Medical Administrative Assistant: Module 8: Supplies, Logs, Schedules, and Other Compliance Requirements

Printers

A printer is required to produce hard copies from computer files. Two types of printers are appropriate for a medical office: inkjet or laser. An inkjet printer can print in different modes. In draft mode, less ink is used and the page can be printed faster. For a professional-looking finish, letter-quality mode is used and, therefore, the printing process is slower. The purpose of the draft setting is to conserve printer toner or ink when printing a large number of pages of a document that is not in its final stages. Inkjet printers cost less than laser printers, but their ink cartridges are more expensive, meaning that the ink cost per printed page is higher. Inkjet printers can be more economical in offices with a lower volume of printing. Laser printers are usually preferred in an office environment with higher printing volume. Additionally, the print quality is much better. Consult with your equipment supplier to see if a multifunctional copier can provide your printer function needs as well. If using a multifunctional machine, it would be best practice to have a backup machine or options available in the event of downtime

Evaluating the Reception Area

A safe environment begins at the front door. The reception room requires a safety check every morning to ensure that it presents no hazards for patients and visitors: Observe the physical environment of the reception room. Studies have shown that the reception room atmosphere can be a reflection of how patients perceive the office and their expectations. Atmosphere affects how people experience their environment and can have a relationship to their response to treatment. Check the temperature. The room temperature should ensure the patients' comfort. Look at the room's appearance. The presence of large plants and attractive paintings softens the office environment. The choice of color and lighting affects behavior. Soft colors and subdued light are calming. The use of relaxing background music has become commonplace in medical and dental offices. Aquariums can provide diversion. Many practices now have flat-screen televisions in the waiting area; some are tuned to health-related programming, others play "scenescapes" (e.g., ocean views and the sound of crashing waves), and some offer local programming suitable for all audiences. Try standing in the reception room and look around. Be conscious of the sights, sounds, and even smells you perceive. Observe the condition of the furniture carefully. Pay attention to chair and table legs—they must be stable and able to support appropriate weight. Perform a safety check. Remember to make a daily visual check of electrical devices, furniture, floors, and lighting before any patients arrive. Lamps and electrical cords should be examined. Bulbs should not dim or flicker, and cords should be in good condition with no evidence of fraying. Be sure lighting is adequate. Check the floor to be certain there are no carpet wrinkles or tears or anything lying on the floor that might cause someone to fall. Do not use decorative or throw rugs. Check the reading material. Neatly arrange magazines. Clean and sanitize reading materials that are shared by patients. Make them accessible in several seating areas. Remove torn and outdated material. Many providers have a prepared brochure that describes the practice, the office policies, and offers information regarding appointments, office hours, and other useful details. An assortment of informative, health-related pamphlets may also be offered in a display rack. Copies of professional medical journals or similar technical material are not appropriate for general display. Check the toys and books. If children's toys or books are provided, they require constant monitoring. All toys should be washable and of a safe design and material with no sharp edges or parts small enough for a child to swallow. The toys should be cleaned and sanitized often and regularly. During daily inspection, remove any broken or visibly soiled toys or books. If at all possible, the children's play area should be situated in a corner or within a half-walled space to contain things within a controlled area to reduce the possibility of adults falling over objects on the floor. In pediatricians' offices, there are usually two reception rooms, or at least a room with a separate section, each with its own play area. One is considered the "well" area, and the other is the "sick" area to separate children with fevers, coughs, nausea and vomiting, diarrhea, and other disease conditions from the well children. Display the smoking policy. Confirm that the Smoke-Free sign is displayed and policy is enforced.

Opening the Office

A well-prepared, organized, and tidy office environment is immediately noticed by patients, providers, and visitors. The surroundings set the tone of the office and the first impression and level of professionalism anticipated. Preparation procedures can differ according to the type of practice, number of providers, weekly schedules, and many other variables. A checklist, specific to your office, should be created and followed to ensure that you cover all daily functions of opening, operating, and closing the office. Arrive at the office in time to open the office and make preparations for receiving patients

If children's toys or books are provided, they require constant monitoring. Which of the following statements is not accurate?

All toys should contain parts small enough for a child to swallow.

Appropriate Attire

Appropriate attire is a necessity as a medical assistant at all times. A reminder about jewelry and hairstyles must be discussed here for safety reasons. Excessive jewelry is not only inappropriate but could present a dangerous situation; for example, jewelry could get caught on a piece of equipment or harbor pathogens in the crevices of the metal. When you are dealing with babies for their checkups and often when they are ill, they can be tempted to pull at dangling earrings, necklaces, and bracelets. This is a danger for many reasons: The jewelry could break, which could result in an injury to both you and the child; the pathogens that are on the jewelry could be transmitted to you or the child; or you could transmit the microorganisms from one patient to another. Remember that you cannot see microorganisms without a microscope, but they are everywhere. Another safety consideration is how you wear your hair. Both male and female medical assistants who have long hair must keep it worn back and secured because of a chance that a patient could grab it. Hair jewelry and ribbons should be conservative and, if worn, cleaned periodically to reduce the possibility of disease transmission. Remember: The health status of the patients is unknown in most cases. A patient can be susceptible and become infected with a microbe from the medical facility during a routine office call.

Inspecting Examination Rooms and Lab Areas

At the beginning of the day, visually inspect all exam rooms for cleanliness (Figure 24-3), even if they were cleaned the previous day, as the provider might have seen a patient after hours. Replace table paper if warranted and be certain waste receptacles are emptied. Observe room temperature and plug in any disconnected electrical equipment. Confirm everything is in working condition. Restock supplies so that needed materials are available. Maintain an inventory control sheet (checklist) and select a set day of the week as restocking day. Of course, you will restock as necessary on a daily basis. Check common areas and ensure they are clean and everything is in order. Check the water level in the autoclave and turn it on. Be sure hazardous waste disposal containers are available for use in all areas where needed. Children, and some adults, have a natural curiosity about things in the examination room, cabinets, or on counters. Anything that might be hazardous or could become contaminated should be kept out of sight. Prescription pads should not be left lying around; they should be kept in a secure, locked area. Secure all electrical cords in the examination rooms so they will not interfere with movement or walking in the room. Chemicals kept in the office for laboratory work must be properly labeled and stored. Chemicals that could become volatile when kept beyond their expiration date must be monitored carefully. Testing patients' urine, blood, and other specimens requires special procedures. Containers for the disposal of used equipment and biohazardous waste receptacles must be readily accessible. A strict adherence to standard precautions is essential to the maintenance of a safe and healthy lab environment.

Closing the Office

At the end of the day, each examination room should be restocked and cleaned, and discarded material should be placed for pickup. This saves time the next morning. Charts must be collected, checked for completeness, and filed in a locked cabinet. If there is not time to file, place charts in a separate area (basket, file cabinet, and so on) designated for charts to be filed and place them in the cabinet to be filed the next day. Some physicians dictate their notes, which must first be typed and placed in the chart before it can be filed. The need to refile paper charts is eliminated with the use of an EHR; however, documents not created or received electronically into the EHR will need to be scanned. All electrical appliances and the autoclave must be turned off, including computers. If you are using a network computer system supported by a larger health care facility or IT department, you need to know the requirements for computer shutdown at the end of the day. It is the office manager's responsibility to confirm (or develop) IT policy concerning computer usage and enforce compliance that is so critical to patient privacy and HIPAA guidelines. It is each staff member's responsibility to follow this policy and never share their password. At the very least, all providers and staff will be required to log off all applications and software programs at day's end. In some cases, the computer may be left powered on for patches and updates to be pushed through. Receipts collected during the day can be taken to the bank for deposit or locked in the office safe. Tidy the reception area and sanitize it. If you have a cleaning service, be sure to inspect for proper cleaning of the entire office suite and report any deficiencies. Pull and prepare charts for the next day. Place consultations, lab and hospital reports with the charts, and then place the charts at the front desk (reception area) for check-in. For offices with an EHR it is best practice to view and print the schedule for the next day, and time permitting, review the patients' electronic charts to see if there are any orders outstanding or any documents that need to be scanned in to the chart. Provide any original documents received for each patient to your provider for his or her review and validation prior to scanning. Always take a walk through the office to complete your checklist of things to do. Activate your answering system, securely lock all the doors and windows, close blinds, activate the alarm system, and turn off the lights. Be aware of your surroundings as you leave the office. Try always to leave with a coworker, rather than leave alone, for safety reasons. If you must leave the office after dark or alone, ask a building attendant for assistance if available.

Safety and security is of high concern in a medical office. A safe environment begins at the front door. The reception room requires a safety check every morning to ensure that it presents no hazards for patients and visitors. Which of the following should be performed when evaluating the reception area?

Check the temperature. Clean and sanitize reading materials that are shared by patients. Remove any broken or visibly soiled toys or books.

Computer Security (continued)

Electrical surges and power outages can destroy information currently being used by the computer if it has not yet been saved by the operator or automatically by the program. Loss of data due to electrical surges and power outages can be prevented by the installation of a protective device known as an uninterrupted power supply (UPS), which contains a battery backup system. A UPS is capable of sensing a surge or outage and automatically switches to a backup battery to preserve the data. The size of the battery determines the length of time the electronic equipment can be sustained. The primary purpose is to allow you time to save your document, exit the program, and shut down your system until the power is again stable. It is very important to establish a backup policy to make copies of office programs and data. Often, this is performed each night. Most online web applications (cloud-based) will back up and refresh continually. Computer hard drives can crash, causing the loss of all programs and stored data. Programs and extensive data can be copied by a peripheral tape backup device, thereby providing a durable copy of information. All central computer data should be backed up on tape or by way of an external backup system daily, such as an off-site facility to protect against loss of files from fire or natural disaster.

________________are used by hospitals, providers' offices, and clinics to send and receive information over telephone lines.

Facsimile (fax) machines

Fax Machine (Facsimile)

Facsimile (fax) machines are used by hospitals, providers' offices, and clinics to send and receive information over telephone lines. The machine makes it possible to send and receive letters, medical reports, laboratory reports, and insurance claims. Providers can use the fax machine to receive and send prescription orders to pharmacies, and the office can also use it for ordering office or medical supplies. Learn the specific procedure for operating the fax machine you will be using. Following are general rules that are important for the use of any fax machine: Always remove paper clips and staples from material to be scanned so you will not damage the fax machine. Make a test copy if the document has color. Dark colors may not copy well and can slow transmission. Do not use correction tape or fluid on documents to be transmitted. Do consider using typed words for numbers to avoid problems with interpretation. If the material you are faxing is confidential, before sending it, call to alert the recipient to be ready to receive the material. The first sheet of any transmission is called the fax cover page. It includes the date, name of recipient, recipient's address and fax number, and the number of pages being sent (including the fax page). The name and fax number of the sender is also included. Any special information required for routing instructions should be added. The fax page (or cover sheet) should also include a confidentiality notice. Be familiar with error messages the fax machine might display, and learn how to correct these problems. The machine might be equipped with built-in service diagnostic codes that can be automatically transmitted over telephone lines to a service provider. Most service calls can be resolved by telephone, therefore reducing costly equipment downtime and labor costs. You might need to resend a message if noise or interference on the telephone line resulted in an unclear transmission or the transmission's not going through. Wait until the transmission is completed. The display will indicate that the message was sent, identifying the date and time of transmission. Remove the original from the machine. Many EHR programs have fax capabilities integrated into the software. For example, Harris CareTracker has MyFax technology to enable secure online faxing. Harris CareTracker automatically generates a cover sheet for faxes. The cover sheet displays the name, address, and phone number of the fax sender and recipient, the date and any text entered in the Notes box when the fax was created. You have the option not to include the cover sheet.

Federal and State Regulations

For the protection of employers and employees, federal and state agencies have established legislation dealing with policies, procedures, and guidelines to reduce disease transmission A number of governmental agencies and regulations they relate to law as they relate to infection control) are involved in the promotion of safety and security in the health care industry, such as the Occupational Safety and Health Administration (OSHA), the Centers for Disease Control and Prevention (CDC), the Clinical Laboratory Improvement Amendments (CLIA), and fire regulations.

_________________consists of the computer workstation and tablets, printers, PDAs, smartphones, scanners, and modems.

Hardware

Office Equipment

In addition to computers, a variety of machines and equipment are required to manage the business operation of a medical office. Large multi-provider offices and clinics have more patients and employees and therefore require a greater number of machines and larger-capacity equipment. Smaller offices and single-provider practices might have less-specialized equipment.

Personal Safety

In addition to safety precautions taken in the workplace, it is a good idea to develop a personal safety plan, both as an employee in a medical office and in your personal life. As an employee, develop a safety checklist that includes: Always using appropriate PPE. The type of PPE will vary according to the procedure performed, and you will need to be able to select the correct types of PPE for the procedure. Knowing where SDS sheets are and how to read them. Knowing where fire extinguishers and eyewash stations are located and how to use them. Fire extinguishers should be present, easily accessible, in good working order, and labeled with inspection date. Operate a fire extinguisher by using the PASS acronym (discussed later in this chapter). Eyewash stations should be present and have documentation of performance of routine maintenance/inspection Always disposing of sharps in puncture-proof, labeled sharps containers. Do not overfill sharps containers. Knowing the proper protocols for use of biohazard and standard waste receptacles. Being aware of your physical surroundings at all times for general safety. Ensure that electrical cords are not frayed; floors have no rolled edges, cracks, or damage; and electrical outlets are not present near water and have ground fault interrupter (GFI) rating. It is also helpful to research methods and tools to prepare for safety in your personal life. For example: Develop a plan for your family in case of an environmental emergency such as tornado or flood. Develop an evacuation plan for your family in case of fire.

Which of the following has the U.S. Department of Justice, Civil Rights Division-National Task Force on Violence Against Health Care Providers recommended for medical facilities?

Install dead bolt locks on office doors leading to hallways and other public areas.

Safety Signs, Symbols, and Labels

It is important to monitor the compliance of proper storage and disposal of supplies and specimens according to standard precautions and OSHA guidelines. It is equally important to be able to recognize and comply with posted signs, symbols, and labels. Perform a review of the facility to ensure the following: Refrigerators used to store reagents, test kits, or biological specimens are labeled with a biohazard symbol and bear the legend, "Not for Storage of Food or Medications." Biohazard waste receptacles bear the biohazard symbol and are lined with red plastic bags. Biohazard waste should be disposed of in an appropriate receptacle only. Chemicals and reagents are evaluated for hazard category classification and labeled with the HCS labels Signs are clearly posted in appropriate places for prohibiting smoking, eating, drinking, or application of cosmetics or contact lenses in the facility.

Children, and some adults, have a natural curiosity about things in the examination room, cabinets, or on counters. Which of the following steps should be taken to ensure safety?

Keep out of sight anything that might be hazardous or could become contaminated. Lock prescription pads in a secure area. Secure all electrical cords in the examination rooms so they will not interfere with movement or walking in the room

Always take a walk through the office to complete your checklist of things to do when closing the office. Which of the following is not a step in closing the office?

Leave the blinds open for cleaning crew to sanitize.

At the end of the day you will be responsible for closing the office. For offices using EHR, what should you do with your computer or tablet?

Log off but keep power on so that the IT department may push through patches or updates.

_________________open more than one file drawer in a vertical file at a time; the unbalanced weight could cause the cabinet to _______________.

Never; tip forward

The U.S. Department of Labor established regulations through_____________ that require employers to provide employees with safe working conditions to protect them from harmful exposure and substances.

OSHA

What application software allows patients to communicate with the practice and providers, using a secure username and password?

Patient portals

Which of the following would not be considered a way to protect patient privacy?

Place fax machines in a visible area in the office.

Which type of software allows a medical office to schedule appointments, record patient demographics and insurance information, verify eligibility, scrub outgoing claims prior to submission (maximizing "pay at first pass"), process claims, check claim status, monitor contracts for underpayment, and generate financial reports?

Practice management software

Clean a Spill

Purpose: Clean a spill (when blood or other body fluids are involved), observing universal precautions. Equipment: Gloves, eye protection, plastic apron with sleeves, hair and shoe covers, biohazard bags, disinfectant, and paper or cloth towels and/or spill kit. Skill: Select appropriate barrier/personal protective equipment (PPE) Skill: Participate in a mock exposure event with documentation of specific steps Skill: Demonstrate proper use of sharps disposal containers Skill: Demonstrate proper disposal of biohazardous material: sharps and regulated wastes Procedure Steps: 1.Select and apply appropriate barrier or personal protective equipment. Wear eye protection (mask and face shield). Wear protective plastic apron with sleeves. Wear protective hair and shoe covers. Wear gloves. 2.Locate the office spill kit or other appropriate cleaning supplies and follow office protocol for cleaning spills. Follow instructions on the spill kit appropriate to the hazard. Be sure to leave cleaning fluids on the affected area for the appropriate amount of time. 3.Thoroughly clean area with an effective disinfectant or a 10 percent solution of household bleach. Soiled paper towels or cloths should be placed in the hazardous waste container. 4.If the spill involves bodily fluids, dispose of materials in biohazard waste container. Place any contaminated paper or cloth towels in the leak-proof biohazard bag. Place a second bag around it and place in biohazard container for disposal. 5.If glass fragments or sharps are involved, use a brush or broom and dustpan to clean up items and place in a puncture-proof biohazard sharps container. Never place your fingers or hand into the top of the sharps container (as an accidental exposure could occur).Sharps containers must be easily accessible to employees and located as close as feasible to the immediate area where sharps are used. The container must be closed using the locking mechanism in the container when the sharps reach the full line indicated on the container. 6.Document the incident, findings, and actions taken, and then date and sign.

Perform Routine Maintenance of Administrative or Clinical Equipment

Purpose: Inspect each item for cleanliness and safe condition and ensure operability. Provide routine maintenance. Note and report any equipment requiring repair. Equipment: Equipment list, clipboard, pen, and access to any necessary maintenance supplies. Skill: Perform routine maintenance of administrative or clinical equipment 1.Assemble equipment and supplies. 2.Inspect each item on the list for cleanliness and record findings. If not clean, clean the item appropriately. 3.Demonstrating self-awareness to an emergency situation, check the equipment for safety factors : Electric cord and plugs Loose screws or bolts 4.Check for operability: Test any light source; replace burned-out bulbs. Inspect items for wear; order replacement parts. Briefly operate seldom-used equipment. Operate seldom-used equipment to ensure that it is in working condition if needed. 5.Check required operational standards: Freezer temperature Refrigerator temperature Autoclave test strip 6.Correctly fill out the equipment maintenance checklist, sign it, and submit it to the appropriate person for action. Write the date on the maintenance checklist. Note and report equipment that requires repairs.

Perform an Inventory of Equipment and Supplies with Documentation

Purpose: Perform a supply inventory; arrange any items that are time sensitive in front; count the number of items in storage and accurately record on the list. Equipment: Clipboard, supply inventory checklist, paper, and pen. Skill: Perform an inventory of equipment and supplies with documentation 1. Enter the date on the form. 2. Check the package dates on time-sensitive materials. Arrange the supplies with the first to expire in front. 3. Count each category of items on the inventory list and complete the form. Enter the number of items left in storage in the appropriate place. Note on the form the supplies below the minimum amount. Sign the form. 4. Give the completed form to the appropriate person to order supplies (if you are not the designated person).

Open the Office and Evaluate the Work Environment to Identify Unsafe Working Conditions

Purpose: Role-play the actions necessary to prepare a medical office to receive patients. Equipment: A simulated office, if available; in a classroom or lab setting, role-play, explaining the procedure. Skill: Evaluate the work environment to identify unsafe working conditions Procedure Steps: 1.Unlock the reception room door. 2.Evaluate and prepare the reception room for cleanliness, comfort, and safety. Adjust heat or air conditioning. Check for safety hazards: Check for frayed electric wires, damaged furniture, or objects on the floor that might cause patients to fall. Check magazines for condition and date. 3.Prepare the front desk area. Turn on computers, printers, and scanners. Check the telephone answering device or call the answering service for any messages. 4. If working in a paper-based office: Pull the charts of patients to be seen. Check each patient's previous visit to see whether any studies were ordered and place results into chart. If working in an EHR office: Review the patient schedule, check for previously ordered studies, and scan to chart. (Provide original copy to provider for review and validation prior to scanning.) Check the patient's previous visit to see whether any studies were ordered and attach to (or place into) chart. Results must be filed in or attached to the chart before the patient is seen, or confirmed as received in the EHR. 5.If it is the policy of the office, prepare a list (or print from the practice management system) of the patients to be seen by provider and the times of their appointments. Place copies in designated areas. 6.Inspect and prepare exam and lab rooms for cleanliness and safety. Check examination rooms to be sure they are clean, safe, and stocked with supplies. Check exam rooms in case the provider saw a patient after office hours. Fill and turn on sterilizer. Prepare hazardous waste disposal containers. 7.List three to five safe working conditions identified: 8.List three to five unsafe working conditions identified:

Close the Office and Evaluate the Work Environment to Identify Unsafe Working Conditions

Purpose: Role-play the actions required to close the office; evaluate the work environment to identify unsafe working conditions and respond appropriately to patients with abnormal behavior patterns. Equipment: A simulated office if available; otherwise, role-play, explaining the procedure to close the office. Skill: Evaluate the work environment to identify unsafe working conditions 1. Verify that all patients for the day have completed their visit and left the office. With a coworker check each room (exam rooms, restroom, waiting room, etc.) to verify that each patient has completed his or her visit and left the office. You do not want to be alone or leave any unattended patient in the office to prevent any emergency or hazardous work environment. 2. Check to see that records are collected and filed in locked cabinets. 3. Demonstrating professional behavior, place any money in the safe or take to the bank to be deposited. 4. Turn off all electrical appliances and computers. Many offices also ask you to unplug electrical appliances. Eliminates the chance of electrical fire. Note: Depending on your IT support center, computers might need to be left turned on but logged off so that software patches and updates can be installed. 5.Check that rooms are cleaned and supplied for the next day. Straighten reception room if time allows. 6. For paper offices: Pull charts for the next day if time allows and prep with lab reports, consults, or available hospital reports. For paperless offices (EHR): Review the next day's schedule for previously ordered studies. Scan to patient EHR chart; provide original to provider for review and validation prior to scanning. 7.Activate the answering device on the phone or notify the answering service and indicate when you will be back in the office. 8.Close and lock all access doors to office. Check that all windows are closed and locked and blinds shut. Turn off lights. Activate alarm system. If necessary, demonstrate self-awareness to an emergency situation. 9.Set the lock and close the door; check to confirm that it is locked. If necessary, demonstrate self-awareness to an emergency situation.

Demonstrate Proper Use of Eyewash Equipment

Purpose: To demonstrate the proper use of the eyewash equipment to be ready for the event of an accidental chemical exposure to the eyes. Equipment: Eyewash station and quality control log. Skill: Demonstrate proper use of eyewash equipment Procedure Steps: 1.Locate the eyewash station and make sure it is accessible and in proper working condition. Locate the eyewash covers and verify functionality. Check that the flow of water is working properly by pushing on or pressing the faucet handle. Verify that both streams of water are equal from both sides and that they cross each other. 2.Check that the bowl is free of rust/trash and that water drains from the bowl. 3.Document in the quality control log.

Comply with Safety Signs, Symbols, and Labels

Purpose: To ensure that designated laboratory areas, chemicals and reagents, and equipment such as the refrigerator and biohazard waste receptacles are labeled appropriately. Equipment: OSHA Hazard Communication Standard Labels and appropriate safety signs. Skill: Comply with safety signs, symbols, and labels Procedure Steps: 1.Ensure the refrigerator used to store reagents, test kits, or any biological specimens is labeled appropriately. Label refrigerator with a biohazard symbol that bears the legend "not for storage of food or medications." 2.Ensure the biohazard receptacles are labeled appropriately. Biohazard waste receptacles must bear the biohazard symbol and are lined with red plastic bags that also bear the biohazard symbol. 3.Ensure all chemicals and reagents are labeled appropriately. Chemicals and reagents are required to have a pictogram, signal word and precautionary statement, the product identifier, and supplier identification. 4.Ensure all designated areas within the facility have the proper signage in place. Signs are clearly posted in appropriate places for prohibiting smoking, eating, drinking, or application of cosmetics or contact lenses in the facility.

Complete an Incident Report Related to an Error in Patient Care

Purpose: To provide documentation required by the risk management department in the event an error occurs in regard to patient care. Equipment: Unusual Occurrence Form (UOR) form, pen. Skill: Complete an incident report related to an error in patient care Skill: Perform risk management procedures Procedure Steps: 1.Report the incident immediately to a supervisor for documentation. This helps determine whether an incident that does not meet safety standards or the standard of care, or routine operations of a provider that deviate from regular operations or established procedures occurred, and the proper protocol according to your facility can be followed. 2.Assemble equipment. Obtain the UOR form and a pen. 3.Fill in the demographic information about the patient. This includes the full name, gender, address, diagnosis, date of birth, attending physician, primary care provider, and insurance information. 4.Fill in location of the event. This includes the name of the practice or hospital name, or other if it occurred elsewhere. 5.Complete the section regarding information about the patient factors prior to the event. This includes the condition and state of the patient (check all boxes that apply). 6.Fill in the categories of event section. Check all boxes that apply. 7.In the space provided, give a written description of the event. Describe how the incident occurred. Examples: "Incorrect medication was administered to the patient"; "Patient given incorrect time to come back for a follow-up." 8.Add any additional persons involved. Include their full name, address, and telephone number. 9.Complete the review section. Indicate if the medical record reflects the event accurately including the patient's status both pre and post event and the effect or outcome of the event. 10.Complete the corrective action section. Attach a copy of the policy and procedure affected. 11.Complete the procedures followed section. Check all boxes that apply. 12.Complete the family/patient attitude after the event section. Check all boxes that apply. 13.Add any additional information that may be warranted and obtain signatures, titles, and dates. Name and signature of the person who prepared the document as well as the signature of the supervisor and/or manager and dates must be obtained. 14.Forward form to the risk management department following the office protocol so proper action can occur.

Safety in the POL

Regarding the collection of specimens, the safety of all patients and health care providers is foremost. As you learned in previous chapters, prevention of disease is of vital importance in preparation for these clinical tasks. You must be alert and conscientious in the performance of your duties to avoid disease transmission. Remember to practice standard precautions, including proper hand washing, with each patient when you collect or handle a specimen. Hand washing is critical in preventing cross-contamination between patients, patients and health care workers, specimens and patients, and specimens and health care workers. The credibility of each individual is challenged by compliance of standards and guidelines set by regulatory bodies. In most situations, you are the only one who will know if you did or did not follow standard precautions and quality assurance recommendations. You must keep your mind on your work and pay attention to detail to protect yourself and others from possible contamination.

Computer Security

Regardless of whether your office has EHR software or not, you must employ best practices for safe computer use. There are a number of considerations for security: Physical access (computers, screens, printers, fax, copier, etc.): You must take action to protect patient information from being viewed by unauthorized users. Use screen privacy shields and automatic screen savers; place equipment out of high-traffic and visual sight areas. Use passwords for each computer and software application, and set applications to log off automatically if inactive for a specified period of time. Catalog all information system components: Hardware: Computer workstation and tablets, printers, PDAs, smartphones, scanners, modems Software: Operating system, billing software, practice management, email, EHR, database Network: Routers, hubs, phone and cable lines, wireless, firewall software and hardware Back up data to ensure integrity from loss, disaster, human error, hard-drive error, virus, or equipment damage. Use the appropriate level of secure backup for the practice: Tapes CDs Off-site (examples include the "cloud" and "web-based" applications, such as Harris CareTracker PM and EMR) Keep network and communication safeguards intact: To defend against attacks and viruses, install firewalls (hardware and software devices that protect an organization's network from intruders). A firewall denies access to unauthorized users and applications, and creates audit trails or logs that identify who accessed the network and when. Firewalls also issue alarms if repeated unsuccessful attempts or abnormal activities occur. Keep antivirus software up to date: Viruses attach themselves to emails, program files, and data files. Be vigilant in keeping antivirus software current. Operating systems programs they run can be inherently open to attack. Understand encryption: HIPAA security standards require you to assess whether unencrypted transmissions of health information are at risk of being accessed by unauthorized entities. If they are, some form of encryption should be considered. Examples are: Patient billing and information exchanged with payers and health plans Usage and case management; authorization and referrals Patient health information gathered from or displayed on a website or portal Lab and other clinical data electronically sent to and received from outside labs Word processing files used in transcription and transferred electronically Emails between providers and patients or between attending and referring providers and their offices Vendor and business relationships chain of trust: Demand that all vendors and business partners fully understand and comply with the HIPAA security standards. Access and security levels to EHR should be monitored and tracked

When considering a room's appearance, which of the following is regularly used to provide an inviting environment?

Relaxing background music and large plants.

Security in the Medical Office

Safety and security is of high concern in a medical office. A criminal can target cash from daily receipts or drugs kept on-site. Unfortunately, physical or sexual assault can also occur when the interior office is accessible from unlocked outside access or the reception area. The U.S. Department of Justice, Civil Rights Division-National Task Force on Violence Against Health Care Providers, has recommended that medical facilities "install dead bolt locks on office doors leading to hallways and other public areas, consider installing a 'buzzer' entry door system (on door between waiting room or reception area and examination rooms or office areas) [and] managers should issue and control keys, conduct semi-annual inventories, and have locks changed when keys are missing." These types of locks provide a degree of security. Any opening between two areas, such as a window, should also be fitted with a security device to prevent unauthorized access. If there are private entry doors, be certain they are kept locked at all times. If you must enter or leave the office when dark, be especially alert. The outside area should be well lit. If building security personnel are available, ask for an escort. Many offices are equipped with electronic security systems. In addition to the private records of patients, many valuable items (computers and medical and office equipment), cash receipts, drugs, and medications are in the office. Security systems can vary from keypad entry with alarm to a sophisticated alarm with camera. If you are the first staff member to arrive at work, it will be necessary to enter the code before opening the door or enter the code on an internal keypad before the entrance delay period expires. Both these systems lend a feeling of safety and security, but be aware: It takes only a few seconds for someone to grab your purse or wallet or force you to hand over office money or drugs. Never enter the office if you see evidence of forced entry or if it appears that someone might be inside or has been inside. Leave at once and call building security or the police.

Safety Data Sheets

Safety data sheets (SDSs), formerly known as material safety data sheets, provide information about working with or handling a particular chemical substance. The information contained in the SDS is very similar to that of the MSDS, although the SDSs are required to be presented in a consistent user-friendly, 16-section format. The U.S. Department of Labor, through OSHA, created SDSs so employers and employees receive materials regarding the hazards of any chemicals and products they encounter and to ensure that all chemicals produced or imported are evaluated. Additionally, comprehensive hazard communication programs must be put in place to deliver the information, and they must include container labeling and other forms of warnings, safety data sheets, and employee training. These forms provide information on health hazards of the substance, precautions for safe handling, control measures to take, emergency and first aid procedures, and more. Sections 1 through 8 contain general information about the chemical, identification, hazards, composition, safe handling practices, and emergency control measures. Sections 9 through 11 and 16 contain information such as physical and chemical properties, stability and reactivity information, toxicological information, exposure control information, when the contents were prepared, and the date of the last revision. Sections 12 through 15, to be consistent with the UN Globally Harmonized System of Classification and Labeling of Chemicals (GHS). SDS documents should be provided with any product when ordered by your supply company. Additionally there are online sites available for free and for purchase where you can access updated forms. SDS forms must be current and easily accessible in the medical office.

Smartphones and Pagers

Smartphones: Providers use smartphones or pagers so they can be contacted regardless of where they are or what they are involved in. A smartphone is a cell phone that also has features similar to a personal digital assistant (PDA) or computer, such as the ability to send and receive email and access the Internet or other software programs. Online patient-physician communication is becoming more common. According to a report from Manhattan Research, about 39 percent of physicians now have electronic communications with their patients, a 14 percent increase since 2006. By 2012, it was estimated that 81 percent of physicians owned and used a smartphone. Emerging technologies and the use of social media will further impact the use of mobile devices and how they are incorporated in the medical field Pagers: A pager is a small electronic device that can receive (and sometimes transmit) signals and short messages. If the provider uses this technology, you would dial the pager number and enter the phone number from which you are calling. This transmits the number to the pager, and the phone number of the caller and the message will be displayed.

encoder

Software application that allows searching or browsing within CPT, HCPCS, ICD-9-CM code sets, and Medicare coding guidelines.

Which of the following governmental agencies has established federal regulatory standards regulating all laboratory testing (except research) performed on humans in the United States?

The Clinical Laboratory Improvement Amendments (CLIA) of 1988

CLIA

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 established federal regulatory standards regulating all laboratory testing (except research) performed on humans in the United States. This governmental agency also establishes regulations for the safety of patients and health care workers. It is their responsibility to ensure that the public is safeguarded by regulating all testing of specimens coming from the human body. All clinical laboratories must adhere to the strict regulations set forth by the legislation.

Global Harmonized System (GHS)

The GHS is a new, single unified system for standardizing and harmonizing the classification and labeling of chemicals, making it more effective, consistent, and easier to understand. It has a more reasonable and complete approach to: Defining health, physical, and environmental hazards of chemicals; Creating classification processes that use available data on chemicals for comparison with the defined hazard criteria; and Communicating hazard information, as well as protective measures, on labels and safety data sheets (SDS).

OSHA

The U.S. Department of Labor established regulations through OSHA that require employers to provide employees with safe working conditions to protect them from harmful exposure and substances. Standards such as the Bloodborne Pathogens Standard regulate the provision of PPE to safeguard employees during patient contact amongst other safeguards. The Hazard Communication Standard (HCS) states employers must develop, implement, and maintain at the workplace a written, comprehensive hazard communication program that includes provisions for container labeling, collection and availability of safety data sheets and an employee training program.

CDC

The U.S. Public Health Department operates the CDC in Atlanta, Georgia. It is the CDC's responsibility to collect data on pathogens and diseases and establish guidelines to prevent their spread. The CDC has developed a system of classifications or categories of infectious diseases related to their method of spread. It was this agency that established guidelines concerning contact with blood and body fluids, referred to as universal precautions. These guidelines were developed to control the spread of hepatitis and AIDS. Universal precautions have since been incorporated into guidelines called standard precautions. These expanded precautions set infection control guidelines to be used by all health care professionals when caring for patients.

Copy Machine

The copy machine is extremely important to the efficiency of the office. A photocopy of correspondence, an insurance form, or patient's insurance card, a patient's record, laboratory reports, or account information is often needed. Frequently, prepared literature, information sheets, and initial information forms require copying. In addition to copying documents, newer copy machines have wireless capabilities and can print documents sent from computer(s), and scan and fax documents directly. Care should be taken to avoid copying material that carries a copyright protection because this is considered illegal unless permission to copy is obtained from the writer or publisher. Routine maintenance will improve the quality of copies. Offices frequently have service and supply arrangements with vendors of equipment and copy materials. Service representatives can demonstrate how to clean the glass, feed rollers, and surfaces, and how to maintain the toner. Large copiers can be programmed to perform several functions such as enlarging or reducing copy size, stapling, sorting, off-set stacking, one- or two-sided copying, and insertion of cover sheets. Ask for additional instruction before attempting to perform these functions. If there is a paper jam or the copier is in some way inoperable, it might be necessary to call the technician for service. One of your duties may be to provide routine cleaning and maintenance of the copier. Each morning, the glass and rollers should be cleaned and the exterior wiped of dust or smudges. Pick up any discarded paper clips or staples that might get into the copier. The paper supply should be filled and the toner checked and replaced as needed. Depending on the model, some toner cartridges can be refilled by a service provider at reduced costs. Always have at least one or more replacement cartridge in reserve, depending on the amount of copying done in your office. Newer models of office copy machines are capable of serving as printers and scanners, in addition to simply making copies, and can be connected directly to the office computer network. Instead of a document being sent to a printer and then using the copier to make copies, the printer is built into the copier, thereby eliminating one paper copy and one peripheral piece of equipment. A copy machine can produce copies at a much lower cost than a printer, and the features of speed, collating, off-set stacking, and more can be very time-saving. The all-in-one printer, fax, scanner, and copy machine is connected to the computer and replaces four individual pieces of equipment.

Infection Control and Personal Safety

The effort to reduce or eliminate exposure to harmful organisms is known as infection control. All types of health care settings and personnel must maintain procedures to control the transmission of organisms. By the very nature of the services provided, health care workers are constantly coming into contact with patients who are ill or who might have contagious diseases. The patients in this setting are also exposed to organisms from other patients. It is extremely important for the health and safety of all concerned to prevent the spread of these organisms. All health care workers must practice standard precautions to protect themselves against acquiring HIV, hepatitis B, or other infectious diseases. This means the appropriate use of gloves, face shields, masks, protective eyewear, aprons, and gowns as needed. Persons likely to be in an emergency situation also need to use mouthpieces, ventilation bags, and other ventilating devices to avoid direct contact with saliva or possible blood due to an injury.

interface

The hardware and software that enable individual computers and components to interact

Fire Regulations

The local fire department will conduct routine walk-throughs of the facility to verify compliance with fire codes. This should be done when first moving into an office, prior to seeing patients. In addition, you should receive an annual inspection. A courtesy inspection is often available by contacting your local fire department. At all times, fire extinguishers should be inspected and labeled, smoke alarms should work properly, and any other safety hazards addressed. Be sure to evaluate the fire extinguisher(s) rating in your office and be able to operate it according to the manufacturer's instructions.

Equipment Maintenance

The medical assistant might be asked to keep track of equipment maintenance because a number of administrative office and clinical equipment pieces must remain operational Most machines come with a manual for routine maintenance. Daily maintenance includes cleaning various parts (with appropriate materials), checking and resetting consumables, replacing parts, and troubleshooting.

Safety in the Medical Office and Laboratory

The medical office, like the home, is a place that should feel safe and secure. But just like a home, it takes conscious effort to ensure that the office has a protective, healthy environment. You should be able to evaluate the lab and medical environment to identify safe versus unsafe working conditions. Some examples of evaluating the environment can include: Using a checklist, perform a safety inspection at intervals according to institution policy and preparing a report on the findings Verifying that needle stick prevention devices (safety needles) are used and proper disposal is performed. Identifying safety techniques that can be used in responding to accidental exposure to blood, other body fluids, and chemicals. If anyone is injured in the medical office, no matter how insignificant it might seem, you must have the individual examined by the provider. If the patient should claim he or she was not injured and refuses examination, the incident must still be carefully recorded on his or her chart and the refusal of care noted. The quality assurance (QA) (also known as risk management) department usually requires any type of accident, unsafe activity, or errors in patient care that do not meet the safety standards or the standard of care, or routine operations of a provider that deviate from regular operations or established procedures, to be reported on an Unusual Occurrence Report form Additionally, some providers might require a signed release of responsibility to protect against a later claim of injury. In the event of an employee injury or exposure to blood or body fluids, OSHA requires an incident report known as the 301 form be completed.

Supply Inventory

The office manager, or in some offices the medical assistant, is expected to maintain an inventory of clinical and administrative supplies. Some of your duties can include inventory and ordering of office (clerical) supplies, clinic supplies (exam room orders), and medication orders. Careful monitoring of inventory is vital. You do not want to run out of needed supplies, yet you also do not want to over-order items, especially since many can have an expiration date and are often quite costly. Good inventory control and cost comparison are essential in your position. Be sure to coordinate your activities with the provider to avoid duplication, and be aware of any updates or changes to items or medications. A minimum amount of supplies to be maintained should be determined and will depend on the type of office practice and the number of patients seen on an average day. All staff should sign out for supplies and medications so the inventory is accurate. Some offices perform this function electronically with the use of scanners and bar codes. Maintain a binder with current information and create an electronic file system using spreadsheets (e.g., Microsoft Excel) to track your inventory and purchases. Keep a current list of all the suppliers (vendors) of goods and services compiled by category, such as administrative, laboratory, clinical, and general. By using a spreadsheet, you can sort this information and create an alphabetical list as well. Document each vendor (business) with the name of the company, the address and phone number(s), email address, website information, and a contact person if possible. A list of what products or services they provide should be entered for each vendor. Some items require special storage, such as a locked cabinet for narcotics or refrigeration for some laboratory items and medications. All items need to be inventoried or counted on a regular basis to be sure adequate supply is on hand to operate the office. If items are time sensitive (date expirations), store in order of expiration, with the first to expire in front. Discard expired items properly. If your office uses linens that require laundering, you will need to factor in the turnaround time so that fresh linens are delivered in a timely manner.

HL7 protocols

The standard for exchanging information between medical applications

Which function is performed when preparing the front desk at the beginning of the day?

Turn on computers, scanners, printers (and other electronic equipment).

Question WorkspaceCheck My WorkThe quality assurance (QA) (also known as risk management) department usually requires any type of accident, unsafe activity, or errors in patient care that do not meet the safety standards or the standard of care, or routine operations of a provider that deviate from regular operations or established procedures, to be reported on an_____________ form.

Unusual Occurrence Report (UOR)

Routine Maintenance and Calibration of Clinical Equipment (Video notes)

Use information by the clinical manager to locate and verify: the serial number manufacturer name technical support number warranty information and the last date of service. Complete a thorough visual inspection of the equipment noting any loose connections, or other safety issues. Clean the item according to the specifications set forth by the manufacturer's operation and service manual. Replace any batteries or light bulbs at this time as well. Examine the item to ensure that it meets the operational and calibration standards set forth by the manufacturer. Equipment should be calibrated as necessary, following the instructions in the manufacturer's manual. If the cleaned and tested equipment is found to be in good operational order, fill out and initial the maintenance log and return the equipment to its proper location Any equipment or item not meeting operational standards should be tagged and reported using the Service Calendar Log

Preparing the Front Desk

When preparing the front desk at the beginning of the day: Turn on computers, scanners, printers (and other electronic equipment). Offices with electronic health records (EHR) must have all computers and tablets operational before the first patient can be checked in and encounter started. Retrieve telephone messages. Retrieve and record all messages from the answering machine. If an outside service is used, call and obtain the messages. Retrieve faxes. Sort per office protocol. Retrieve printed lab and hospital reports. Sort per office protocol. Place charts for check-in. At least one day before, pull charts and look at the appointment book or run a hard copy from the computer of all patients who have appointments that day. You will need to attach reports of any previously ordered studies (labs, consults) to the chart. Have materials (registration package documents) ready to create charts for scheduled new patients. This process should be done at least the day before to reduce morning preparation duties. Many offices like to post a copy of the day's schedule and place it on the provider's desk for his or her personal use and reference. The workflow of offices using an EHR will vary, but schedules are generated electronically, lab orders and results are placed and received electronically, and there are no paper charts. All nonelectronic documents (faxed hospital reports, consults, etc.) will need to be viewed by the provider, validated, and then scanned to the patient's electronic chart. Prepare sign-in sheet, cash balance forms, and so on. Have daily forms available along with pens and other basic equipment. When working in the business office area during the day, pay special attention to file drawers and cupboard doors. NEVER open more than one file drawer in a vertical file at a time because the unbalanced weight could cause the cabinet to tip forward. You could sustain a back or extremity injury from the automatic reaction to catch a cabinet. Also, be careful with opened bottom drawers, which can easily be tripped over. Wall cupboards pose another safety hazard. If the door is left open, you could strike your head quite forcefully when you stand up or rise up from underneath. All electrical cords must be kept behind desks and other office furnishings so that they cannot be tripped over. All equipment should operate properly and show no evidence of electrical shorts or damage. With the ever-increasing amount of electronic equipment in a medical office, it is extremely important that wiring is adequate and the cords are neatly bundled, out of the way.

Cleaning Spills and Dropped Objects

When the spill involves bodily fluids such as blood or urine, universal precautions must be observed by using gloves and eye protection and placing materials in a biohazard waste bag. Your office should have a standard spill kit on hand. Properly bag contaminated clothing and materials in a leak-proof, labeled biohazard bag. Place a second bag around the first and dispose of it in the proper method (licensed waste disposal service). After the spill is cleaned, the area must be thoroughly cleaned with an effective disinfectant or a 10 percent solution of household bleach. The soiled paper towels or clothes should also be discarded in the hazardous waste container. Cleaning a spill. (A) Open spill kit and pour coagulating powder on spill. (B) When spilled materials have been absorbed, use scoop to remove. (C) Place in an appropriate biohazard container. (D) Clean the area with a 10 percent bleach solution. Be aware of any objects dropped on the floor, and be sure they are picked up immediately to prevent falls. Glass fragments are best picked up using a brush or broom and dustpan and placed into a puncture-proof sharps container. If they do not fit in the puncture-proof sharps container, larger pieces of glass must be discarded in such a way that they will not puncture plastic bag liners of a waste receptacle—this could accidentally cut someone. Fragments could be carefully wrapped in layers of newspaper or placed inside empty cardboard or plastic containers before being deposited in the receptacles.

Keeping Immunizations up to Date

When working in the medical field with patients, it makes good sense to be protected from every possible disease. Check with your family physician and find out whether you need any updating on your own immunizations. Staying current with immunizations is essential. For those who have respiratory conditions, having protection against pneumonia and influenza is also generally recommended. If you are going to be working directly with patients and there is a risk of coming in contact with blood or other body fluids, you should receive the series of three HBV (hepatitis B virus) injections. The permanent record of this vaccine should be kept in your employee file. If you are hired in a new position in which you supposedly will not be in contact with patients and you have not received the HBV, or if your new employer states that it is not necessary for you to have the vaccine, the employer must sign a waiver indicating this. This signed document should be kept in your employee file. Some facilities may also allow you to decline the vaccination; if this is the case, you must sign a declination waiver. In addition, some individuals are allergic to the contents of the culture media of certain vaccines. If you are allergic, this should also be documented in your employee file.

Dictation-Transcription

With all the changes in technology and the integration and interoperability with other software programs, it is imperative to keep up-to-date with your knowledge and skills. Some offices outsource dictation or have specific transcribers in the office. Many medical offices and providers are now using speech recognition software. One popular application is Dragon Naturally Speaking by Nuance. Dragon Medical 10.1 allows the user to create transcription-free medical records, email, and correspondence up to three times faster than most people type, with up to 99 percent accuracy. Dragon Naturally Speaking offers seamless compatibility with Microsoft Office and networks and interfaces with EHR programs. Use of voice recognition software has been found to reduce cost and turnaround time compared with traditional transcription methods. As with any transcription or voice recognition program, there can be difficulties setting up the profiles and accuracy. Always carefully proofread to eliminate any errors.

threshold

a minimum amount of supplies to be maintained; also known as par level.

inventory

an itemized list of goods in stock.

biohazardous

any material that has been in contact with body fluid and is potentially capable of transmitting disease.

atmosphere

any surrounding influence.

peripheral

anything you plug into a computer--- for example, a printer, USB flash drive, monitor or scanner

If you are the first staff member to arrive at work, it will be necessary to enter the security code to the system before opening the door or enter the code on an internal keypad before the entrance delay period expires. However, you should:

be aware: It takes only a few seconds for someone to grab your purse or wallet or force you to hand over office money or drugs.

When performing a safety check, remember to make a daily visual check of electrical devices, furniture, floors, and lighting before any patients arrive. Check the floor to be certain there are no __________________ that might cause someone to fall.

carpet wrinkles tears in the flooring no decorative or throw rugs

In general, the term EMR (electronic medical records) refers to:

clinical functions.

hazards

dangers; risks.

volatile

easily changed into a gas or tending to change into a vapor; usually considered potentially dangerous.

contraction

in spelling and punctuation, a shortened version of the word or group of words created by the omission of internal letters, with missing letters usually marks by apostrophe

Careful monitoring of inventory is vital. You do not want to run out of needed supplies, yet you also do not want to _______________, especially since many can have an expiration date and are often quite costly.

over-order items

assault

physical harm; a violent attack.

Improper setup of workstations or repetitive use of computer equipment (e.g., keyboarding) can

result in physical injury.

For offices using EHR software dictated notes, hospital discharge reports, and consults should be:

scanned in the patient's electronic chart.

Wearing Protective Barriers

selecting and wearing appropriate personal protective equipment (PPE) is essential in infection control and contributing to a safe work environment. When collecting specimens from patients, the basic recommended PPE includes gloves, face shields, fluid-resistant lab coats, and respirators for airborne pathogens. Pay attention to proper fit when wearing protective barriers. If a gown is too large or too small, the purpose of the gown will be defeated. Latex or vinyl gloves should also fit snugly but not be too tight or too loose. Gloves that are too small will most likely tear. Loose clothing or gloves could catch on something and be ripped or snagged, which could present a possible exposure to potentially infectious materials. When working with specimens and recording information, you must be careful not to touch items that you would normally touch without gloves, such as light switches, door and drawer handles and pulls, phones, charts, and equipment. Develop the habit of completing one task at a time when possible. Complete the procedure that requires gloving and other personal protective equipment and then record the results after you have removed the protective barriers. For example, if you are assisting with a sigmoidoscopy wearing PPE, complete the assisting, clean up, remove the contaminated barriers, and then perform the charting of the procedure. If you write in the patient's chart with the contaminated gloves still on, you will be contaminating everything you touch and possibly exposing others to biohazardous residue.

dictation

spoken words; recorded voice communication.

environment

surroundings.

It is necessary to back up data to ensure integrity from loss, disaster, human error, hard-drive error, virus, or equipment damage using:

tapes, CDs, and off-site (cloud-based) applications.

ergonomic

the applied science of being concerned with the nature and characteristics of people as they relate to design and activities with the intention of producing more effective results and greater safety

reception

the fact or manner of being received.

Daily maintenance of office equipment includes cleaning various parts (with appropriate materials), checking and resetting consumables, replacing parts, and:

troubleshooting.

transcription

writing over from one book or medium into another; typing in full in ordinary letters.