Patient Safety Organization Certification for Initial Listing and Related Forms, Patient Safety Confidentiality Complaint Form, and Common Formats

ICR 201806-0935-001

OMB: 0935-0143

Federal Form Document

ICR Details
0935-0143 201806-0935-001
Active 201411-0935-001
HHS/AHRQ
Patient Safety Organization Certification for Initial Listing and Related Forms, Patient Safety Confidentiality Complaint Form, and Common Formats
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 11/14/2018
Retrieve Notice of Action (NOA) 09/18/2018
  Inventory as of this Action Requested Previously Approved
11/30/2021 36 Months From Approved
1,219 0 0
100,725 0 0
0 0 0

The Patient Safety and Quality Improvement Act of 2005 (hereafter the Patient Safety Act), 42 U.S.C. 299b-21 to 299b-26, was enacted in response to growing concern about patient safety in the United States and the Institute of Medicine's 1999 report, To Err is Human: Building a Safer Health System. The goal of the statute is to improve patient safety by providing an incentive for health care providers to work voluntarily with experts in patient safety to reduce risks and hazards to the safety and quality of patient care. The Patient Safety Act signifies the Federal Government's commitment to fostering a culture of patient safety among health care providers; it offers a mechanism for creating an environment in which the causes of risks and hazards to patient safety can be thoroughly and honestly examined and discussed without fear of penalties and liabilities. It provides for the voluntary formation of Patient Safety Organizations (PSOs) that can collect, aggregate, and analyze confidential information reported voluntarily by health care providers. By analyzing substantial amounts of patient safety event information across multiple institutions, PSOs will be able to identify patterns of failures and propose measures to eliminate or reduce patient safety risks and hazards.

US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  
None

Not associated with rulemaking

  83 FR 8274 02/26/2018
83 FR 25668 06/04/2018
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,219 0 0 50 0 1,169
Annual Time Burden (Hours) 100,725 0 0 21 0 100,704
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The previous information collection request (ICR) included an estimate of 100,704 total burden hours for the Common Formats and the following forms: PSO Certification for Initial Listing Form, PSO Certification for Continued Listing Form, PSO Two Bona Fide Contracts Requirement Form, PSO Disclosure Statement Form, PSO Profile Form, PSO Change of Listing Form, and the OCR Patient Safety Confidentiality Form. The estimated burden hours for the current ICR, which now includes the new PSO Voluntary Relinquishment Form, are 100,722.88 which represent an increase of 18.88 hours.

$4,198,560
No
    No
    No
No
No
No
Uncollected
Erwin Brown 301 427-1652 erwin.brown@ahrq.hhs.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/18/2018


© 2024 OMB.report | Privacy Policy