Agency Information Collection Activities: Proposed Collection; Comment Request

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Published

March 7, 2024

Issuing agencies

Health and Human Services DepartmentAgency for Healthcare Research and Quality

Abstract

This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed updates to the currently approved information collection project: "Implementation and Testing of Diagnostic Safety Resources." In accordance with the Paperwork Reduction Act of 1995, AHRQ invites the public to comment on this proposed information collection.

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<title>Federal Register, Volume 89 Issue 46 (Thursday, March 7, 2024)</title>
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[Federal Register Volume 89, Number 46 (Thursday, March 7, 2024)]
[Notices]
[Pages 16574-16579]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-04786]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality

Agency Information Collection Activities: Proposed Collection;
Comment Request

AGENCY: Agency for Healthcare Research and Quality, HHS.

ACTION: Notice.

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SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed updates to the
currently approved information collection project: ``Implementation and
Testing of Diagnostic Safety Resources.'' In accordance with the
Paperwork Reduction Act of 1995, AHRQ invites the public to comment on
this proposed information collection.

DATES: Comments on this notice must be received by May 6, 2024.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at REPORTSCLEARANCE
<a href="/cdn-cgi/l/email-protection#eba4adada2a8aeb9ab8a83999ac5838398c58c849d"><span class="__cf_email__" data-cfemail="2f606969666c6a7d6f4e475d5e0147475c01484059">[email&#160;protected]</span></a>.
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by email at REPORTSCLEARANCE
<a href="/cdn-cgi/l/email-protection#4a050c0c03090f180a2b22383b64222239642d253c"><span class="__cf_email__" data-cfemail="7a353c3c33393f283a1b12080b54121209541d150c">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION:

Proposed Project

Implementation and Testing of Diagnostic Safety Resources

Patient safety is a pillar of the Agency for Healthcare Research
and Quality's (AHRQ's) mission to support the highest quality
healthcare. While progress has been made in many areas of patient
safety, the field of diagnostic safety has emerged as a particular area
of concern. It is estimated that every person in the United States will
experience a diagnostic error in their lifetime (Institute of Medicine,
2015) which can lead to inappropriate, delayed, or withheld treatment
and ultimately poor health outcomes, distress, and increased costs.
Diagnostic errors can occur for many reasons: lack of meaningful
engagement between clinicians, patients, and families; a fragmented
healthcare system not designed to account for an increasingly complex
diagnostic process; minimal (if any) feedback to clinicians about their
diagnostic performance; and a culture that does not always support
transparent disclosure of diagnostic errors (Institute of Medicine,
2015). Leaders in diagnostic excellence suggest that multi-pronged
efforts are needed to address this complex problem and go beyond
individual behaviors to system-level changes and empowering patients to
engage in their care (Institute of Medicine, 2015; Henriksen, et al.,
2017).
Improving diagnostic safety and quality is an AHRQ priority. In
recognition of the multifaceted approach needed to effectively advance
diagnostic safety, AHRQ recently supported the development of three
tools to prevent diagnostic errors and have prioritized these tools for
implementation and testing. These resources vary in the types of
stakeholders they target, a critical

[[Page 16575]]

advancement in our approach to diagnostic excellence.
<bullet> Calibrate Dx. This tool, targeted to individual
clinicians, invites users to select a topic or condition, review
diagnostic performance on a sample of cases for insights and learning
opportunities, and debrief with a peer. This resource will be tested in
all settings where clinicians are involved in the diagnostic process,
including both inpatient and ambulatory settings.
<bullet> Measure Dx. This tool supports healthcare organizations in
building sustainable teams for improving diagnostic excellence,
identifying current capacity gaps, engaging in measurement strategies
as part of a systematic approach to reviewing available data, and
translating findings into learning opportunities. This resource will be
tested in both inpatient and ambulatory settings; it is expected to be
implemented more commonly in inpatient settings.
<bullet> Toolkit for Engaging Patients to Improve Diagnostic Safety
(Patient Toolkit). This tool prepares patients, families, and health
professionals to work together as partners to improve diagnostic
safety; encourages patients to prepare for visits; and encourages
providers to listen for 60 seconds before interrupting the patient.
This resource will be tested in ambulatory settings only.
The goal of this research is to implement and test these three
diagnostic safety resources to identify specific ways in which each
resource can be used to maximize its value. For each resource the
following will be examined:

(1) Feasibility of implementation--barriers, facilitators, success
factors, and time needed for implementation
(2) Level of adoption--number and type of clinicians aware of and/or
using the resource, number of organizational leaders endorsing the
resource
(3) Effectiveness of the resource--number of diagnostic safety events
(Measure Dx and Patient Toolkit), clinician self-efficacy for
diagnostic decision-making (Calibrate Dx)
(4) Maintenance and sustainability--the number and type of patient
safety processes in place, barriers and facilitators to maintenance and
sustainability

This project will implement and test these three diagnostic safety
resources across a minimum of 150 sites to up to 219 sites (i.e., 50 to
73 sites per resource). An Implementation and Testing period for each
resource will last 12 months, with Calibrate Dx starting implementation
first and Measure Dx and the Toolkit for Engaging Patients starting
implementation six months later. This timing allows for staggered
recruitment to ensure adequate sample size and to pilot implementation
processes with a single diagnostic safety resource first, transferring
lessons learned about implementation and testing to the implementation
of the two other resources. A Sustainability period will begin as soon
as the 12-month Implementation and Testing Period is complete and will
continue for 14 additional months for each resource.
To achieve the goals of this project the following data collections
will be implemented:
1. Site Interest Form--A short form completed once by up to 1,060
sites interested in participating in the project. Used to indicate
interest in the project and by AHRQ to evaluate whether the site meets
the minimum participation criteria.
2. Site Information Form--Completed once by site leaders at 265
sites that begin the project enrollment process, this form collects
additional contact information, data on patient mix, and information on
the organization's diagnostic safety teams, resource commitments, and
capacity for implementing the resources.
3. Safer Dx Checklist--Completed once by 219 sites who fully
complete enrollment activities and begin implementation of one of the
three resources (82.6% of the 265 sites who begin enrollment
activities). The Safer Dx Checklist is a tool that allows healthcare
organizations to understand the current state of their diagnostic
practices, identify areas to improve, and track progress toward
diagnostic excellence over time. This will be completed prior to actual
implementation of the resource.
4. Exit Interviews Protocol--Completed once by an estimated 69
sites (30% of those implementing one of the three resources) that
withdraw from the project, this telephone interview will collect
information on why the site could not sustain their efforts or
participation.
5. A baseline assessment of patient safety culture will be
conducted once for each of the 219 sites that begin participation.
Completed once by site leads depending on the setting:
a. SOPS[supreg] Medical Office Survey with Diagnostic Safety
Supplemental Item Set--Completed once by the site lead for 109
ambulatory clinics.
b. SOPS[supreg] Hospital Survey with Diagnostic Safety Supplemental
Item Set--Completed once by the site lead for 110 inpatient sites.
6. Post-training Evaluation Form--Completed once by 1,350
clinicians and managers (90% of the 1,500 participants) attending the
project's training sessions. The data will be used to track the
perceived value of the training provided to enrolled sites.
7. Post-technical Assistance Evaluation Form--Administered up to 3
times to 1,500 clinicians and managers participating in the project's
Learning Collaborative sessions; an estimated 90% response rate to this
collection with a total of 4,050 forms completed. The data will be used
to track the perceived value of the technical assistance provided to
enrolled sites.
8. Clinical Sustainability Assessment Tool (CSAT)--Completed by 219
site leaders once between months 9 to 12 in advance of the 14-month
sustainability period. The CSAT is a self-assessment to evaluate
sustainability capacity of a clinical practice.
9. Implementation Interviews Protocol--A qualitative, semi-
structured interview will be conducted with 438 site leads and/or
frontline staff (up to 2 individuals from each site) at two points in
time during implementation (e.g., 6- and 18-months). The protocol is
designed to elicit participant perspectives on implementation of the
resource, capture lessons learned and best practices, and when
possible, to provide support for adjustment to the implementation.
In addition to those noted above, the project will implement the
following data collections specific to the individual resources.
For Measure Dx, the following data collections will be implemented:
10. Measure Dx Organizational Self-Assessment--This is one of the
main components of the Measure Dx resource and is designed to gauge the
organization's readiness to engage with Measure Dx. This checklist will
be completed once by up to 73 Measure Dx sites during the project
onboarding process.
11. Measure Dx Declaration of Measurement Strategy--The 73 Measure
Dx sites will complete this form once to indicate their selection of
measurement strategy to be implemented and provide confirmation of
minimum necessary capabilities.
12. Diagnostic Safety Event Report--These reports will provide
aggregate information on diagnostic safety events identified during a
12-month reporting period. The report will be completed by each
participating site 3 times over the course of the testing and
sustainability period at 3-, 12-, and 24-months; a total

[[Page 16576]]

of 219 reports will be completed over the course of the project. Note
that the contractor is not attempting to collect these reports at Month
0. Since part of the Measure Dx resource's goal is to support
implementation of a measurement strategy, Month 3 will serve as the
baseline.
13. Additional information on site safety culture, including use of
diagnostic safety event data, activities to improve the quality of
care, and the work environment will be collected through a survey at 3-
, 12-, and 24-months during the implementation/sustainment. Five
members of the Measure Dx team at each site will be surveyed; the
expected response rate is 85% at each of the three administration
periods. Depending on the setting, the following survey will be
fielded:
a. Omnibus Safety and Culture Survey_Medical Offices--Completed by
clinicians at 36 ambulatory clinics.
b. Omnibus Safety and Culture Survey_Hospitals--Completed by
clinicians at 37 inpatient sites.
For Calibrate Dx, the following data collections will be
implemented:
14. Calibrate Dx Survey--This survey collects clinicians'
reflections on their diagnostic performance for 3-5 cases, with
additional metrics around time to complete the review and the number of
cases reviewed. This will be completed quarterly (following the
Calibrate Dx guidance for implementation) during the implementation and
testing period by up to 5 clinicians per site; with an estimated a 90%
response rate to this collection.
15. Clinician Self-Efficacy Survey--The survey assesses clinician
self-efficacy with diagnostic safety case review and improvement. Up to
5 clinicians per site will be asked to complete this survey two times,
after training and again at the end of the testing phase, with an
estimated 90% response rate to this collection.
For Patient Toolkit, the following data collections will be
implemented:
16. Provider Characteristics Form--This form will be completed once
by up to 15 providers at each of the 73 enrolled sites. This form
collects information on practitioner type, years in practice,
specialty, subspecialty, and percent of time spent in clinical
practice.
17. Patient Toolkit Survey--Provider--This survey assesses
provider-perceived skills and quality of communication. It will be
administered to up to 15 providers at each site at five timepoints
(Baseline, 3-, 6-, 9-, and 12-months), with a 90% anticipated response
rate.
18. Provider Interview Protocol--A total of 50 qualitative, semi-
structured interviews with site clinicians will be conducted during
implementation. The interview protocol collects information related to
diagnostic safety events; patient safety culture; feasibility,
acceptability, utility, adoption, and spread of the Patient Toolkit;
and insights into clinician experience.
19. Patient Toolkit Survey--Patient--The survey assesses patient-
perceived experience and quality of communication, and collects basic
patient demographics (e.g., age, gender, education, race, ethnicity).
This will be administered to site patients over a 1-week period at five
timepoints (Baseline, 3-, 6-, 9-, and 12-months). The survey will be
provided to patients upon check-out from a healthcare visit. A total of
12,500 surveys will be completed during each 1-week period.
20. Patient Interview Protocol--A total of 50 qualitative, semi-
structured interviews will be completed with site patients during
implementation. The interview protocol collects information on reason
for visit, provider communication, and other insights into patient
experience.
This study is being conducted by AHRQ through its contractor, RAND,
pursuant to AHRQ's statutory authority to conduct and support research
on healthcare and on systems for the delivery of such care, including
activities with respect to the quality, effectiveness, efficiency,
appropriateness, and value of healthcare services and with respect to
quality measurement and improvement. 42 U.S.C. 299a(a)(1) and (2).

Method of Collection

The data collection methods for this evaluation were selected to
reduce participant burden and, where possible, to allow participants a
choice of response mode. In addition, technology is used for data
capture and qualitative coding and analysis.
Several forms and data collection instruments will be administered
using a web mode. Site leads and participants will receive a link
allowing them to complete the form online. The Site Interest Form will
also be accepted as a hardcopy should organizations prefer to mail or
fax these forms. All other forms will be administered either by a
fillable form that can be returned via email, mail, or fax depending on
the site or participant preference.
Interviews will be conducted by phone or video call (e.g.,
Microsoft Teams, Zoom) with interviewers using a hardcopy version of
the protocol. Interviews will be audio-recorded and transcribed,
following verbal consent from participants. Qualitative software will
be used for data coding and analysis of interviews.
The patient surveys will be provided to patients upon check-out
from a healthcare visit and they will be encouraged to complete the
survey before leaving the office. The survey will include a QR code to
allow patients to access a web version of the form. Alternatively, the
patient can complete the paper survey and it will be collected at the
site, minimizing the need for patients to return the paper survey by
mail. The paper surveys will be formatted for data scanning, and data
from all paper surveys returned to the contractor will be scanned into
an electronic datafile.

Estimated Annual Respondent Burden

This section summarizes the total burden hours for this information
collection effort in addition to the cost associated with those hours.
Exhibit 1 contains estimated response burdens for each subject
population participating in the evaluation's data collection
activities.
1. Site Interest Form--A physician or manager at an interested site
will complete the form only once to indicate interest in participating.
The form will be completed by 1,060 respondents and requires 6 minutes
to complete.
2. Site Information Form--A physician or manager at an interested
site will complete the form only once to provide additional contact
information, data on patient mix, and information on the organization's
diagnostic safety teams, resource commitments, and capacity for
implementing the resources. The form will be completed by 265
respondents and requires 20 minutes to complete.
3. Safer Dx Checklist--A physician or manager at participating
sites will complete the form only once to allow the participating site
to understand the current state of their diagnostic practices, identify
areas to improve, and track progress toward diagnostic excellence over
time. The form will be completed by 219 respondents and requires 15
minutes to complete.
4. Exit Interviews Protocol--A physician or manager at sites that
withdraw from the project will complete the form once to provide
information on why the site could not sustain their efforts or
participation. The form will be completed by 69 respondents and
requires 10 minutes to complete.
5a. SOPS[supreg] Medical Office Survey with Diagnostic Safety
Supplemental Item Set--A physician or manager at participating
ambulatory sites will

[[Page 16577]]

complete the form to provide a baseline assessment of patient safety
culture. The form will be completed by 109 respondents and requires 15
minutes to complete.
5b. SOPS[supreg] Hospital Survey with Diagnostic Safety
Supplemental Item Set--A physician or manager at participating hospital
sites will complete the form to provide a baseline assessment of
patient safety culture. The form will be completed by 110 respondents
and requires 15 minutes to complete.
6. Post-training Evaluation Form--A physician, nurse practitioner,
physician assistant, or manager will complete the form once to indicate
the perceived value of the training provided to participating sites.
The form will be completed by 1350 respondents and requires 3 minutes
to complete.
7. Post-technical Assistance Evaluation Form--A physician, nurse
practitioner, physician assistant, or manager will complete the form up
to three times to indicate the perceived value of the technical
assistance provided to participating sites. The form will be completed
by 1350 respondents, three times, and requires 2 minutes to complete.
8. Clinical Sustainability Assessment Tool (CSAT)--A physician or
manager at participating sites will complete the form to evaluate the
sustainability capacity of a clinical practice. The form will be
completed by 219 respondents and requires 15 minutes to complete.
9. Implementation Interviews Protocol--A physician, nurse
practitioner, physician assistant, or manager will participate in an
interview two times to provide their perspectives at different stages
of the implementation. The interview will be completed by up to 438
respondents, two times, and requires 1 hour to complete.
10. Measure Dx Organizational Self-Assessment--A physician, nurse
practitioner, physician assistant, or manager will complete the form
only once to gauge the organization's readiness to engage with Measure
Dx. The form will be completed by 73 respondents and requires 30
minutes to complete.
11. Measure Dx Declaration of Measurement Strategy--A physician,
nurse practitioner, physician assistant, or manager will complete the
form only once to indicate their selection of measurement strategy to
be implemented and provide confirmation of minimum necessary
capabilities. The form will be completed by 73 respondents and requires
5 minutes to complete.
12. Diagnostic Safety Event Report--A physician, nurse
practitioner, physician assistant, or manager will complete the form
three times to provide aggregate information on diagnostic safety
events. The form will be completed by 73 respondents, three times, and
requires 1 hour to complete.
13a. Omnibus Safety and Culture Survey_Medical Offices--A
physician, nurse practitioner, physician assistant, or manager will
complete the form three times to provide information on safety culture
at ambulatory sites. The form will be completed by 162 respondents,
three times, and requires 20 minutes to complete.
13b. Omnibus Safety and Culture Survey_Hospitals--A physician,
nurse practitioner, physician assistant, or manager will complete the
form three times to provide information on safety culture at inpatient
sites. The form will be completed by 167 respondents, three times, and
requires 20 minutes to complete.
14. Calibrate Dx Survey--A physician, nurse practitioner, or
physician assistant will complete the form four times to provide
reflections on their diagnostic performance for 3-5 cases, with
additional metrics around time to complete the review and the number of
cases reviewed. The form will be completed by 329 respondents, four
times, and requires 30 minutes to complete.
15. Clinician Self-Efficacy Survey--A physician, nurse
practitioner, or physician assistant will complete the form two times
to provide information on their self-efficacy with diagnostic safety
case review and improvement. The form will be completed by 329
respondents, two times, and requires 3 minutes to complete.
16. Provider Characteristics Form--A physician, nurse practitioner,
or physician assistant will complete the form once to provide
information on practitioner type, years in practice, specialty,
subspecialty, and percent of time spent in clinical practice. The form
will be completed by 986 respondents and requires 1 minute to complete.
17. Patient Toolkit Survey--Provider--A physician, nurse
practitioner, or physician assistant will complete the form five times
to provide information on provider-perceived skills and quality of
communication. The form will be completed by 986 respondents, five
times, and requires 2 minutes to complete.
18. Provider Interview Protocol--A physician, nurse practitioner,
or physician assistant will participate in an interview once to provide
information related to diagnostic safety events; patient safety
culture; feasibility, acceptability, utility, adoption, and spread of
the Patient Toolkit; and insights into clinician experience. The
interview will be completed by up to 50 respondents and requires 45
minutes to complete.
19. Patient Toolkit Survey--Patient--Patients will complete the
form only once to provide information on their experience and quality
of communication, and demographics information. The form will be
completed by 62,500 respondents and requires 5 minutes to complete.
20. Patient Interview Protocol--Patients will participate in an
interview once to provide information on reason for visit, provider
communication, and other insights into patient experience. The
interview will be completed by up to 50 respondents and requires 45
minutes to complete.
For the three-year clearance period, the estimated annualized
burden hours for the data collection activities are 8,195.

Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Form name Number of responses per Hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
1: Site Interest Form........................... 1,060 1 6/60 106
2: Site Information Form........................ 265 1 20/60 88
3: Safer Dx Checklist........................... 219 1 15/60 55
4: Exit Interviews Protocol..................... 69 1 10/60 12
5a: SOPS[supreg] Medical Office Survey with 109 1 15/60 27
Diagnostic Safety Supplemental Item Set........
5b: SOPS[supreg] Hospital Survey with Diagnostic 110 1 15/60 28
Safety Supplemental Item Set...................

[[Page 16578]]

6: Post-training Evaluation Form................ 1,350 1 3/60 68
7: Post-technical Assistance Evaluation Form.... 1,350 3 2/60 135
8: Clinical Sustainability Assessment Tool 219 1 15/60 55
(CSAT).........................................
9: Implementation Interviews Protocol........... 438 2 1 876
10: Measure Dx Organizational Self-Assessment... 73 1 30/60 37
11: Measure Dx Declaration of Measurement 73 1 5/60 6
Strategy.......................................
12: Diagnostic Safety Event Report.............. 73 3 1 219
13a: Omnibus Safety and Culture Survey_Medical 162 3 20/60 162
Offices........................................
13b: Omnibus Safety and Culture Survey_Hospitals 167 3 20/60 167
14: Calibrate Dx Survey......................... 329 4 30/60 657
15: Clinician Self-Efficacy Survey.............. 329 2 3/60 33
16: Provider Characteristics Form............... 986 1 1/60 16
17: Patient Toolkit Survey-Provider............. 986 5 2/60 164
18: Provider Interview Protocol................. 50 1 45/60 38
19: Patient Toolkit Survey--Patient............. 62,500 1 5/60 5,208
20: Patient Interview Protocol.................. 50 1 45/60 38
---------------------------------------------------------------
Total....................................... .............. .............. .............. 8,195
----------------------------------------------------------------------------------------------------------------

Exhibit 2 shows the estimated annualized cost burden based on the
respondents' time to complete the data collection forms. The total cost
burden is estimated to be $457,432.

Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate * burden
----------------------------------------------------------------------------------------------------------------
1: Site Interest Form........................... 1060 106 \a\ $97.30 $10,314
2: Site Information Form........................ 265 88 \a\ 97.30 8,562
3: Safer Dx Checklist........................... 219 55 \a\ 97.30 5,352
4: Exit Interviews Protocol..................... 69 12 \a\ 97.30 1,168
5a: SOPS[supreg] Medical Office Survey with 109 27 \a\ 97.30 2,627
Diagnostic Safety Supplemental Item Set........
5b: SOPS[supreg] Hospital Survey with Diagnostic 110 28 \a\ 97.30 2,724
Safety Supplemental Item Set...................
6: Post-training Evaluation Form................ 1350 68 \b\ 102.90 6,997
7: Post-technical Assistance Evaluation Form.... 1350 135 \b\ 102.90 13,892
8: Clinical Sustainability Assessment Tool 219 55 \a\ 97.30 5,352
(CSAT).........................................
9: Implementation Interviews Protocol........... 438 876 \b\ 102.90 90,140
10: Measure Dx Organizational Self-Assessment... 73 37 \b\ 102.90 3,807
11: Measure Dx Declaration of Measurement 73 6 \b\ 102.90 617
Strategy.......................................
12: Diagnostic Safety Event Report.............. 73 219 \b\ 102.90 22,535
13a: Omnibus Safety and Culture Survey_Medical 162 162 \b\ 102.90 16,670
Offices........................................
13b: Omnibus Safety and Culture Survey_Hospitals 167 167 \b\ 102.90 17,184
14: Calibrate Dx Survey......................... 329 657 \c\ 102.83 67,559
15: Clinician Self-Efficacy Survey.............. 329 33 \c\ 102.83 3,393
16: Provider Characteristics Form............... 986 16 \c\ 102.83 1,645
17: Patient Toolkit Survey-Provider............. 986 164 \c\ 102.83 16,864
18: Provider Interview Protocol................. 50 38 \c\ 102.83 3,908
19: Patient Toolkit Survey--Patient............. 62500 5208 \d\ 29.76 154,990
20: Patient Interview Protocol.................. 50 38 \d\ 29.76 1,131
---------------------------------------------------------------
Total....................................... .............. .............. .............. 457,432
----------------------------------------------------------------------------------------------------------------
* National Compensation Survey: Occupational wages in the United States May 2022, ``U.S. Department of Labor,
Bureau of Labor Statistics.''
\a\ Based on the weighted mean hourly wage for physicians (broad) ($121.15; occupation code 29-1210; 60%) and
Medical and Health Services Managers ($61.53; Code 11-9111; 40%).
\b\ Based on the weighted mean hourly wage for physicians (broad) ($121.15; occupation code 29-1210; 70%); nurse
practitioners (broad) ($59.94; occupation code 29-1170; 15%); physician assistants (broad) ($60.23; occupation
code 29-1070; 10%); and medical and health services managers (broad) ($61.53; Code 11-9111; 5%).
\c\ Based on the weighted mean hourly wage for physicians (broad) ($121.15; occupation code 29-1210; 70%); nurse
practitioners (broad) ($59.94; occupation code 29-1170; 15%); and physician assistants (broad) ($60.23;
occupation code 29-1070; 15%).
\d\ Based on the mean wages for All Occupations (Code 00-0000).

[[Page 16579]]

Request for Comments

In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3520, comments on AHRQ's information collection are requested with
regard to any of the following: (a) whether the proposed collection of
information is necessary for the proper performance of AHRQ's health
care research and health care information dissemination functions,
including whether the information will have practical utility; (b) the
accuracy of AHRQ's estimate of burden (including hours and costs) of
the proposed collection(s) of information; (c) ways to enhance the
quality, utility and clarity of the information to be collected; and
(d) ways to minimize the burden of the collection of information upon
the respondents, including the use of automated collection techniques
or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.

Dated: March 1, 2024.
Marquita Cullom,
Associate Director.
[FR Doc. 2024-04786 Filed 3-6-24; 8:45 am]
BILLING CODE 4160-90-P

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