Change Request Justification - 29MAY2020

Change Memo for

“National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19)

Surveillance in Healthcare Facilities”

(OMB Control No. 0920-1290)

Expiration Date: 09/30/2020

Program Contact

Lauren Wattenmaker

Surveillance Branch

Division of Healthcare Quality Promotion

National Center for Emerging and Zoonotic Infectious Diseases

Centers for Disease Control and Prevention

Atlanta, Georgia 30333

Phone: 404-718-5842

Email: nlh3@cdc.gov

Submission Date: May 29, 2020

The Centers for Disease Control and Prevention (CDC), Division of Healthcare Quality Promotion (DHQP) requests a nonmaterial/non-substantive of the currently approved Information Collection Request: “National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities (OMB Control No. 0920-1290).”

The COVID-19 Patient Impact and Hospital Capacity data collection tool was released with the NHSN COVID-19 Module on March 27, 2020. Facility-level data collected through NHSN as part of the COVID-19 Module are being made available to a broader set of Federal, state, and local agency data users than data typically collected by NHSN. Specifically, COVID-19 data at the state, county, territory, and facility level submitted to NHSN will continue to be used for public health emergency response activities by CDC’s emergency COVID-19 response, by the U.S. Department of Health and Human Services’ (HHS’) COVID-19 tracking system maintained in the Office of the Assistant Secretary of Preparedness and Response as part of the National Response Coordination Center at the Federal Emergency Management Agency (FEMA), and by the White House Coronavirus Task Force.

In order to strengthen the COVID-19 response efforts, the White House Coronavirus Task Force has requested additional data elements be added to the Patient Impact and Hospital Capacity form. Specifically, we are adding two new data field for daily collection:

• HOSPITALIZED and ICU: Patients currently hospitalized in an inpatient ICU bed who have suspected or confirmed COVID-19

• Number of Hospitalized and ICU with Confirmed COVID-19 (subset)

We are additionally modifying existing data elements for clarity based on user input by adding subset fields to nine data elements that request number of confirmed COVID-19 counts.

We estimate these changes will add five minutes to the previously approved burden for this data collection tool. The previous burden calculated for this form consisted of 327,285 hours. As a result of the changes proposed in this change memo, the burden for this form will increase by 46,755 hours.

Type of Respondent	Form Name	No. of Respondents	No. Responses per Respondent	Avg. Burden per response (in hrs.)	Total Burden (in hrs.)
Microbiologist (IP)	COVID-19 Patient Impact Module Form	2079	180	40/60	249,480
Business and financial operations occupations	COVID-19 Patient Impact Module Form	519	180	40/60	62,280
State and local health department occupations	COVID-19 Patient Impact Module Form	519	180	40/60	62,280

The previous burden calculated for this entire data collection consisted of 1,159,736 hours. As a result of the changes proposed in this change memo, the new burden will consist of 1,206,491 hours.

Type of Respondent	Form Name	No. of Respondents	No. Responses per Respondent	Avg. Burden per response (in hrs.)	Total Burden (in hrs.)
Microbiologist (IP)	COVID-19 Patient Impact Module Form	2079	180	35/60	249,480
Business and financial operations occupations	COVID-19 Patient Impact Module Form	519	180	35/60	62,280
State and local health department occupations	COVID-19 Patient Impact Module Form	519	180	35/60	62,280
Microbiologist (IP)	COVID-19 Healthcare Worker Form	2079	180	25/60	155,925
Business and financial operations occupations	COVID-19 Healthcare Worker Form	519	180	25/60	38,925
State and local health department occupations	COVID-19 Healthcare Worker Form	519	180	25/60	38,925
Microbiologist (IP)	COVID-19 Supplies Form	2079	180	25/60	155,925
Business and financial operations occupations	COVID-19 Supplies Form	519	180	25/60	38,925
State and local health department occupations	COVID-19 Supplies Form	519	180	25/60	38,925
LTCF personnel	NHSN and Secure Access Management Services (SAMS) enrollment	11,500	1	60/60	11,500
LTCF personnel	COVID-19 Module, Long Term Care Facility: Staff and Personnel Impact form	9,782	26	15	63,583
Business and financial operations occupations	COVID-19 Module, Long Term Care Facility: Staff and Personnel Impact form	2,446	26	15/60	15,899
State and local health department occupations	COVID-19 Module, Long Term Care Facility: Staff and Personnel Impact form	2,446	26	15/60	15,899
LTCF personnel	COVID-19 Module, Long Term Care Facility Staff and Personnel Impact form (retrospective data entry)	4,891	1	15/60	1,223
Business and financial operations occupations	COVID-19 Module, Long Term Care Facility Staff and Personnel Impact form (retrospective data entry)	1,223	1	15/60	306
state and local health department occupations	COVID-19 Module, Long Term Care Facility Staff and Personnel Impact form (retrospective data entry)	1,223	1	15/60	306
LTCF personnel	COVID-19 Module, Long Term Care Facility: Resident Impact and Facility Capacity form	9,782	26	20/60	84,777
Business and financial operations occupations	COVID-19 Module, Long Term Care Facility: Resident Impact and Facility Capacity form	2,446	26	20/60	21,199
State and local health department occupations	COVID-19 Module, Long Term Care Facility: Resident Impact and Facility Capacity form	2,446	26	20/60	21,199
LTCF personnel	COVID-19 Module, Long Term Care Facility Resident Impact and Facility Capacity form (retrospective data entry)	4,891	1	15/60	1,223
Business and financial operations occupations	COVID-19 Module, Long Term Care Facility Resident Impact and Facility Capacity form (retrospective data entry)	1,223	1	15/60	306
state and local health department occupations	COVID-19 Module, Long Term Care Facility Resident Impact and Facility Capacity form (retrospective data entry)	1,223	1	15/60	306
LTCF personnel	COVID-19 Module, Long Term Care Facility: Ventilator Capacity & Supplies form	9,782	26	5/60	21,194
Business and financial operations occupations	COVID-19 Module, Long Term Care Facility: Ventilator Capacity & Supplies form	2,446	26	5/60	5,300
State and local health department occupations	COVID-19 Module, Long Term Care Facility: Ventilator Capacity & Supplies form	2,446	26	5/60	5,300
LTCF personnel	COVID-19 Module, Long Term Care Facility: Supplies & Personal Protective Equipment form	9,782	26	15/60	63,583
Business and financial operations occupations	COVID-19 Module, Long Term Care Facility: Supplies & Personal Protective Equipment form	2,446	26	15/60	15,899
State and local health department occupations	COVID-19 Module, Long Term Care Facility: Supplies & Personal Protective Equipment form	2,446	26	15/60	15,899
Total					1,206,491

Attachments:

1. COVID-19 Patient Impact and Hospital Capacity Form

2. Table of Instructions for COVID-19 Patient Impact and Hospital Capacity Form