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74536 Federal Register / Vol. 71, No.

238 / Tuesday, December 12, 2006 / Notices

Susan R. Woskie, PhD ............................................................................. University of Massachusetts Lowell, Lowell, MA.

Background Information on the CERHR DEPARTMENT OF HEALTH AND home setting. The instrument will be
HUMAN SERVICES pilot tested with staff in 40 nursing
The NTP established CERHR in June homes. The data collected will be
1998 [Federal Register, December 14, Agency for Healthcare Research and analyzed to determine the psychometric
1998 (Volume 63, Number 239, page Quality properties of the survey’s items and
68782)]. CERHR is a publicly accessible dimensions and provide information for
resource for information about adverse Agency Information Collection the revision and shortening of the final
reproductive and/or developmental Activities: Proposed Collection; survey based on an assessment of its
health effects associated with exposure Comment Request reliability and construct validity. The
to environmental and/or occupational AGENCY: Agency for Healthcare Research final survey will be made publicly
exposures. Expert panels conduct and Quality, Department of Health and available to enable nursing homes to
scientific evaluations of agents selected Human Services. assess their resident safety culture.
by the CERHR in public forums. ACTION: Notice. Methods of Collection
CERHR invites the nomination of SUMMARY: This notice announces the
agents for review or scientists for its A purposive sample of 40 nursing
intention of the Agency for Healthcare homes will be recruited and selected.
expert registry. Information about Research and Quality (AHRQ) to request
CERHR and the nomination process can These nursing homes will represent a
that the Office of Management and distrubition of bed size, nature of
be obtained from its homepage (http:// Budget (OMB) allow the proposed ownership (non-profit/for-profit), or by contacting Dr. information collection project: ‘‘Pilot urbanity (urban/rural), and geographic
Shelby (see FOR FURTHER INFORMATION Study of Proposed Nursing Home region of the United States. Recruited
CONTACT above). CERHR selects Survey on Resident Safety’’. In nursing homes will be allocated to each
chemicals for evaluation based upon accordance with the Paperwork category in numbers roughly
several factors including production Reduction Act of 1995, Public Law 104– proportionate to the national
volume, potential for human exposure 13 (44 U.S.C. 3506(c)(2)(A)), AHRQ distribution of homes in each category.
from use and occurrence in the invites the public to comment on this
proposed information collection. All employees, contractors and
environment, extent of public concern, agency staff in all job classes in nursing
and extent of data from reproductive DATES: Comments on this notice must be
homes with up to 200 employees will be
and developmental toxicity studies. received by February 12, 2007. asked to respond to the survey. In
CERHR follows a formal, multi-step ADDRESSES: Written comments should nursing homes with more than 200
process for review and evaluation of be submitted to: Doris Lefkowitz, employees, a random sample of 200
selected chemicals. The formal Reports Clearance Officer, AHRQ, 540 employees will be selected. Since not all
evaluation process was published in the Gaither Road, Room #5036, Rockville, nursing homes staff have access to or are
MD 20850. familiar with e-mail or the internet,
Federal Register on July 16, 2001 Copies of the proposed collection
(Volume 66, Number 136, pages 37047– paper surveys will be administered.
plans, data collection instruments, and Standard non-response follow-up
37048) and is available on the CERHR specific details on the estimated burden
Web site under ‘‘About CERHR’’ or in techniques such as reminder postcards
can be obtained from AHRQ’s Reports and distrubiton of a second survey will
printed copy from CERHR. Clearance Officer. be used. Individuals and organizations
Dated: November 27, 2006. FOR FURTHER INFORMATION CONTACT: contacted will be assured of the
Samuel H. Wilson, Doris Lefkowitz, AHRQ, Reports confidentiality of their replies under
Deputy Director, National Institute of Clearance Officer, (301) 427–1477. Section 924(c) of the Healthcare
Environmental Health Sciences and National SUPPLEMENTARY INFORMATION: Research and Quality Act of 1999.
Toxicology Program. Proposed Project Estimated Annual Respondent Burden
[FR Doc. E6–21040 Filed 12–11–06; 8:45 am]
‘‘Pilot Study of Proposed Nursing Home The survey will be distributed to
Survey on Resident Safety’’ approximately 5,500 nursing home
This activity is an expansion and employees, with a target response rate of
refinement of AHRQ’s Hospital Survey 70%, or 3,850 returned surveys.
on Patient Safety Culture (HSOPSC) Respondents should take approximately
which was developed and released to 15 minutes to complete the survey.
the public for use in November 2004. Therefore, we estimate that the
This proposed new tool is based on the respondent burden for completing the
HSOPSC but also contains new and survey will be 963 hours (3,850
revised items as well as dimensions that completes multiplied by 0.25 hours per
more accurately apply to the nursing completed survey).

Estimated Estimated
Number of Re-
Number of Re- Time per Re- Total Re-
Type of Respondent sponses per
spondents spondent spondent Bur-
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(hours) den Hours

Nursing home staff member ............................................................................ 3,850 1 0.25 963

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Federal Register / Vol. 71, No. 238 / Tuesday, December 12, 2006 / Notices 74537

Estimated Annual Costs to the Federal information collection project: Veterans Affairs suggests that in one out
Government ‘‘Development of an Electronic System of every 10,000 hospitalizations, a
The total cost to the Government for for Reporting Medication Errors and patient dies due directly to a medical
developing this survey is approximately Adverse Drug Events in Primary Care error .4
$319,000, and is being funded solely by Practice (MEADERS).’’ In accordance In response to the growing concern
AHRQ. This estimate includes the costs with the Paperwork Reduction Act of over medical errors, the Agency for
of a background literature review, 1995, Public Law 104–13 (44 U.S.C. Healthcare Research and Quality
survey development, cognitive testing, 3506(c)(2)(A)), AHRQ invites the public (AHRQ) has published three important
pilot data collection, data analysis, and to comment on this proposed monographs outlining the problem of
preparation of final deliverables and information collection. errors,5 their effects on the quality of
reports. DATES: Comments on this notice must be care,6 and offering suggestions on
received by February 12, 2007. improving patient safety.7 The first
Request for Comments recommendation of this third
ADDRESSES: Written comments should
In accordance with the above-cited monograph was to ‘‘capture information
be submitted to: Doris Lefkowitz, on patient safety—including both
Paperwork Reduction Act legislation, Reports Clearance Officer, AHRQ, 540
comments on AHRQ’s information adverse events and near misses—as a
Gaither Road, Room #5036, Rockville, byproduct of care, and use this
collection are requested with regard to MD 20850.
any of the following: (a) Whether the information to design even safer care
Copies of the proposed collection delivery systems.’’ One central theme to
proposed collection of information is plans, data collection instruments, and
necessary for the proper performance of each of these monographs is that there
specific details on the estimated burden simply is too much chaotic information
AHRQ health care research and health can be obtained from AHRQ’s Reports
care information dissemination flowing in the medical environment for
Clearance Officer. a single provider to handle effectively.
functions, including whether the
FOR FURTHER INFORMATION CONTACT: Therefore, solutions to the problem of
information will have practical utility;
(b) the accuracy of AHRQ’s estimate of Doris Lefkowitz, AHRQ, Reports medical errors should include some
burden (including hours and costs) of Clearance Officer, (301) 427–1477. combination of health information
the proposed collection(s) of SUPPLEMENTARY INFORMATION: technology and redesign of health care
information; (c) ways to enhance the systems to enhance the prevalence of
Proposed Project appropriate decisions (i.e., avoiding
quality, utility, and clarity of the
information to be collected; and (d) ‘‘Development of an Electronic System errors of omission) and reduce the
ways to minimize the burden of the for Reporting Medication Errors and occurrence of avoidable mistakes (i.e.,
collection of information upon the Adverse Drug Events in Primary Care avoiding errors of commission).
Practice (MEADERS)’’ A recent conference sponsored by
respondents, including the use of
AHRQ highlighted interventions to
automated collection techniques or The project is being conducted in improve medical decision-making and
other forms of information technology. response to an AHRQ RFP entitled
Comments submitted in response to reduce medical errors.8 Most of the
‘‘Resource Center for Primary Care interventions presented were based in
this notice will be summarized and Practice-Based Research Networks
included in the Agency’s subsequent hospitals, where the most intensive and
(PBRNs)’’ (issued under Contract 290– immediately life-threatening events
request for OMB approval of the 88–0008). occur. Yet the majority of medical
proposed information collection. All In response to a proposed decisions are made in outpatient
comments will become a matter of modification to AHRQ contract no. practices and offices where there has
public record. 290.02.0008, the PBRN Resource Center been little error-reduction research
Dated: December 1, 2006. is proposing to assist AHRQ in its performed. Further, most outpatient
Carolyn M. Clancy, continued commitment to assessing the studies have been performed in
Director. status and capabilities of its funded academic medical centers which have
[FR Doc. 06–9642 Filed 12–11–06; 8:45 am] PBRNs and making available to them capabilities, providers, and patients that
the tools and resources necessary to may not typify the average U.S. medical
improve the quality of care they practice.9
provide. Through the modification of With the recent passing of the Patient
DEPARTMENT OF HEALTH AND this contract, the PBRN Resource Center Safety and Quality Improvement Act of
HUMAN SERVICES will develop and make available an 2005, 42 U.S.C. 299b–21–b–26, now is
electronic system for reporting an opportune time to evaluate a primary
Agency for Healthcare Research and medication errors and adverse drug care error reporting system, and PBRNs
Quality events that occur in outpatient are an ideally suited place to study
physician practices of selected PBRNs to interventions aimed at reporting and
Agency Information Collection their own practices for quality reducing medical errors. In most
Activities: Proposed Collection; improvement purposes and to the Food primary care practices there is no
Comment Request and Drug Administration (FDA). mechanism in place to report medical
AGENCY: Agency for Healthcare Research The landmark Harvard Medical errors as they occur. We propose to
and Quality, Department of Health and Practice Study was published in 1991 develop, implement, and study an
Human Services. and stated that 98,000 Americans die outpatient error reporting system to
ACTION: Notice. each year from medical errors. 1 better understand the ability of
Although the exact figure has been physicians to identify their own errors
jlentini on PROD1PC65 with NOTICES

SUMMARY: This notice announces the disputed, no one disputes the fact that and their willingness to report them to
intention of the Agency for Healthcare too many Americans are injured their own practices and the FDA and
Research and Quality (AHRQ) to request unnecessarily by medical mistakes that AHRQ. We will focus on the most
that the Office of Management and could be avoided.2 3 Another study common invasive intervention invoked
Budget (OMB) allow the proposed performed by the Department of in outpatient practice—drug treatment

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