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July 6 -- The Census Bureau has asked OMB to approve its request to conduct the Management and Organizational Practices Survey-Hospitals (MOPS-HP) in late 2020 and invites economists to submit comments to OMB on MOPS-HP by August 6, 2020. MOPS-HP is a joint statistical project with the Harvard Business School.
 
The Census Bureau proposes conducting the MOPS-HP in order to provide critical information on the health sector. The MOPS-HP will collect information on the use of structured management practices from Chief Nursing Officers (CNOs) at approximately 4,500 hospitals with the goal of producing four publicly-available indices that measure key characteristics of these structured management practices. The proposed MOPS-HP will ask about performance monitoring, goals, staff management, the use of standardized clinical protocols, and medical record documentation. Some questions are adapted from the Management and Organizational Practices Survey (MOPS), conducted in the manufacturing sector, allowing for inter-sectoral comparisons.  

The MOPS-HP will provide a nationally representative sample, enabling stakeholders to understand the role of structured management practices in financial and clinical outcomes in U.S. hospitals. Questions developed and tested for the MOPS-HP instrument are adapted from the 2015 MOPS and the 2009 World Management Survey’s (WMS) healthcare instrument.

The current pandemic highlights the relevance of hospital management practices, especially as they relate to hospitals’ ability to respond to shocks to their organization and the health care system. The Census Bureau has included two questions in the MOPS-HP content to help improve measurement of hospital preparedness. These questions, numbered 30 and 36, will provide information on two elements of responsiveness, hospitals’ coordinated deployment of frontline clinical workers and hospitals’ ability to quickly respond to needed changes in standardized clinical protocols.  

The Census Bureau plans to use the data collected from the MOPS-HP's questions on medical record documentation to construct an index measuring the management of multiple objectives—clinical and financial—that would inform policymakers concerned with both aspects of hospital performance. By examining any links between the survey's measures of management practices and clinical outcomes, the survey may help to inform policymakers and to encourage practices that are beneficial to patients and our population as a whole. Hospital administrators could utilize planned public indices to benchmark their own practices, and subsequently make decisions or set policies to improve their financial and clinical outcomes.

The MOPS-HP data could be used in combination with the Census Bureau's collected data on hospital finances, including revenues and expenses, to improve our understanding on how management practices may impact financial performance.

The Centers for Medicare and Medicaid Services' Hospital Compare data or the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey could be used in conjunction with the MOPS-HP to determine whether hospitals with more structured management practices have higher overall patient ratings and are more likely to be recommended.

The National Hospital Care Survey from the National Center for Health Statistics could be used in combination with the MOPS-HP's index to evaluate how management practices relate to hospital utilization and patient care.

Data from the Surveys on Patient Safety Culture-Hospital Survey from the Agency for Healthcare Research and Quality could be used to study whether hospitals with more structured management practices have fewer patient safety events.

The MOPS-HP is a sample survey of approximately 4,500 establishments classified as a general medical or surgical hospital. The sample represents a universe of approximately 5,000 establishments, based on the Census Bureau’s Business Register and 2017 Economic Census data. Establishments were selected if they were classified as a general medical or surgical hospital and associated with a firm included in the Service Annual Survey’s (SAS) sample. The SAS unit response rate has been in the 65-70% range in recent years. We estimate the final unit response rate for the MOPS-HP will be approximately 70%. The Census Bureau will conduct the MOPS-HP on a mandatory basis under authority of Title 13, United States Code.    

Schedule:
 
Initial mail out                                                     November 2020
Respondent follow-ups                                            December 2020 – May 2021
Data collection instrument closeout            June 2021
Data analysis and tabulation                                    June 2021 – January 2022
Publication of press release                                    February 2022

MOPS-HP submission to OMB:  https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202007-0607-002  Click IC List for questionnaire, Click View Supporting Statement and Other Documents for supporting statement narrative on purpose, uses, collection and estimation methods, and schedule
Attachments A thru F and H:  https://www.reginfo.gov/public/do/PRAViewIC?ref_nbr=202007-0607-002&icID=242575

Point of contact:  Edward Watkins, U.S. Census Bureau, (301) 763-4750  Edward.E.Watkins.III@census.gov
 
The AEAStat primer on how to respond to a call for comments on a federal data collection is available at https://www.aeaweb.org/content/file?id=5806

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