RHIT Domain 6: Leadership

The acute-care hospital discharges an average of 55 patients per day. The HIM department is open during normal business hours only. The volume productivity standard is six records per hour when coding 4.5 hours per day. Assuming that standards are met, how many FTE coders does the facility need to have on staff in order to ensure that there is no backlog? a. 2.85 b. 5 c. 14.26 d. 27

a 385 charts per week / 5 days / 27 standard charts per day = 2.85 (Horton 2016a, 185-186).

In a recent documentation quality audit, the HIM manager discovered that the orthopedic surgeons have a high rate of noncompliance with history and physical examinations being available in the patient's record prior to surgery. Which of the following is the best action for the HIM manager to take to address this noncompliance issue? a. Discuss this issue and the importance of compliance with the chief of surgery b. Report the noncompliance to the OIG c. Post the names of noncompliant physicians on the door of the physician's lounge d. Discuss this issue and the importance compliance with the HIM staff

a A complete history and physical report represents the attending physician's assessment of the patient's current health status, and accreditation standards require it to be completed within 24 hours of admission. In this case, the HIM manager should provide the chief of surgery with information on non-compliant physicians and work together with the chief of surgery to resolve this issue (Brickner 2016, 84; Horton 2016a, 383).

A recent HIM trend is instituting a clinical documentation improvement program. This is not a small undertaking. Which of the following can be used by the HIM manager to assist in measuring whether or not the program is successful? a. Dashboard b. Policy c. Procedure d. Benchmark

a A dashboard is a management report of process measures. Dashboards can assist in measuring whether or not the program is successful. A monthly dashboard might show the number of clarifications requested by a CDI specialist that impacted a diagnosis-related group based on a benchmark (Giannangelo 2016b, 324-325).

Coding accuracy is best determined by: a. A predefined audit process b. Medicare Conditions of Participation c. Payer audits d. Joint Commission Standards for Accreditation

a Accuracy of coding is best determined by a predefined audit process. The audits allow the facility to confirm that the policies and procedures of the organization are being met and to identify problems that need to be addressed and corrected (Foltz et al. 2016, 459).

Which of the following is one of the five best practices for management of financial measures in the CDI program? a. Track and report on CC capture rates across the organization and by service b. Build relationships with QIO and primary insurers c. Publish data to benchmarking organizations d. Document corrective actions

a Because the financial impact of a clinical documentation improvement (CDI) program is important and because many programs may lose their continued funding without the ability to demonstrate economic value, every organization should have a best practices approach to managing the financial measurement of its CDI program. One of these best practices is to track and report on MCC and CC capture rates across the organization and by service (Hess 2015, 251).

An HIM supervisor is revising job descriptions for record scanning positions. These positions have been in existence for just over one year. Which of the following would be the most appropriate action to take to make sure all tasks being performed are included in the new job descriptions? a. Ask current staff members to keep a diary for a certain period of time on how they spend their time b. Review job descriptions from other hospitals c. Make random observations of job tasks d. Refer the matter to the human resources department

a Collecting data on current performance and tasks allows the HIM supervisor to include all tasks that are being performed in the new job descriptions. When more than one person is performing a task, the data could be collected over time and averaged. One method of doing this is to keep a diary for a period of time on how they spend their time. The experience and overall performance of each person must be considered in setting the standard (Prater 2016, 588).

Charles is a supervisor of the imaging section of the HIM department. In trying to update scanning productivity standards, Charles calls around to other area hospitals to ask what their scanning standards are. This is an example of what source of performance data? a. Benchmarking b. Job Appraisal c. Observation d. Work sampling

a Comparing an organization's performance to the performance of other organizations that provide the same types of service is known as benchmarking. Internal benchmarking is also important to establish a baseline for the organization to find ways to improve effectiveness (Shaw and Carter 2015, 46).

To develop performance standards for release of information turnaround time, the manager conducted a literature search and contacted peer institutions. Which method did she use? a. Benchmarking b. Workflow analysis c. Productivity analysis d. Work measurement

a Comparing an organization's performance to the performance of other organizations that provide the same types of service is known as benchmarking. Internal benchmarking is also important to establish a baseline for the organization to find ways to improve effectiveness (Shaw and Carter 2015, 46).

As part of Community Hospital's organization-wide quality improvement initiative, the HIM director is establishing benchmarks for all of the divisions within the HIM department. The following table shows sample productivity benchmarks for record analysis the director found through a literature search. Given this information, how should the director proceed in establishing benchmarks for the department? Sample Productivity Benchmarks Productivity Benchmarks Per Hour Function Low Average High Assembly (charts per hour) Inpatient 8 20 Observation/outpatient surgery/newborn/maternity 5 14 60 Other outpatient 20 120 a. Determine whether the source of the benchmark data is from a comparable institution b. Use the low benchmark example as a beginning point for implementation c. Contact the hospital statistician to determine whether the data are relevant d. Use the average benchmark example as a beginning point for implementation

a Comparing an organization's performance to the performance of other organizations that provide the same types of services is known as external benchmarking. The other organizations need not be in the same region of the country, but they should be comparable organizations in terms of patient mix and size (Shaw and Carter 2015, 76).

Which of the following strategies would be best to ensure that all stakeholders are engaged in the planning and development of an organization EHR system? a. Form an EHR steering committee b. Put out a press release c. Distribute an organization-wide memorandum from the CEO d. Put out a notice on the organization's intranet

a Most organizations create an electronic health records (EHR) steering committee to engage all the various stakeholders in EHR planning and development. This ensures that the EHR planning is comprehensive and also starts the process of introducing change and gaining buy-in (Amatayakul 2016, 310).

The HIM and IT departments are working together to justify additional employee password training. The additional training would cost approximately $100,000 with the expectation that password calls to the IT help desk will be reduced by 20 percent. The IT department has done a cost analysis of help desk calls solving password issues. Given this data and approximately 40 password calls per day, can the cost of the additional training be justified? Costs Associated with Each IT Help Desk Call to Resolve Password Issues Personnel Cost User's time—30 minutes $15 Telephone cost—30 minutes $2 Call Desk time—30 minutes $16 Call Desk IS facilities time $17 Total $50 a. Training will provide $146,000 savings in help desk support and can be justified. b. The results of training will provide $365,000 savings in help desk support and can be justified. c. The cost of training will be recouped in less than half a year and can be justified. d. The cost of training is not justified because qualitative results cannot be measured to calculate a return on investment.

a Current cost: $50 × 40 calls per day = $2,000 per day × 365 days = $730,000. Cost with reduced number of help desk calls: $50 × (40 × 0.80) calls per day = $1,600 per day × 365 days = $584,000, or a savings of $146,000. Training costs of $100,000 will be recouped and a savings of $46,000 realized (Gordon and Gordon 2016b, 548).

An HIM department is researching various options for scanning the hospital's health records. The department director would like to achieve efficiencies through scanning, such as performing coding and cancer registry functions remotely. Given these considerations, which of the following would be the best scanning process? a. Scanning all documents at the time of patient discharge b. Scanning all documents after physicians have completed any record deficiencies c. Begin remote work only after all deficiencies have been corrected in the paper record d. Using scanners with the maximum amount of output

a Digital scanners create images of handwritten and printed documents that are then stored in health record databases as electronic files. The data can be interfaced in the current EHR with the document scanning system. Using scanned images solves many of the problems associated with traditional paper-based health records and hybrid records. Scanning at patient discharge allows the all of the contents of the record to be available in a timely manner for other functions such as remote coding and cancer registry (Russo 2013b, 335).

Dr. Jones is the first physician in the practice to adopt the e-prescribing application. He says he likes to try out new technologies and to be a role model for other physicians. Dr. Jones is at what step in the innovation adoption life cycle? a. Early adopter b. Early majority c. Laggard d. Late majority

a Early adopters are a little more cautious than the innovators but these individuals are the change leaders within the organization. These individuals do not require information to change but they like to have how-to-manuals and information sheets on how to participate within the change, which can be provided by the change agents. In this situation, Dr. Jones is an early adopter of the e-prescribing application (AHIMA 2014, 52; Kelly and Greenstone 2016, 72).

Which of the following is a data collection tool that records the workflow of current processes? a. Flow chart b. Force-field analysis c. Pareto chart d. Scatter diagram

a Flow charts help all the team members understand the process in the same way. The work involved in developing the flow chart allows the team to thoroughly understand every step in the process as well as the sequence of steps. The flow chart provides a visual picture of each decision point and each event that must be completed. It readily points out places where there are redundancy and complex and problematic areas (Carter and Palmer 2016, 513).

After an outpatient review, individual audit results by coder should become part of the: a. Individual employee's performance evaluation b. Patient's health record c. Coding compliance review summary d. Mission of the coding team

a Individual audit results by coder may identify that certain coders are ready to be cross trained in another category of coding. Regardless of the corrective actions taken, the results should become part of each employee's performance evaluation (Schraffenberger and Kuehn 2011, 320).

A hospital currently uses the patient's Social Security number as their patient identifier. The hospital risk manager has identified this as a potential identity fraud risk and wants the information removed. The risk manager is not getting cooperation from the physicians and others in the hospital who say they need the information for identification and other purposes. Given this situation, what should the HIM director suggest? a. Avoid displaying the number on any document, screen, or data collection field b. Allow the information in both electronic and paper forms since a variety of people need this data c. Require employees to sign confidentiality agreements if they have access to Social Security numbers d. Contact legal counsel for advice

a It is generally agreed that Social Security numbers (SSNs) should not be used as patient identifiers. The Social Security Administration is adamant in its opposition to using the SSN for purposes other than those identified by law. AHIMA is in agreement on this issue due to privacy, confidentiality, and security issues related to the use of the SSN (Sayles 2016b, 59).

Jane is responsible for developing the positions needed for scanning inactive records in anticipation of EHR implementation. Since she has no scanning experience, Jane called the supervisors of the scanning function at three different facilities to pick their brains in regards to scanning jobs. This is an example of what type of data collection in the job analysis process: a. Using external sources b. Diary method c. Observation method d. Work imaging

a Managers can collect information about a job from a variety of sources. One of these is to use external sources' data for job analysis. In this scenario, Jane contacts other external sources at other facilities in order to use their information to create the scanning function requirements (Prater 2016, 568-569).

Performance standards are used to: a. Communicate performance expectations b. Assign daily work c. Describe the elements of a job d. Prepare a job advertisement

a Managers must be able to report on the amount, efficiency, and quality of work being done in a unit. Employees need to know what is expected of them, and how they are doing relative to expectations. Setting performance standards and measuring performance can address the needs of both (Prater 2016, 587).

If steps in a revenue cycle process are handled separately in sequence by individual workers, the method of organizing work is called which of the following? a. Serial work division b. Parallel work division c. Processing d. Benchmarking

a One of two major ways to organize process work is serial work division, assembly line fashion, where tasks or steps are handled separately in sequence by multiple individuals (Prater 2016, 584).

When interviewing candidates for a job, Angela likes to get a feel for how their experiences will shape their future actions. She likes to ask the question, "Tell me about a time when you had to prioritize three or four courses of action, what they were, and how you decided to prioritize each one. Did you choose correctly? How did it work out?" This is what type of interview question? a. Behavior b. Job knowledge c. Situational d. Work requirement

a One way hiring managers can improve effectiveness of job interviews includes using job-related situational or behavioral questions based on job description. An example of a behavioral question would be to ask a candidate to relate behavior from the past to a job situation (for example, describe a situation where you had to deal with a subordinate's chronic tardiness, and explain how you handled it) (Prater 2016, 574).

University medical center would like to give access to the EHR to referring physicians for their patients' information for continuing care. The HIM manager should recommend which of the following: a. That access be granted that is view-only b. That unlimited access be granted c. Deny any access to the EHR d. Deny access unless the patient gives written consent

a Organizations that allow referral providers access to their EHRs should determine which information will be accessible. Steps should be taken to ensure that this is a view-only access. It should be tested at each upgrade to ensure the view-only status continues (Russo 2013b, 364).

Angela's annual performance appraisal is scheduled for next month. She has been asked by her supervisor to provide the names of two peers and one person in another department with whom she regularly interacts. These individuals will contribute to Angela's evaluation. This is an example of what type of performance appraisal method? a. 360 performance appraisal b. Critical incident method c. Essay evaluation d. Graphic rating scale

a Performance appraisal refers to the formal system of review and evaluation methods used to assess employee and team performance. The 360 performance appraisal method utilizes team members as part of the appraisal process. Some of the pros of this method are that bias is reduced by including multiple perspectives from inside and outside the organization (that is, managers, subordinates, peers, customers; may also include self-appraisal); it is development-focused; less useful for promotion, compensation; and it emphasizes team and customer relationships (Prater 2016, 575-576).

One of the first steps in this managerial function is to perform an environmental scan of internal organization and external industry. This is which managerial function? a. Planning b. Organizing c. Leading d. Controlling

a Planning is the examination of the future and preparation of action strategies to attain goals of the department or healthcare facility; for example, a director in the HIM department may use the planning function to prepare for the future state of the department after the implementation of a new release of information software system installation (Gordon and Gordon 2016b, 535).

The coding staff at University Hospital has access to the Internet for research purposes while performing their job duties. The coding manager has noticed an increase in use and distraction by her coders who are using social media while on the job. In this situation, what should the coding manager develop and use to handle the inappropriate use of the Internet by her coding staff? a. Policy b. Standard c. Procedure d. Benchmark

a Policies are the principles describing how a department or an organization will handle a specific situation or execute a specific process. They are clear, simple statements of how an HIM department will conduct its services, actions, or business; and a set of guidelines and steps to help with decision making (Gordon and Gordon 2016b, 537-538).

HIM managers set different types of standards to evaluate employee performance for functions such as coding, analysis, and release of information. These standards are called: a. Productivity standards b. Accreditation standards c. Privacy standards d. Regulatory standards

a Productivity is defined as a unit of performance defined by management in quantitative standards. Productivity allows organization to measure how well the organization converts input into output, or labor into a product or service. Most HIM departments have productivity standards in the department, such a coding, analysis, and release of information (Horton 2016a, 185).

Position descriptions, policies and procedures, training checklists, and performance standards are all examples of: a. Staffing tools b. Organizational policies c. Strategic plans d. Items on a training checklist

a Staffing tools may be used to plan and manage staff resources. Staffing tools include: position descriptions, which outline the work and qualifications required by the job; performance standards, which establish expectations for how well the job will be done and how much work will be accomplished; and written policies and procedures explaining staffing requirements and scheduling, which assist the supervisor in being fair and objective and help the staff understand the rules (Prater 2016, 568, 584-592).

As part of the clinic's performance improvement program, an HIM director wants to implement benchmarking for the transcription division at a large physician clinic. The clinic has 21 transcriptionists who average about 140 lines per hour. The transcription unit supports 80 physicians at a cost of 15 cents per line. What should be the first step that the supervisor takes to establish benchmarks for the transcription division? a. Clearly define what is to be studied and accomplished by instituting benchmarks. b. Hold a meeting with the transcriptionists to announce the benchmark program. c. Obtain benchmarks from other institutions. d. Hire a consultant to assist with the process.

a The first step in benchmarking is to determine the performance measure to be studied and what is to be accomplished. Once a benchmark for a performance measure is determined, analyzing data collection results becomes more meaningful (Shaw and Carter 2015, 29).

An HIM department is projecting workforce needs for its document scanning process. The intent of the department is to scan patient records at the time of discharge, providing a 24-hour turnaround time. The hospital has an average daily discharge of 120 patients, and each patient record has an average of 200 pages. Given the benchmarks listed here, what is the least amount of work hours needed each day to meet a 24-hour turnaround time? National Benchmarks for Document Scanning Processes Function Expectations per Worked Hour Prepping 340-500 images Scanning 1,200-2,400 images Quality Control 1,600-2,000 images Indexing 600-800 images a. 100 hours b. 146 hours c. 1,000 hours d. 3,740 hours

a The question is asking for the least amount of hours needed to meet the 24-hour turnaround time. The average discharge in a 24-hour period is 120 patients, and the average number of pages for each patient chart is 200. So, 120 × 200 = 24,000 pages in a 24-hour period. Each chart must be prepped, scanned, checked for quality, and indexed. The highest number of pages that can go through all these processes in an hour would be: 500 images in prepping; 2,400 images in scanning; 2,000 images in quality control; and 800 images in indexing. 24,000 / 500 = 48 hours needed for prepping 24,000 / 2,400 = 10 hours for scanning 24,000 / 2,000 = 12 hours for quality control 24,000 / 800 = 30 hours for indexing 48 + 10 + 12 + 30 = 100 hours, at least, needed each day to meet a 24-hour turnaround time (Prater 2016, 587-588).

Which of the following is a problem-solving technique that focuses on working with individuals to find a mutually acceptable solution? a. Nominal group technique b. Change management c. Brainstorming d. New beginnings

a Using the nominal group technique, the group writes down their suggestions anonymously and then votes on which ideas are the most appropriate for the context of the discussion. This technique focuses on finding a communally acceptable solution (Kellogg 2016b, 483).

The HIM director has put together a group of department employees to develop coding benchmarks for the number and types of charts to be coded per work hour. The group includes seven employees from the analysis, transcription, release of information, and coding sections. No managers are included on the team because the HIM director wants a bottom-up approach to benchmark development. What fundamental team leadership mistake is the HIM director making with composition of the team? a. Insufficient knowledge of team members b. Too many team members c. Unspecific team charge d. Too few team members

a Whether selecting a permanent staff team or members of a team for a short-term project, making the right choice is fundamental to the team's success. Putting together a team involves understanding the challenges to be faced and considering all of the perspectives, experience, and knowledge that will be needed. The members of the team should be selected for what they can contribute to the team. Member selection should not be based purely on job title; rather, team members should be selected for the tasks that they actually can perform and the responsibilities they can carry out (Kellogg 2016b, 487).

Incorporating a workflow function in an electronic information system would help support: a. Tasks that need to be performed in a specific sequence b. Moving patients from point to point c. Registration of patients d. Making computer output available on laser disk

a Workflow and process designs ensure the most efficient and effective use of electronic information systems (Amatayakul 2016, 287).

The medical transcription improvement team wants to identify the cause of poor transcription quality. Which of the following tools would best aid the team in identifying the root cause of the problem? a. Flowchart b. Fishbone diagram c. Pareto chart d. Scatter diagram

b A cause-and-effect diagram, also known as a fishbone diagram because of its characteristic fish shape, is an investigation technique that facilitates the identification of the various factors that contribute to a problem. It facilitates root-cause analysis, in order to determine the cause of the problem (Carter and Palmer 2016, 515).

Which HIM role works with patients to help them understand health data? a. Resource manager b. Data translator c. Data analyst d. Data security, data privacy, and confidentiality manager

b A data translator works as the liaison between the patient and his or her health data. Data translators assist the patient in understanding their rights, such as the right to control access to their protected health information. They work with patients to help overcome barriers such as translating medical terminology into understandable terms (Sayles and Trawick 2014, 244-245).

Clinical documentation improvement staff members must work directly with this department to obtain data about retrospective physician queries: a. Coding b. Health information management c. Compliance d. Case management

b A feedback loop between clinical documentation improvement (CDI) and health information management (HIM) should be in place as a best practice. It is necessary to ensure the CDI manager works directly with the HIM manager to obtain data about retrospective physician queries (Hess 2015, 245).

Which of the following is a written description of an organization's formal position? a. Hierarchy chart b. Policy c. Organizational chart d. Procedure

b A policy is a clearly stated and comprehensive statement that establishes the parameters for decision making and action and is the written description of the organization's formal position. Policies are developed at both the institutional and departmental levels. In both cases, policies should be consistent within the organization. They must be developed in accordance with applicable laws and reflect actual practice (Gordon and Gordon 2016b, 537).

A governing principle that describes how a department or an organization is supposed to handle a specific situation or execute a specific process is a: a. Position statement b. Policy c. Procedure d. Performance appraisal

b A policy is a governing principle that describe how a department or an organization is supposed to handle a specific situation or execute a specific process (Sayles and Gordon 2016, 666).

The HIM director conducted an analysis of the coding department that revealed that 10 of the coders are credentialed and have at least 10 years of experience. However, the top five coders are leaving their employment within the next three months. This is an example of which type of analysis? a. External b. Internal c. Market d. Workflow

b An internal analysis involves reviewing the inner working of the healthcare organization to determine strengths and weaknesses of the business practice and process. The scenario is an example of internal analysis (Gordon and Gordon 2016b, 541-542).

Managing the adoption and implementation of new processes is called: a. Management by design b. Change management c. Process flow implementation d. Visioning

b Change management is the formal process of introducing change, getting it adopted, and diffusing it throughout the organization (Gordon and Gordon 2016b, 544).

What is the formal process of introducing change, adopting the change, and diffusing it throughout the organization? a. SWOT b. Change management c. Supply management d. Workflow

b Change management is the formal process of introducing change, getting it adopted, and diffusing it throughout the organization (Gordon and Gordon 2016b, 544).

An HIM director reviews the departmental scanning productivity reports for the past three months and sees that productivity is below that of the national average. Which of the following actions should the director take? a. Reduce the salary of the nonproductive workers. b. Investigate whether there are factors contributing to the low productivity that are not reflected in the national benchmarks. c. Meet with departmental supervisors to discuss the issue. d. Assess whether or not the current economy is affecting productivity.

b Comparing an organization's performance to the performance of other organizations that provide the same types of service is known as benchmarking. Internal benchmarking is also important to establish a baseline for the organization to find ways to improve effectiveness. Benchmark averages can be helpful in setting productivity standards, but do not necessarily reflect variations in procedures from organization to organization. Investigating what factors may be contributing to the low productivity for this organization will give a better understanding of the variation (Shaw and Carter 2015, 46).

In planning a compliance training session, you want to allow adult learners the flexibility to proceed at their own pace. Which would be the best choice among the following training methods? a. On-the-job training b. Computer-based c. Classroom lecture d. Seminar with break-out groups

b Computer-based training is a form of self-directed learning, an approach that allows learners to control their own education at their own pace (Prater 2016, 593).

In a management sense, controlling means: a. Directing people to carry out tasks b. Monitoring performance c. Providing little choice in job descriptions d. Making people do what a manager wants

b Controlling is the function in which performance is monitored according to policies and procedures. In HIM, controlling includes monitoring the performance of employees for quality, accuracy, and timeliness of completion of duties (Gordon and Gordon 2016b, 534).

After implementing a new EHR, the HIM department is noticing that documents are occasionally found in the wrong health record or are mislabeled. Which of the following would be the best approach to manage these errors in the EHR? a. Ignore them because it does not matter b. Establish an error-management team to receive notice of these instances and correct them c. Establish a policy for HIM staff to be more careful d. Report these issues to the IT department to resolve them

b Error management is part of data integrity which means that data should be complete, accurate, consistent, and up-to-date. Ensuring the integrity of healthcare data is important because providers use data in making decisions about patient care (Johns 2015, 211).

Which of the following is a positive aspect of using employee self-appraisal as a source of data for performance appraisal? a. Employees are in the best position to provide objective review without overstatement b. The supervisor is kept informed of the employee's accomplishments c. Appraiser and employee training on the purpose and procedures of this process is essential d. Peer pressure of evaluation can motivate team members to be more productive

b Methods used in performance appraisal must meet criteria for validity and reliability. Management decisions on pay, promotion, or dismissal based on performance appraisal are subject to defense in discrimination lawsuits. Employee self-appraisal provides the opportunity for the employee to keep the supervisor informed of accomplishments and issues (Prater 2016, 575-576).

The HIM manager is also the facility privacy officer. In this role, she is required to provide her expertise in regard to HIPAA privacy and security regulations. She oversees initial training of the workforce for the organization. Which of the following is the best setting to accomplish this initial training to ensure all workforce members are trained? a. College coursework b. New employee orientation c. On-the-job training d. Local HIM association meeting

b New employee orientation includes a group of activities to help the employee feel knowledgeable and competent. Educational programs required for employees organizationalwide (such as HIPAA, privacy, etc.) are training initiated with new employee orientation (Prater 2016, 591).

An HIM technician is paid an hourly rate and is eligible for overtime pay, consistent with the Fair Labor Standards Act. Her position would be classified as which of the following? a. Exempt b. Nonexempt c. Full-time d. Professional

b Nonexempt employees are covered by FLSA overtime provisions; this includes hourly-paid jobs (Prater 2016, 558).

A coding supervisor who makes up the weekly work schedule would engage in what type of planning? a. Long range b. Operational c. Tactical d. Strategic

b Operational planning is the specific day-to-day tasks required in operating a healthcare organization or an HIM department. Making up the weekly work schedule would be part of operational planning (Gordon and Gordon 2016b, 541).

Delegation is a skill that managers develop to show employees that they trust them with authority to perform certain projects on their own. Delegation falls under what managerial function? a. Planning b. Organizing c. Leading d. Controlling

b Organization is coordinating all of the tasks and responsibilities of a department to guarantee the work to be accomplished is completed correctly. A director or supervisor is responsible for the decisions concerning the division of labor for the HIM department (Gordon and Gordon 2016b, 534).

Performance monitoring is data driven and the HIM department needs access to data in order to make important decisions. One way to provide real-time data and important information that can be monitored at a glance is to use which of the following? a. Benchmark b. Dashboards c. Pareto chart d. Time ladder

b Performance monitoring is data driven. The organization's leadership uses the information displayed on the dashboard to guide operations and determine improvement projects. Having real-time data in an easily assessable format like a dashboard allows leaders to keep track of high-impact, high-risk, or high-value processes and make adjustments on a daily basis if needed (Carter and Palmer 2016, 502).

As the assistant director of the HIM department, Judy is responsible for creating a job description for the new application specialist position. As part of the data collection phase, Judy researches the AHIMA Body of Knowledge to locate similar job descriptions already on file. The Body of Knowledge is what source of data? a. Primary b. Secondary c. Tertiary d. The Body of Knowledge should not be used a source of data

b Secondary data sources for job analysis are information obtained from subject matter experts, human resource consultants, job data banks, or competency models. The AHIMA Body of Knowledge would be considered data from subject matter experts (Kelly and Greenstone 2016, 117).

City Hospital has implemented a procedure that allows inpatients to decide whether they want to be listed in the hospital's directory. The directory information includes the patient's name, location in the hospital, and general condition. If a patient elects to be in the directory, this information is used to inform callers who know the patient's name. Some patients have requested that they be listed in the directory but information is to be released to only a list of specific people the patient provides. A hospital committee is considering changing the policy to accommodate these types of patients. In this case, what type of advice should the HIM director provide? a. Approve the requests because this is a patient right under HIPAA regulations. b. Deny these requests because screening of calls is difficult to manage and if information is given in error, this would be considered a violation of HIPAA. c. Develop two different types of directories—one directory for provision of all information and one directory for provision of information to selected friends and family of the patient. d. Deny these requests and seek approval from the Office for Civil Rights.

b The HIPAA Privacy Rule allows individuals to decide whether they want to be listed in a facility directory when they are admitted to a facility. If the patient decides to be listed in the facility directory, the patient should be informed that only callers who know his or her name will be given any of this limited information. Covered entities generally do not, however, have to provide screening of visitors or calls for patients because such an activity is too difficult to manage with the number of employees and volunteers involved in the process of forwarding calls and directing visitors. If the covered entity agreed to the screening and could not meet the agreement, it could be considered a violation of this standard of the Privacy Rule (Thomason 2013, 105).

As an HIM manager, Chelsea documents both positive and negative examples of her employee's work throughout the year. She refers back to these examples during annual evaluations. This is an example of what type of performance appraisal method? a. 360 performance appraisal b. Critical incident method c. Essay evaluation d. Graphic rating scale

b The critical incident method is a method of performance appraisal that includes an ongoing written log of examples of an employee's job-related behavior during the appraisal period is used. It offers specific examples for development and is important that a manager documents both positive actions and negative incidents. This method can be used to supplement rating methods (Prater 2016, 576).

Helen is the HIM department head, and has been asked to share a SWOT analysis of her department with her new boss. One aspect of Helen's SWOT analysis indicates that the chart tracking software is over 10 years old and is not compatible with the digital dictation system. In a SWOT analysis, this would be a(n): a. Strength b. Weakness c. Opportunity d. Threat

b The process to develop a strategic and operational plan begins with a SWOT (acronym for strengths, weaknesses, opportunities, and threats) analysis. In a SWOT analysis, key leadership personnel determine the strengths of the organization (what the company does well), the weaknesses (needs for improvement), and establishes future opportunities (and evaluates threats to those opportunities). This scenario is an example of weakness in a SWOT analysis (Gordon and Gordon 2016b, 542).

Which of the following behaviors is an early indicator of resistance to change that an employee might exhibit when presented with a new project? a. Asking repeated questions during a department meeting about the new project b. Missing planning meetings to determine the implementation schedule for the new project c. Reading industry articles on the new project to gain knowledge prior to installation d. Volunteering to be on an implementation committee for the new project

b The underlying tenet is all human beings prefer doing things that have the most meaning for themselves. When people believe change is going to be harmful to themselves or their career they are resistant to change. To overcome this resistance, leaders need to patiently sell the idea of change by educating their team and carefully disseminating information. Missing planning meetings would be perceived as being resistant to the change (Kellogg 2016b, 480).

A standard of performance or best practice for a particular process or outcome is called a(n): a. Performance measure b. Benchmark c. Improvement opportunity d. Data measure

b When an organization compares its current performance to its own internal historical data, or uses data from similar external organizations across the country, it helps establish a benchmark, also known as a standard of performance or best practice, for a particular process or outcome (Shaw and Carter 2015, 29).

Before the actual job analysis process begins, an HIM manager must complete the following: a. Collect primary data to support the job analysis b. Execute a workflow analysis c. Perform a needs assessment d. Write a job description

c A needs analysis is a procedure performed by collecting and analyzing data to determine what is required, lacking, or desired by an employee, group, or organization. A needs assessment is a process for determining how to close a learning or performance gap as it relates to jobs performed in a particular department (Kelly and Greenstone 2016, 115).

A statement or guideline that directs decision making or behavior is called a: a. Directive b. Procedure c. Policy d. Rule

c A policy is a statement that describes general guidelines that direct behavior or direct and constrain decision making in the organization (Gordon and Gordon 2016b, 537).

A document that describes the steps involved in performing a specific function is a: a. Position statement b. Policy c. Procedure d. Performance appraisal

c A procedure is a document that describes the steps involved in performing a specific function (Sayles and Gordon 2016, 667).

Community Hospital recently implemented a fully integrated electronic health record (EHR) system. The process for record analysis will be significantly different with this new system. The process is changing from the hybrid to a fully electronic analysis process. Which of the following should the HIM manager modify to reflect this process change? a. Policy b. Standard c. Procedure d. Benchmark

c A procedure is a document that describes the steps involved in performing a specific function that define the processes by which the policies are put into action (Gordon and Gordon 2016b, 538).

A comprehensive retrospective review should be conducted at least once a year of what aspect of the clinical documentation improvement program? a. Proficiency statistics b. Compliance issues c. All query opportunities d. Core key measures

c A standard should be set that all query opportunities within a CDI program should undergo comprehensive review retrospectively at least once a year (Hess 2015, 211).

What kind of planning addresses long-term needs and sets comprehensive plans of action? a. Tactical b. Operational c. Strategic d. Administrative

c A strategic plan is the document in which the leadership of a healthcare organization identifies the organization's overall mission, vision, and goals to help define the long-term direction of the organization (Gordon and Gordon 2016b, 533).

City Hospital's HIPAA committee is considering a change in policy to allow hospital employees who are also hospital patients to access their own patient information in the hospital's EHR system. A committee member notes that HIPAA provides rights to patients to view their own health information. However, another member wonders if this action might present other problems. In this situation, what information should the HIM director provide? a. HIPAA requires that employees have access to their own information, so grant privileges to the employees to perform this function. b. HIPAA does not allow employees to have access to their own information, so the procedure should not be implemented. c. Allowing employees to access their own records using their job-based access rights appears to violate HIPAA's minimum necessary requirement; therefore, allow employees to access their records through normal procedures. d. Employees are considered a special class of people under HIPAA and the procedure should be implemented.

c Allowing employees of a covered entity to access their own protected health information electronically results in a situation in which the covered entity may be in compliance with parts of the HIPAA Privacy Rule but in violation of other sections of the Privacy Rule. An ideal situation would be to establish a patient portal through which all patients may view their own records in a secure manner and for which an employee has neither more or less rights than any other patient (Thomason 2013, 109).

Each year when coding updates are published, Amy plans a face-to-face seminar training program for coders, business office employees, and physician office personnel involved in coding and billing. It generally takes her three weeks to complete the training of all necessary personnel. Which method of employee training is being described? a. Self-directed learning b. On-the-job training c. Classroom-based learning d. Online training

c Classroom-based learning refers to instructor-led, face-to-face training such as traditional lectures, workshops, and seminars. This method is commonly used by managers because it is familiar and content is relatively quick, easy, and inexpensive to develop (Prater 2016, 593).

Coding productivity is measured by: a. Quantity b. Quality c. Quantity and quality d. Volume

c Coding productivity is measured by two indicators of a coder's skill are the types of errors he or she makes and the speed at which he or she can work (Sayles 2016b, 74).

When a meaningful ________ is developed, an organization is more likely to achieve its goals and be profitable. a. Physician education b. Organizational value statement c. Vision statement d. CDI mission statement

c Every clinical documentation improvement (CDI) needs a strong vision that is both compelling and consistent with the organization's overall values, vision, and mission statement. This allows the organization to increase their likelihood of meeting their goals and being profitable (Hess 2015, 240).

Community Hospital wants to offer information technology services to City Hospital, another smaller hospital in the area. This arrangement will financially help both institutions. In reviewing the process to establish this arrangement, the CEO asks the HIM director if there are any barriers to establishing this relationship with regard to HIPAA. In this situation, which of the following should the HIM director advise? a. There are no barriers prescribed by HIPAA for this arrangement. b. Community Hospital needs to expand their organized healthcare arrangement to include the other hospital. c. City Hospital should obtain a business associate agreement with Community Hospital. d. Community Hospital should obtain a business associate agreement with City Hospital.

c In this situation, the smaller hospital should obtain a business associate agreement with the facility providing the information services (Thomason 2013, 25).

A tornado touched down in the community and multiple patients were brought to the hospital. The HIM director has asked all department personnel to report to the emergency staging area to help with record management. The HIM director is performing which function of management? a. Planning b. Organizing c. Leading d. Controlling

c Leading is the function in which people are directed and motivated to achieve the goals of the healthcare organization. In this scenario, the HIM director is performing the leading function of management (Gordon and Gordon 2016b, 534).

Community Hospital is implementing a hybrid record. Some documentation will be paper-based and digitally scanned postdischarge. Other parts of the record will be totally electronic. The Medical Record Committee is discussing how interim reports in the health record should be handled. Some on the committee think that all interim reports should be discarded and only the final reports retained in the scanned record. Others take the opposite position. What should the HIM director recommend? a. Maintaining only the final results provides the greatest measure of security. b. Maintain only the interim reports and discard the final reports. c. Maintaining all interim reports provides the greatest measure of security. d. Maintaining only final reports results in a high volume of duplicate reports.

c Maintaining all interim reports provides the greatest measure of security. Managing health information in a hybrid record environment is challenging, but by maintaining the reports, the facility will reduce some potential problems (AHIMA E-HIM Taskforce Report 2010).

A supervisor wants to determine whether the release-of-information staff members are working at optimal output. Which of the following would be most useful to determine this? a. Review work attendance records to see who is absent from work the most. b. Walk through the work area at random times of the day to make sure that employees are at their desks and working. c. Set productivity standards for the area, and review results on a regular basis. d. Determine the backlog of work not performed each day.

c Managers must be able to report on the amount, efficiency, and quality of work being done in a unit. Employees need to know what is expected of them, and how they are doing relative to expectations. Setting performance standards and measuring performance can address the needs of both (Prater 2016, 587).

An HIM department is planning to implement virtual teams for the coding and data analytics areas. Some in the facility are skeptical of this arrangement, believing that off-site employees cannot be managed. Given this work format, how can the supervisor best gauge productivity of the virtual staff? a. Require staff to call in to the office every morning b. Require a daily conference call with all staff c. Set clear goals and productivity standards and see that these are met d. Install camcorders on each team's computer to ensure that they are at their workstations

c Managing remote staff presents new considerations. It is not necessarily more difficult to manage remote staff; rather, it presents different challenges. In the remote environment, managers may need to rely on productivity and coding accuracy reports to determine the success of remote employees. When allowing coders to work from home or contracting with remote coders, work expectations must be established in advance (Prater 2016, 586-587).

As the director of HIM services, Mitch receives a weekly report from his coding supervisor. The report graphically displays inpatient and outpatient coding volume data, employee turnover rates, and the number of claim denials due to coding errors. This snapshot report is called a: a. Benchmark report b. Budget c. Dashboard d. Performance appraisal

c Performance monitoring is data driven. The organization's leadership uses the information displayed on the dashboard to guide operations and determine improvement projects. Having real-time data in an easily assessable format like a dashboard allows leaders to keep track of high-impact, high-risk, or high-value processes and make adjustments on a daily basis if needed (Carter and Palmer 2016, 502).

The HIM department at Memorial Hospital will install a computer-assisted coding (CAC) system next month. Meetings were held with all coders so they had input into the process and could address any concerns. HIM managers are working together to ensure the process is as smooth as possible. This is an example of what kind of change? a. Emergent b. Open-ended c. Planned d. Strategic

c Planned change is a formal process that is introduced methodically and is actively influenced by manager or change agents (Kellogg 2016b, 481-482; Kelly and Greenstone 2016, 75)

Which of the following is the approved method for implementing an organization's formal position? a. Hierarchy chart b. Organizational chart c. Policy and procedure d. Mission statement

c Policies and procedures also can be considered organizational tools. Policies are written descriptions of the organization's formal positions. Procedures are the approved methods for implementing those positions. Together, they spell out what the organization expects employees to do and how they are expected to do it (Gordon and Gordon 2016b, 537-538).

An audit of the document imaging process reveals that the HIM department staff is scanning 250 pages per hour and indexing 114 pages per hour. If the department is meeting its productivity standard for scanning, but is only meeting 60 percent of the indexing standard, how many more pages per hour must be indexed to meet the indexing standard? a. 45.6 pages b. 68.4 pages c. 76 pages d. 190 pages

c Productivity standards should be based on both accuracy and volume. In this situation, 114 / 0.60 = 190; 190 − 114 = 76 more pages will need to be indexed to meet the productivity standard (Schraffenberger and Kuehn 2011, 76).

Which policy ensures that the minimum penalty appropriate to the level of employee offense is applied? a. Employment at will b. Downsizing c. Progressive penalties d. Discipline without punishment

c Progressive penalties ensure that the minimum penalty appropriate to the level of offense is applied. Penalties may include but are not limited to oral warning for first unexcused tardiness and written warning for the second instance; serious rule violations, such as bringing a weapon to work, may result in immediate dismissal (Prater 2016, 581).

Quality standards for coding accuracy should be: a. At least 80 percent b. At least 90 percent c. As close to 100 percent as possible d. No specific standards are possible

c Quality coding is an important component of coding compliance. Standards for coding accuracy should be as close to 100 percent as possible (Foltz et al. 2016, 462).

A coder with a vision impairment may need additional workspace lighting and a larger computer monitor installed with adjustments to screen contrast and magnification. This would an example of a(n): a. Unreasonable accommodation b. Essential job function c. Reasonable accommodation d. Discrimination

c Reasonable accommodations are actions taken by an employer to allow a disabled applicant or employee access to a work opportunity. The disabled person is typically expected to request the accommodation. Examples of accommodations might include altering their work schedule, modifying office equipment or software (Prater 2016, 561).

In designing input by clinicians for an EHR system, which of the following would be effective for a clinician when the data are repetitive and the vocabulary used is fairly limited? a. Drop-down menus b. Point and click fields c. Speech recognition d. Structured templates

c Speech recognition can be very effective in certain situations when data entry is fairly repetitive and the vocabulary used is fairly limited. As speech recognition improves, it is becoming a replacement for other forms of dictation. In some cases, the user reviews the speech as it is being converted to type and makes any needed corrections; in other cases, the speech is sent to a special device where it generates type for another individual to review and edit (Sayles and Trawick 2014, 189-191).

To date, the HIM department has not charged for copies of records requested by the patient. However, the policy is currently under review for revision. One HIM committee member suggests using the copying fee established by the state. Another committee member thinks that HIPAA will not allow for copying fees. What input should the HIM director provide? a. HIPAA does not allow charges for copying of medical records. b. Use the state formula because HIPAA allows hospitals to use the state formula. c. Base charges on the cost of labor and supplies for copying and postage if copies are mailed while following the state copy fee schedule. d. Because HIPAA allows for reasonable and customary charges, charge only for the paper used for copying the records.

c The HIPAA Privacy Rule intent is to allow an individual to obtain copies of records for a fee that is reasonable enough that an individual could pay for it. The Privacy Rule requires that the copy fee for the individual be reasonable and cost based. It can only include the costs of labor for copying and postage, when mailed. The commentary to the Privacy Rule expands upon this standard. If paper copies are made, the fee can include the cost of the paper. If electronic copies are made, the fee can include copies of the media used (Thomason 2013, 96).

Which of the following is one of the four criteria describing the basics of best of practice clinical documentation improvement (CDI) programs? a. Intangible best practices in middle revenue cycle b. Practices must be central to only one area c. Must be supported by research and actual application by multiple healthcare systems d. Best practices with high validity are included

c The four criteria describing the basics of best practice in CDI programs are: remain constant over time; be supported by research or actual application by more than one healthcare system; affect at least two out of three management areas; and provide some measureable value to the organization (Hess 2015, 239).

The HIM director is part of the revenue cycle management team. The discharged-not-final-billed days are increasing because discharges are increasing. The number of coding staff is five. In an effort to increase productivity, the HIM director is researching staffing alternatives. With the implementation of an electronic document storage system, telecommuting has been suggested as an alternative. Studies report that coding productivity can increase as much as 20 percent with telecommuting. Given that discharges have increased from 100 per day to 144, how many more FTEs would need to be hired if the department went to telecommuting? a. 0.5 FTE b. 0.75 FTE c. 1 FTE d. 2 FTEs

c The productivity increase with telecommuting is 20 percent. The facility has five coders who are currently coding a total of 100 charts a day. With this 20 percent increase, each of the existing five coders can code four records more per day each (a 20 percent increase). This amounts to 120 charts: 24 × 5 = 120. If the discharges increase by 44 charts, the facility would need one more FTE in the telecommuting staffing model, since each coder can code 24 records per day (Horton 2016a, 185-186).

An HIM director is requesting the purchase of a document imaging system. However, the Hospital Budget Committee is reluctant to approve the request because of the expense. The committee thinks that the money is better spent implementing CPOE and other EHR applications. Which of the following might the HIM director use as a cost-benefit justification? a. The EHR system will take too long to implement. b. The Joint Commission requires that the hospital move to digital scanning. c. "Discharged, not final billed" and accounts receivable days can be improved because of workflow efficiencies. d. HIPAA requires the use of digital tracking of release of information.

c Typical performance statistics maintained by the accounts receivable department include days in accounts receivable and aging of accounts. Facilities typically set performance goals for this standard. Understanding the workflow within a department is crucial for the supervisor in managing the departmental resources. To understand and control the workflow, the supervisor can perform a workflow analysis and then design the process to be more effective and efficient (Casto and Forrestal 2015, 255; Prater 2016, 568).

Kevin is responsible for updating all job descriptions in the HIM department. In order to gather information about the data analyst position to establish standards, he spends time interviewing and observing Sophie, who has held this job for three years. What type of study in Kevin conducting on the data analyst position? a. Coaching b. Recruiting c. Work imaging d. Job sharing

c Work imaging occurs when the supervisor gets a snapshot of the current process and then use that data, along with benchmarking data, to establish standards for a position within their department (Schraffenberger and Kuehn 2011, 276-279).

The manager calculated a unit and time productivity statistic based on employee self-reported data. He used the ________ method to develop this performance standard. a. Benchmarking b. Work distribution analysis c. Work measurement d. Workflow analysis

c Work measurement is based on assessment of internal data collected on actual work performed within the organization and the calculation of time it takes to do the work (Prater 2016, 587).

In all positions it is important to develop requirements for employee success to perform their job. For the release information technician position, the statement, "apply policies and procedures for disclosure of health information to process requests with 98% accuracy," would be considered a: a. Procedure b. Mission c. Policy d. Competency

d Competencies are "do" statements identifying measureable skills, abilities, behaviors, or other characteristics required of an individual in order to complete the work required in a successful manner. This example provides competencies for a release of information specialist (Prater 2016, 568-569).

Elizabeth prepares a weekly dashboard report with key performance indicators of the HIM department to send to the chief executive officer. Preparation of this report falls under what managerial function? a. Planning b. Organizing c. Leading d. Controlling

d Controlling is the function in which performance is monitored according to policies and procedures. In HIM, controlling includes monitoring the performance of employees for quality, accuracy, and timeliness of completion of duties (Gordon and Gordon 2016b, 534).

Dr. Smith wants to use a lot of free text in his EHR. What should be your response? a. Good idea, Dr. Smith. This allows you to customize the documentation for each patient. b. Dr. Smith, we recommend that you do not use any free text in the EHR. c. Dr. Smith, we recommend that you should use free text only in your more complex cases. d. Dr. Smith, we recommend that you use little, if any, free text in the EHR.

d Free-text data is the unstructured narrative data that is the result of a person typing data into an information system. It is undefined, unlimited, and unstructured, meaning that the typist can type anything into the field or document. The amount of free-text in the EHR should be limited as the ability to manipulate data is diminished (Sayles 2016b, 69).

Privacy awareness and training must be provided to all employees in order to prevent privacy breaches. This requirement is covered under which of the following laws? a. Civil Rights Act of 1991 b. Consolidated Omnibus Budget Reconciliation Act c. Fair Labor Standards Act d. Health Insurance Portability and Accountability Act

d HIPAA provides standards regarding administrative requirements that are important to the health information professional, including requirements for privacy training. Every member of the covered entity's workforce must be trained in PHI policies and procedures to include maintaining the privacy of patient information, upholding individual rights guaranteed by the Privacy Rule, and reporting alleged breaches and other Privacy Rule violations (Rinehart- Thompson 2016b, 242).

Clinical documentation policies and procedures should: a. Dictate the practices and procedures for medical treatment b. Encompass nationally recognized guidelines c. Meet all the requirements of physician leaders d. Be created by and specifically for each organization

d In order to be both effective and efficient, each organization must be guided by policies and procedures that are created and specific to the organization. This includes policies and procedures regarding clinical documentation (Hess 2015, 172).

One release of information (ROI) specialist handles requests from insurance and managed care companies. Another handles requests from attorneys and courts. Each completes all steps in the business process from beginning to end. This is an example of which of the following? a. Serial work division b. Job sharing c. Job rotation d. Parallel work division

d In parallel work division, the same tasks are handled simultaneously by several workers; each completes all steps in the process from beginning to end, working independently of the other employees (Prater 2016, 584).

The people within the organization who oversee the operation of a broad scope of functions such as coding, transcription, and release of information at the department level are referred to as: a. Senior managers b. The board of directors c. Supervisory managers d. Middle managers

d Middle management involves the people within the organization who oversee the operation of a broad scope of functions; for example, the HIM manager may oversee coding, transcription, and release of information at the departmental level or they may oversee a defined product or line of service, such as in the case of a radiology department manager (Gordon and Gordon 2016b, 536).

Which of the following would be an indicator of process problems in a health information department? a. 5% decline in the number of patients who indicate satisfaction with hospital care b. 10% increase in the average length of stay c. 15% reduction in bed turnover rate d. 18% error rate on abstracting data

d Performance measurement compares work outcomes to the established performance standards and results are typically expressed in quantifiable terms, such as rates. An 18% error rate on abstracting data would be indicative of a process problem in the HIM department. The other three options are process problems for other areas of the hospital (Prater 2016, 588).

When reviewing the monthly performance report, a manager noticed the coding accuracy rate was below standard. She considered whether this difference might be related to a recent change in systems or attributed to another factor. This manager is performing which of the following? a. Performance measurement b. Workforce planning c. Work observation study d. Variance analysis

d Reported performance data are regularly analyzed for variance. Variance—where actual performance does not meet, varies, or is significantly different from the standard—should be further assessed (Prater 2016, 588).

Which of the following is an alternate work schedule option that has been made possible by the growth and development of technology? a. Compressed workweek b. Flextime c. Open systems d. Telecommuting

d Telecommuting, also called remote or virtual work, allows employees to use technology to perform work and link with the organization from home or another out-of-office location. The organization usually provides a computer and the required software (Prater 2016, 586).

The HIM department is developing a system to track coding productivity. The director wants the system to track the productivity of each coder by productive hours worked per day, health record ID, type of records coded, and to provide weekly productivity reports and analyses. Which of the following tools would be best to use for this purpose? a. Word-processing documents b. Paper log book c. Spreadsheet d. Database management system

d The database management system is the best option to collect, store, manipulate, and retrieve data for this situation. Paper and word-processing documents cannot sort and store the data in a meaningful way for this purpose. Spreadsheets should be used for accounting-type functions and not for data storage (Brinda 2016, 146).

One element of Helen's SWOT analysis mentions the hospital across town recently sent all their coders home to work remotely. Currently all coding done at Helen's hospital is done in-house. In a SWOT analysis, remote coding done by the other hospital would be a(n): a. Strength b. Weakness c. Opportunity d. Threat

d The process to develop a strategic and operational plan begins with a SWOT (acronym for strengths, weaknesses, opportunities, and threats) analysis. In a SWOT analysis, key leadership personnel determine the strengths of the organization (what the company does well), the weaknesses (needs for improvement), and establishes future opportunities (and evaluates threats to those opportunities). This scenario is an example of threat in the SWOT analysis (Gordon and Gordon 2016b, 542).

The RHIT supervisor for the filing and retrieval section of Community Clinic is developing a staffing schedule for the year. The clinic is open 260 days per year and has an average of 600 clinic visits per day. The standard for filing records is 60 records per hour. The standard for retrieval of records is 40 records per hour. Given these standards, how many filing hours will be required daily to retrieve and file records for each clinic day? a. 6 hours per day b. 10 hours per day c. 15 hours per day d. 25 hours per day

d Timeliness of the storage and retrieval processes can be monitored. In this situation, each clinic visit represents a patient record that will need to be retrieved (or pulled) and stored (filed back), 600 / 60 = 10; 600 / 40 = 15; 10 + 15 = 25 hours per day (Horton 2016a, 185-186).

The RHIT supervisor for the filing and retrieval section of Community Clinic is developing a staffing schedule for the year. The clinic is open 260 days per year and has an average of 500 clinic visits per day. The standard for filing records is 50 records per hour. The standard for retrieval of records is 40 records per hour. Given these standards, how many filing hours will be required daily to retrieve and file records for each clinic day? a. 10 hours per day b. 11.11 hours per day c. 12.5 hours per day d. 22.5 hours per day

d Timeliness of the storage and retrieval processes should be monitored. In this situation, each clinic visit represents a patient record that will need to be retrieved (or pulled) and stored (filed back). The calculation is: (500 / 50) + (500 / 40) = 22.5 hours per day (Sayles 2016b, 66-67).

The HIM supervisor has set a key performance standard for the release of information (ROI) staff related to the time between receipt of a request and when the request is sent to the requestor. This standard is considered the ROI: a. Control workflow b. Overlap c. Duplicate rate d. Turnaround time

d Turnaround time is the time between receipt of the release of information (ROI) request and when the request is sent to the requestor. The supervisor is responsible for insuring that release of information ROI turnaround times are met (Sayles 2016b, 73).

What document outlines the work to be performed by a specific employee or group of employees with the same responsibilities? a. Union contract b. Policy and Procedure Manual c. Job evaluation d. Job description

d What document outlines the work to be performed by a specific employee or group of employees with the same responsibilities? a. Union contract b. Policy and Procedure Manual c. Job evaluation d. Job description

The leader of the coding performance improvement team wants all of her team members to clearly understand the coding process. Which of the following would be the best tool for accomplishing this objective? a. Scatter diagram b. Force-field analysis c. Pareto chart d. Flow chart

d When a team examines a process with the intention of making improvements, it must first understand the process thoroughly. Each team member has a unique perspective and significant insight about how a portion of the process works. Flow charts help all the team members understand the process in the same way (Carter and Palmer 2016, 513).

Which of the following items on Abigail's to do list is most likely to require a critical conversation? a. Ask Thomas to act as a coach for the new scanning clerk scheduled to start next week b. Meet with the director for a discussion on whether I should consider going back to school for my master's degree c. Tell Patricia she has been selected for promotion to lead transcriptionist to fill the vacancy left when Sara retired d. Place Daniel on probation due to continuing problems with decreasing coding productivity and coding accuracy

d While managing conflict, there are time when difficult or critical conversations need to take place in order for resolution to occur to move change to the next level. Poor communication creates obstacles for managing critical conversations in conflict situations. Critical or crucial conversations are about challenging issues where emotions are involved and the outcomes of the conversation have a large impact on relationships or workplace dynamics (Kelly and Greenstone 2016, 86).

Based on a productivity log, a coder completed 23 charts during a 7.5-hour workday. The performance standard is 4 charts per hour. How many charts did he code per hour? Round to the nearest whole number. a. 2.06 b. 4.1 c. 23 d. 3

d Work measurement is based on assessment of internal data collected on actual work performed within the organization and the calculation of time it takes to do the work. Employees log what they do and the time spent on tasks in units of work received and processed each day. 23 charts/7.5 hours = 3.06, which is rounded to 3 charts per hour (Prater 2016, 587-588).

Joe is a supervisor of the imaging section of the HIM department. In trying to update scanning productivity standards, Joe asked the current scanners to track their tasks on an activity log. Each scanner logs in the time it takes to scan a specific amount of records. This is an example of what source of performance data? a. Benchmarking b. Job appraisal c. Observation d. Work sampling

d Work sampling is a statistical method that reviews a select portion of tasks performed and provides baseline data for further job performance assessment. Work sampling takes into account the quantity of activities that can be completed within a certain timeframe (Kelly and Greenstone 2016, 161).

Which of the following can assist managers with the tasks of monitoring productivity and forecasting budgets? a. Intermediary bulletins b. Mapping errors c. Revenue codes d. Workload statistics

d Workload statistics can assist managers with the tasks of monitoring productivity and provide data regarding resources used, such as equipment, personnel, services, and supplies (Schraffenberger and Kuehn 2011, 223).