The study will not be used to answer questions about causality or degrees of effectiveness (e.g., to what degree did a given intervention cause an improvement in patient flow?). Rather, the study seeks to enhance understanding of factors affecting decisionmaking and adoption processes that facilitate or hinder implementation. Insights and lessons learned about organizational, technical and resource challenges arising from these improvement activities may be of interest or benefit to others seeking to identify and adopt strategies to address similar problems in their EDs.

This study is being conducted pursuant to AHRQ's statutory authority to conduct and support research on health care and on systems for the delivery of such care, including activities with respect to: The quality, effectiveness, efficiency, appropriateness and value of health care services; quality measurement and improvement; and health care costs, productivity, organization, and market forces. 42 U.S.C. 299a(a)(1), (2), and (6).

Method of Collection

AHRQ seeks approval for the following data collection activities:

Inperson interviews will be conducted within two months of the implementation with up to 12 individuals at each of the 6 sites during twoday site visits to each of the hospitals.

Telephone interviews will be conducted approximately 6 months after implementation with 12 individuals from each of the six hospitals (most or all of whom will be the same individuals interviewed in person). Estimated Annual Respondent Burden

Exhibit 1 shows the estimated annualized burden hours for the hospitals' time to participate in this study. Inperson interviews will be conducted within two months of implementation with 12 administrative and clinical personnel from each of the six participating hospitals and will require about one hour. Telephone interviews will be conducted approximately six months thereafter with 12 individuals (administrative and clinical) from each hospital and will take about 45 minutes. The total estimated burden for participation in this study is 126 hours. Exhibit 1Estimated Annualized Burden Hours Number of Data collection Number of responses per Hours per Total burden hospitals hospital response hours Inperson interviews............................ 6 12 1.0 72 Telephone interviews............................ 6 12 45/60 54

Total....................................... 12 na na 126

Exhibit 2 shows the estimated annualized cost burden for the respondents' time to provide the requested data. The total cost burden is approximately $4,419.
Exhibit 2Estimated Annualized Cost Burden Total burden Average hourly Total cost Data collection hours wage rate * burden Inperson interviews............................................ 72 $35.07 $2,525 Telephone interviews............................................ 54 $35.07 1,894

Total....................................................... 126 na 4,419 * For the interviews, the hourly rate of $35.07 is an average of the admini strative personnel hourly wage of $14.53, the physician rate of $62.52, and the registered nurse rate of $28.15. National Compensation Survey: Occupational Wages in the United States 2005, U.S. Department of Labor, Bureau of Labor Statistics. Estimated Annual Costs to the Federal Government

Exhibit 3 shows the total and annualized cost to the government for this eighteenmonth study.
Exhibit 3Estimated Cost
Annualized Cost component Total cost cost Project Development..................... 52,446 34,964 Data Collection Activities.............. 90,298 60,199 [[Page 11111]]
Data Processing and Analysis............ 70,569 47,046 Publication of Results.................. 41,420 27,613 Project Management...................... 68,908 45,939 Overhead................................ 76,320 50,880

Total............................... $399,961 266,641 Request for Comments

In accordance with the abovecited Paperwork Reduction Act legislation, 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 9, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E95581 Filed 31309; 8:45 am]
BILLING CODE 416090M

FOR FURTHER INFORMATION CONTACT

Doris Lefkowitz, AHRQ Reports Clearance Officer, (301) 4271477, or by email at
doris.lefkowitz@ahrq.hhs.gov.