Notice2024-21564
Agency Information Collection Activities: Proposed Collection; Comment Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 20, 2024
Issuing agencies
Health and Human Services DepartmentAgency for Healthcare Research and Quality
Abstract
In compliance with the Paperwork Reduction Act of 1995, 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 reinstatement without change of the information collection project Evaluating the Implementation of PCOR to Increase Referral, Enrollment, and Retention through Automatic Referral to Cardiac Rehabilitation (CR) with Care Coordinator OMB No. 0935-0252 for which approval has expired. The reinstatement of this previously approved PRA collection for which approval has expired is required in order to discontinue this collection.
Full Text
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<title>Federal Register, Volume 89 Issue 183 (Friday, September 20, 2024)</title>
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[Federal Register Volume 89, Number 183 (Friday, September 20, 2024)]
[Notices]
[Pages 77153-77155]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-21564]
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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: Information collection notice.
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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, 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 reinstatement without change of the information
collection project Evaluating the Implementation of PCOR to Increase
Referral, Enrollment, and Retention through Automatic Referral to
Cardiac Rehabilitation (CR) with Care Coordinator OMB No. 0935-0252 for
which approval has expired. The reinstatement of this previously
approved PRA collection for which approval has expired is required in
order to discontinue this collection.
DATES: Comments on this notice must be received by November 19, 2024.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at
<a href="/cdn-cgi/l/email-protection#d785928798858384949b929685969994929891919e94928597b6bfa5a6f9bfbfa4f9b0b8a1"><span class="__cf_email__" data-cfemail="d48691849b8680879798919586959a97919b92929d97918694b5bca6a5fabcbca7fab3bba2">[email 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
<a href="/cdn-cgi/l/email-protection#722037223d202621313e373320333c31373d34343b31372032131a00035c1a1a015c151d04"><span class="__cf_email__" data-cfemail="a7f5e2f7e8f5f3f4e4ebe2e6f5e6e9e4e2e8e1e1eee4e2f5e7c6cfd5d689cfcfd489c0c8d1">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
Title of Information Collection: Evaluating the Implementation of
PCOR to Increase Referral, Enrollment, and Retention through Automatic
Referral to Cardiac Rehabilitation (CR) with Care Coordinator.
OMB No.: 0935-0252.
Type of Request: Reinstatement without change to discontinue the
collection.
The aim of this project, known as TAKEheart, was to (a) raise
awareness about the benefits of cardiac rehabilitation (CR) after
myocardial infarction or coronary revascularization, then to (b) spread
knowledge about the best practices to increase referrals to CR, and,
finally, (c) to increase CR uptake.
AHRQ evaluated TAKEheart to assess:
<bullet> the extent and effectiveness of the dissemination and
implementation efforts
<bullet> the uptake and usage of Automatic Referral with Care
Coordination and
<bullet> levels of referral to CR at the end of the intervention.
Evaluation results were used to improve the intervention and to
provide guidance for future AHRQ dissemination and implementation
projects. Two cohorts of ``Partner Hospitals,'' up to 125 hospitals in
total, engaged in efforts to implement Automatic Referral with Care
Coordination over twelve-month periods. The evaluation ascertained the
diversity of hospitals engaged in the activities that contributed to
(or hindered) their efforts, and the types of support which they
reported having been most (and least) useful. This information was used
to improve recruitment, technical assistance, and tools for the second
cohort.
In addition, hospitals--including those involved in the
implementation--were invited to attend Affinity Group virtual meetings
organized around specific topics of interest which are not intrinsic to
Automatic Referral with Care Coordination. Hospital staff engaged in
Affinity Groups created a vibrant Learning Community. The evaluation
determined which Affinity Groups engaged the most participants of the
Learning Community, and which resources participants determined the
most useful. This information was used to develop resources which were
available on a new, permanent website dedicated to improving CR.
This study was conducted by AHRQ through its contractor, Abt
Associates Inc., pursuant to AHRQ's statutory authority to disseminate
government-funded research relevant to comparative clinical
effectiveness research. 42 U.S.C. 299b-37(a).
Method of Collection
To collect data on the many facets of the intervention, the
collection implemented multiple data collection tools, each of which
had a specific purpose and set of respondents.
1. Partner Hospital Champion Survey. Each Partner Hospital
designated a ``Champion'' who coordinated activities associated with
implementing Automatic Referral with Care Coordination at the hospital
and provide the Champion's name and email address. Champions could have
had any role in the hospital, although they were expected to be in
relevant positions, such as cardiologists or quality improvement
managers. We conducted online surveys of 125 Champions (one Champion
per hospital). We used the email addresses to send the Champion a
survey at two points: seven months after the start of implementation
and at the end of the 12-month implementation period. The first survey
focused on four constructs. First, it captured data about the hospital
context, such as whether it had prior experience customizing an EMR or
is a safety net hospital. Second,
[[Page 77154]]
it addressed the hospital's decision to participate in TAKEheart.
Third, it captured data on the CR programs the hospital refers to,
whether the number or type has changed, and why. Fourth, it collected
feedback on the training and technical assistance received. The second
survey focused on three constructs. The first construct collected
feedback on the TAKEheart components, including training, technical
assistance, and use of the website. The second construct asked about
the hospitals' response to participating in TAKEheart, such as changes
to referral workflow or CR programs. The third construct asked those
Partner Hospitals that had not completed the process of implementing
Automatic Referral with Care Coordination whether they anticipated
continuing to work towards that goal and their confidence in
succeeding.
2. Partner Hospital Interviews.
a. Interviews with Partner Hospital Champions. We selected, from
each cohort, eight Partner Hospitals which demonstrated a strong
interest in addressing underserved populations or reducing disparities
in participation in cardiac rehabilitation. We conducted a key
informant interview with the Champion of each selected Partner Hospital
to delve into how they were addressing the needs of underserved
populations by implementing Automatic Referral with Care Coordination.
b. Interviews with Partner Hospital cardiologists. We selected,
from each cohort, eight hospitals based on criteria selected in
conversation with AHRQ, such as hospitals which serve specific
populations, or have the same EMRs, which informed their experience
customizing the EMR. We conducted semi-structured interviews with one
cardiologist at each of the selected hospitals twice. In the second
month of the cohort implementation, we asked about their needs,
concerns, and expectations of the program. In the 11th month of the
cohort implementation, we determined whether their concerns were
addressed appropriately and adequately.
c. Interviews with Partner Hospitals that withdraw. We expected
that a small number of Partner Hospitals would withdraw from the
cohort. We identified these hospitals by their lack of participation in
training and technical assistance events; Technical Assistance (TA)
Providers confirmed their withdrawal. We interviewed up to nine
withdrawing hospitals to better understand the reason for withdrawal
(e.g., a merger resulted in a loss of support for the intervention,
Champion left), as well as facilitators and barriers of each hospitals'
approach to implementing Automatic Referral with Care Coordination. If
more than nine hospitals withdrew, we ceased interviewing.
3. Learning Community Participant Survey. We conducted online
surveys of 250 currently active Learning Community participants at two
points in time, in months 18 and 31 of the project. We administered the
survey by sending a link to an online survey to email addresses entered
by virtual meeting participants during registration. The email
described the purpose of the survey.
4. Learning Community Follow-up Survey. We conducted a brief online
survey with up to 15 Learning Community participants following the
final virtual meeting for each of 10 Affinity Group, to ascertain
whether the hospitals were able to act on what they learned during the
session. The total sample was 150 Learning Community participants.
Estimated Annual Respondent Burden
Exhibit 1 presents estimates of the reporting burden hours for the
data collection efforts. Time estimates were based on prior experiences
and what could reasonably be requested of participating health care
organizations. The number of respondents listed in column A, Exhibit 1
reflects a projected 90% response rate for data collection effort 1,
and an 80% response rate for efforts 3 and 4 below.
1. Partner Hospital Champion Survey. We assumed 113 hospital
champions would complete the survey based on a 90% response rate. It
was expected to take up to 45 minutes to complete for a total of 169.5
hours to complete.
2. Partner Hospital Interviews. In-depth interviews occured with
select Partner Hospital staff.
a. Interviews with Partner Hospital Champions. We had a single, 90
minute interview with eight Partner Hospital Champions, in each cohort,
from Partner Hospital which have a common characteristic of particular
interest, for a total of 24 hours.
b. Interviews with Partner Hospital cardiologists. We held
individual, up-to-30 minute interviews with eight cardiologists, twice
in each cohort, for a total of 16 hours.
c. Interviews with Partner Hospitals that withdraw. We interviewed
up to nine withdrawing hospitals for no more than 20 minutes to better
understand the reason for withdrawal as well as facilitators and
barriers, for a total of 2.7 hours.
3. Learning Community Participant Survey. We assumed 200 Learning
Community participants would complete the survey based on an 80%
response rate. It was expected to take up to 15 minutes to complete
each survey for a total of 100 hours.
Learning Community Follow-up Survey. We conducted a brief, up to 10
minute, online survey of participants of each of just ten selected
Affinity Groups at two months after the virtual meeting. We assumed 120
Learning Community participants would complete the survey based on an
80% response rate. It was expected to take up to 15 minutes to complete
each survey for a total of 20.4 hours.
Exhibit 1--Estimated Annualized Burden Hours
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B. Number of
Data collection method or project activity A. Number of responses per C. Hours per D. Total
respondents respondent response burden hours
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1. Partner Hospital Champion Survey *........... 113 2 0.75 169.5
2a. Interviews with Partner Hospital Champions.. 16 1 1.5 24.0
2b. Interviews with Partner Hospital 16 2 0.5 16.0
Cardiologists..................................
2c. Interviews with Partner Hospitals that 9 1 0.3 2.7
withdraw.......................................
3. Learning Community Survey **................. 200 2 0.25 100.0
4. Learning Community Follow-up Survey **....... 120 1 0.17 20.4
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Total....................................... 474 .............. .............. 332.6
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* Number of respondents (Column A) reflects a sample size assuming a 90% response rate for this data collection
effort.
** Number of respondents (Column A) reflects a sample size assuming an 80% response rate for this data
collection effort.
[[Page 77155]]
Exhibit 2, below, presents the estimated annualized cost burden
associated with the respondents' time to participate in this research.
The total cost burden was estimated to be about $21,497.
Exhibit 2--Estimated Annualized Cost Burden
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A. Number of B. Total Average hourly Total cost
Data collection method or project activity respondents burden hours wage rate burden
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1. Partner Hospital Champion Survey *........... 113 169.5 $72.27 $12,250
2a. Interviews with Partner Hospital Champions.. 16 24.0 72.27 1,734
2b. Interviews with Partner Hospital 16 16.0 96.58 1,545
Cardiologists..................................
2c. Interviews with Partner Hospitals that 9 2.7 72.27 195
withdraw.......................................
3. Learning Community Survey **................. 200 100.0 47.95 4,795
4. Learning Community Follow-up Survey **....... 120 20.4 47.95 978
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Total....................................... 474 332.6 .............. 21,497
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* Number of respondents (Column A) reflects a sample size assuming a 90% response rate for this data collection
effort.
** Number of respondents (Column A) reflects a sample size assuming an 80% response rate for this data
collection effort.
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: September 17, 2024.
Marquita Cullom,
Associate Director.
[FR Doc. 2024-21564 Filed 9-19-24; 8:45 am]
BILLING CODE 4160-90-P
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