assistance to hospitals and their survey vendors through a dedicated email address ([email protected] that is routed to Westat) and via toll-free phone number (888-808-7108).

Step 2: Registration for Potential Participants. A secure data submission website allows interested parties, specifically health systems and hospitals, to register and submit data. The interested party’s point-of-contact (POC) will complete a number of data submission steps and forms. First, the online one-page Registration Form will take approximately five minutes to complete (see Attachment A). After registering, if registrants are deemed eligible to submit data, an automated email will be sent to authenticate the account and update the user password (see Attachment E, Email #1).

Once users are registered and have a password, they will be able to enter the main page menu of the Web site. Information about eligibility requirements, data use agreements, and data file specifications regarding how to prepare their data for inclusion in the Child HCAHPS database will be posted and can be reviewed.

Step 3: Enter Hospital Information. This step requires each health system or hospital that wishes to voluntarily submit their Child HCAHPS survey, to submit the requested characteristics such as the name of the hospital, size, state, etc.

Step 4: Upload Data Use Agreement (DUA). To protect the privacy of all participating hospitals, a duly authorized representative from the hospital must sign a data use agreement (DUA) (see Attachment B). The DUA language was reviewed and approved by AHRQ’s general counsel and asserts that the hospital’s data will be handled in a secure manner using necessary administrative, technical, and physical safeguards to limit access to the data and maintain its confidentiality. In addition, the DUA explains that the data are used only for the purposes of the database, that only aggregated results will be reported, and that the hospital will not be identified by name. Data are not included in the database without this signed DUA. Users can upload a copy of the signed agreement to an online portal.

Step 5: Upload Questionnaire. Each hospital or health system must upload a copy of the questionnaire used to ensure it confirms to the CAHPS standard for inclusion in the Database. Once the questionnaire is reviewed by CAHPS Database staff, an email notification will be sent to the registrant within three business days with an approval or rejection. Only hospitals that receive questionnaire approval may subsequently submit data files (see Attachment E, Email #8).

Step 6: Secure Online Data Submission. To enable participants to transmit their Child HCAHPS survey data to the contractor in a secure manner, an online data submission extranet was developed. The online system was designed to accept survey data collected by the Child HCAHPS survey. Survey data are to be submitted in the required data file format. Data files must conform to the Data File Layout Specifications provided by the Child HCAHPS Database. Since the unit of analysis is at the hospital level, users must upload one data file per hospital. Vendors that represent multiple hospitals will have the option to submit a zip file if they would prefer to submit more than one file at a time.

Data File Approval. Once a data file is successfully uploaded, a program written in Visual Basic (VB) will read the submitted files and load them into a SQL database that stores the data. Upon submission, a data file status report will be produced and made available to the participant. This report will display a frequency distribution for each survey item and identify any out-of-range values or errors. If data file errors are detected, the submitter may review the Data File Status Report for further detail. Participants are expected to correct any errors and resubmit their data file(s) for processing. If the data have been properly received, a CAHPS Database staff member then reviews the report for additional data quality checks. If any data problems are discovered, users will be notified immediately along with a description of the problem. If there are no problems with the data file (or with other aspects of the submission) the CAHPS Database staff will grant final approval status and an email will be sent to the participant contact via the database submission extranet indicating their data will be included in the Child HCAHPS Database (see Attachment E, Email #10).

Step 7: Account Status. Participants have the opportunity to check the status of their account at any time during the submission process. Only those data receiving final approval by the CAHPS Database staff will be included in the Child HCAHPS Database.

3. Methods to Maximize Response Rates

AHRQ makes a number of guidance documents and other materials available to assist hospitals with the Child HCAHPS surveys through their website. AHRQ provides a Survey User’s Guide, which provides instructions and tips about constructing the sampling frame, choosing the sample, maintaining confidentiality, collecting the data, tracking returned questionnaires and calculating the response rate (at https://www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/hospital/about/fielding-child-hcahps-93.pdf).

The CAHPS User Network is the principal source of CAHPS survey products, information about CAHPS-related products and services, technical assistance for survey users, and networking opportunities for users and researchers. The User Network is funded by the U.S. Agency for Healthcare Research and Quality

The CAHPS User Network promotes their databases to encourage data submission in a number of ways:

1. Send GovDelivery messages to participants who registered for CAHPS News and Events;

2. Organizational partners and stakeholders that have national reach to hospitals;

3. Users that have contacted the HCAHPS technical assistance helpline about the HCAHPS survey;

4. Other outlets such as national Webcasts and conferences.

As noted earlier in this document under Information Collection Procedures, Step 1 – Call for Data Submission, announcements about the opening of data submission go out through various publicity sources as a way to boost hospital participation in the database. AHRQ’s electronic newsletter and communications target approximately 160,000 subscribers. In addition, the AHRQ CAHPS News and Events listserv targets approximately 84,000 subscribers. AHRQ, through its contractor Westat, provides free technical assistance to users through a dedicated email box and toll-free phone number. In addition, reminders are sent to database registrants to remind them of the deadline for data submission.

4. Tests of Procedures

The CAHPS Database staff talks with submitters about their experience and uses their feedback to improve the collection process.

5. Statistical Consultants

Joann Sorra, PhD

Westat

1600 Research Blvd.

Rockville, MD 20850

[email protected]

Naomi Yount, PhD

Westat

1600 Research Blvd.

Rockville, MD 20850

[email protected]

List of Attachments:

Attachment A: Child HCAHPS Registration Form

Attachment B: Child HCAHPS Database Data Use Agreement

Attachment E: Submission Emails

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