DEVELOPMENT AND TESTING OF THE CAHPS SURVEY FOR CANCER CARE project that will lead to the development and testing of a cancer focused version of AHRQ?s Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. This survey (Cancer CAHPS) will facilitate the systematic assessment of patient perceptions of the quality of cancer care they receive in a variety of treatment settings. AHRQ is the lead federal agency for the development and dissemination of standardized, evidence-based surveys and related tools for assessing patient experiences with the U.S. health care system. AHRQ?s CAHPS program has become the focal point of a national effort to measure, report on, and improve the quality of health care as perceived by consumers and patients. Since 1995, the CAHPS consortium?a team of government health agencies, grantees, and contractors?have developed a number of ambulatory care and facility-based instruments, including those designed to obtain consumer assessments of care received through health plans, individual physicians, group practices, hospital, nursing homes, and a variety of other settings. Despite significant contributions made by the CAHPS consortium in advancing measurement of patient experiences with care, systematic evaluations of patient experiences within the context of cancer care remain limited. Given the tremendous impact of cancer and its treatment on cancer patients? and survivors? health outcomes, it is essential to understand patients? perspective on how well the health care delivery system meets both their medical and psychosocial needs. One of the missions of the NCI?s Division of Cancer Control and Population Sciences (DCCPS) is to ?coordinate and sponsor research to measure, evaluate, and improve patient-centered outcomes of cancer care delivery across the cancer care continuum.? A priority area of focus is research that would facilitate the delivery of patient-centered cancer care. Given that patient-centeredness is a cornerstone of the CAHPS family of surveys, DCCPS is proposing to collaborate with AHRQ in developing and testing the Cancer CAHPS patient survey. This survey will facilitate understanding of quality of care from the perspective of cancer patients and survivors during different phases of the cancer control continuum. In addition to support from DCCPS, the Cancer CAHPS project will be supported by AHRQ?s Comparative Effectiveness program and AHRQ?s Patient Safety program. The Comparative Effectiveness program is particularly interested in the development and testing of measures that assess patient perceptions of shared decision-making especially within the context of emerging treatment modalities for prostate, colorectal and breast cancers. The Patient Safety program is interested in facilitating measurement of patient safety issues and reports of adverse events from the cancer patient?s point of view. The Cancer CAHPS project would be conducted via a contract mechanism to be awarded by AHRQ in consultation with NCI, to one or more private-sector groups that participate in AHRQ?s Accelerating Change and Transformation in Organizations and Networks (ACTION) program. The contractor shall accomplish the following major aims of the project: a) develop and test a survey based on CAHPS survey design principles through which cancer patients and survivors can report on the quality of care they receive in different care delivery settings;b) develop and test formats for reporting data from this survey to cancer patients and other audiences;c) prepare and submit a package to obtain use of the CAHPS trademark;d) work with AHRQ and NCI to develop and implement a dissemination plan;and e) submit the completed survey to the National Quality Forum (NQF) for approval. n order to accomplish the goals of the Cancer CAHPS project, AHRQ and NCI would work collaboratively to select one or more potential contractors from within the membership of AHRQ?s ACTION program. While the contract would be administered by AHRQ, the NCI project officer will, along with the AHRQ Task Order Officer (TOO), serve as co-scientific lead for the federal government. Core tasks to be conducted by the contractor in collaboration with and after approval of AHRQ and NCI staff, may include but are not be limited to the following: Task 1: Arrange a kick-off meeting with AHRQ/NCI staff to finalize the scope of work, table of deliverables, timeline for all activities and deliverables, and to discuss a strategy for developing the survey content. Task 2: Schedule regular conference calls and meetings with AHRQ/NCI staff to review progress and plan next steps. Task 3: Develop first draft of the survey. The contractor will conduct a series of activities that would result in the development of the core survey and supplemental item sets in a way that adequately address AHRQ and NCI priority areas identified for the Cancer CAHPS survey such as patient-centered care, shared decision-making, patient safety, etc. These activities may include but are not limited to: ? Conduct a literature review and an environmental scan to locate surveys from both published literature and unpublished sources that assess patient experiences with cancer care. ? Publish a call for measures in the federal register to invite organizations and individuals who have developed surveys or survey items on the focal topics of this project to submit them for inclusion in the Cancer CAHPS Survey. ? Identify and convene a Technical Expert Panel to advise on survey content and administration, and facilitate access to organizations/individuals who can participate in cognitive or field testing. ? Plan and conduct focus groups as needed with cancer patients, survivors, and clinicians to inform the content of the survey. ? Develop and test a Spanish language version of the survey. Task 4: Develop Office of Management and Budget (OMB) package and seek Institutional Review Board (IRB) approval for conducting cognitive tests and field administration. Task 6: Plan and conduct a field test of survey items. The contractor will develop and implement plans for field testing of survey items. The plans will include at least these elements: description of testing goals;criteria for selection of participants, sites and recruitment procedures;survey administration procedures;sampling plans for each testing situation;and how testing data will be analyzed and reported. The contractor will ultimately be responsible for development of all materials contained in CAHPS Survey Reporting Kits. Task 7: Draft and test formats for reporting data. The contractor will work with AHRQ/NCI staff to design and test a format or formats for reporting the data to consumers, cancer patients and treatment facilities. To accomplish this, the contractor will perform at least these tasks: ▪Identify specific audiences who will use the reports and for what purposes ▪Determine if more than a single reporting format is needed ▪Perform factor analyses of field test data to determine first draft composites ▪Develop language to explain composites to report users ▪Test first draft composites with users and retest if necessary ▪Finalize composites, descriptions and explanatory language Task 8: Prepare a package to obtain use of the CAHPS trademark. The contractor will prepare a package to submit the final survey to the CAHPS consortium (AHRQ and the current CAHPS grantees) to request use of the CAHPS trademark. To maximize chances that this request will be granted, the contractor will develop the survey in accordance with CAHPS survey design principles a variety of relevant audiences. Task 9: Prepare a package to obtain NQF approval. Task 10: Finalize the CAHPS Survey and Reporting Kit Prepare a package to obtain use of CAHPS trademark. The processes of obtaining the CAHPS trademark and NQF endorsement may result in refinements to the survey and related materials. The contractor will make all changes to Survey and Reporting Kit for the CAHPS Survey for Cancer Care resulting from these activities. These materials must be prepared in a format that will allow the User Network Contractor to upload them to the AHRQ website, where all CAHPS products are published. All materials must be 508C compliant. Task 11: Confer with CAHPS User Network Contractor. The current CAHPS User Network (UN) Contractor is Westat, a consulting firm with offices in Rockville, Maryland. The main purpose of this contract is to provide technical assistance to users of all CAHPS products. As part of the Cancer CAHPS project, the contractor will work closely with the UN contractor to ensure that the UN staff have adequate information about the Cancer CAHPS survey to provide appropriate technical assistance to potential users of the survey. Task 12: Work with AHRQ?s Office of Communication and Knowledge Transfer to develop a dissemination plan for the survey. Task 13: Prepare presentations and articles for publication. The contractor will work with AHRQ/NCI staff to prepare articles for publication about the development of the Cancer CAHPS survey. AHRQ/NCI scientific staff involved in this project will serve as co-authors as appropriate. In addition to the above core tasks, optional tasks for the contractor may be identified jointly by AHRQ and NCI staff.
