Basic Management Principles
According to CLIA '88, which of the following laboratory personnel is responsible for ensuring the employment of qualified, competent testing personnel within a moderate to high complexity testing environment?
Laboratory Director
Which of these processes would be characteristic of "Lean" laboratory production?
Load patient samples onto automated analyzers as the samples arrive to the work area.
The Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations apply to which type of patient health information?
Paper, electronic, and oral forms
All of the following are examples of Protected Health Information (PHI), EXCEPT?
Patient's education level
HIPAA stands for:
Health Insurance Portability and Accountability Act
In 1996, which of the following was adopted by the United States Department of Health and Human Services to provide standards for facilitating healthcare-related electronic transactions and to ensure health insurance coverage after leaving an employer?
Health Insurance Portability and Accountability Act
What is a workload reporting system and why is it an important part of laboratory management?
Helps in planning, developing, and maintaining efficient laboratory services with administrative and budget controls
In today's global market and competitiveness, customer service is of utmost importance in both hospital and clinical outpatient sites. The first _____ _____ of a meeting with a patient will provide the patient with a memory about the experience. The patient will share this experience with others; therefore, a positive introduction is important.
30 seconds
According to Westgard and CLIA, how many specimens should be run by each method on the same day for 8 to 20 days to compare a test method with a comparative method?
40-100
The overtime budget for the laboratory is $37,883, but $60,419 has already been spent. What percent over budget does this represent?
59%
What type of policy is required by OSHA for every laboratory that uses hazardous chemicals?
Chemical hygiene plan
A laboratory is in the process of implementing Lean techniques to become more efficient in its processes. A team is performing a waste walk to determine where there is waste in the laboratory. Which question below would help the team identify if the Lean waste form known as "waiting" is present in this laboratory?
Is there too much dependency on others to complete a task before you can begin a task?
The laboratory compliance plan states that an employee can be disciplined for violating laws and compliance policies up to and including:
Immediate termination
Which occurrence is a medical error?
Incompatible blood is transfused into a patient during surgery
The Lean approach seeks to streamline the process. What is the major measurement for Lean?
Time
Which of the following procedures should be followed when storing supplies or reagents that do not have a manufacturer-assigned expiration date?
C. Store supplies in a manner that ensures the oldest will be used first.
General Hospital is considering the addition of a new chemistry panel containing 12 tests. The laboratory is asked to calculate the total cost of quality control per new chemistry test panel. Quality control must be performed 3 times per day (every 8 hours). The labor cost per quality control test for this panel is $2.63. A month's worth of quality control reagent costs $354.00. What is the total quality control cost per new chemistry test panel if 76,000 of these new panels are performed each year?
$0.09
You are a chemistry laboratory technologist assigned with the task of calculating the cost per analysis of a new immunoassay analyzer. The immunoassay analyzer will cost $762,000 with a maintenance contract priced at $7,500 per year. The director estimates that you will run approximately 490 test per month on this new analyzer. The typical amount of time your laboratory uses a piece of equipment is 7 years. What is the equipment cost per each new immunoassay test performed?
$19.79
Your community hospital is considering the addition of a new hematology screening test. The laboratory is asked to calculate the total cost of quality control per new test. Quality control must be performed 3 times per day (every 8 hours). The labor cost per quality control test is $8.95 each. A day's worth of quality control reagent costs $23.62. What is the total quality control cost per new hematology test if 6700 of these new tests are performed each year?
$2.75
What minimum level of specific resistance (megohms@25o C) is required for a Type I water system:
10.0
Error rates in the laboratory are estimated at what rate?
Between 1:164 to 1:8300 results.
What does the abbreviation FTE stand for?
Full Time Equivalent
In which of the following circumstances is it acceptable to change a physician's testing orders without contacting the physician first?
It is the sole responsibility of the physician to change the test order.
Computer passwords for laboratory computers should be:
Kept confidential
What is a LIS in a hospital setting?
Laboratory Information System
What is the definition of a waived laboratory test or procedure?
Tests that are cleared by the FDA for home use
A laboratory information system (LIS) consists of:
The computer hardware and software which provide the means to manage data used in laboratory operations.
The definition of competency can best be described as:
The standardized requirements for those who work in the clinical laboratory to accurately perform their job.
A laboratory test flags as a critical result. The technologist repeats the test and it again flags as a critical result. Which of these scenarios correctly describes all the actions that need to be taken after this occurs?
The technologist phones the patient's caregiver, reports the result and asks the caregiver to read back the information; documents his placement of the call, who was notified, time and date of notification.
The federal government has categorized critical biological agents into three groups: A, B, and C. Why are the agents in category A classified as the highest-priority?
These organisms can be easily disseminated or transmitted person-to-person.
Which of the following activities may lead to a HIPAA violation lawsuit?
Throwing laboratory test requests into the regular trash.
A laboratory manager wants to evaluate the timeliness of patient services in order to prevent medical errors caused by a delay in treatment. Measuring the turnaround time for which of these analytes would provide the most timely and valuable information?
Troponin tests from the emergency department.
What is the role of a sentinel laboratory within the Laboratory Response Network (LRN)?
Use standardized testing protocols to rule-out critical biological agents or refer them to one of the LRN reference laboratories for identification
Which of the following best defines "effective clinical laboratory services?"
Using evidence to identify the best test to detect or diagnose a condition
Good Manufacturing Practices applies to all of the following, EXCEPT:
Waste
Which of the following is considered to be a variable cost in the clinical laboratory?
Overtime pay
What is the correct order of steps that should be taken when a Six Sigma approach is used for problem-solving?
Define, Measure, Analyze, Improve, Control
A tool used to show chain of command by defining responsibility and authority is a/an:
Organizational chart
Which of the following would be the BEST data source to identify opportunities to improve timeliness?
Outliers in turnaround time studies
The time needed for the retention of laboratory records (and as applicable: slides, blocks, and tissue) is typically ___ year(s) and ___ year(s) for immunohematology records.
2 years, 5 years
Which of the following is an illegal topic to ask about during an employee interview?
Age of the applicant
How long will it take to start accruing revenue for a new microbiology identification analyzer if the initial cost is $459,000 and produces $800,000 in annual laboratory income?
6.9 months
Your laboratory has 17,264 hours of total paid labor time. Of this amount, 1458 hours are nonproductive hours. If your employees work 40-hour work weeks each year, what is the total number of FTEs (full time equivalents) needed to run the laboratory?
8.3
A reference laboratory has 23,264 hours of total paid labor time. Of this amount, 2781 hours are nonproductive hours. If your employees work 40-hour work weeks each year, what is the total number of productive full time equivalents (FTEs) needed to run the laboratory?
9.8
A laboratory information system (LIS) generated number used for identifying a laboratory specimen for tracking and reporting purposes is called:
Accession number
Where can sentinel laboratory staff find the standardized testing protocols?
American Society for Microbiology (ASM) website
Which of these policies should be followed when conducting an employee's performance evaluation?
An employee's performance should be compared only to an established performance standard, job description, and reward system-not to the performance of other employees or hear-say.
Which of the following best defines "waste" in Lean thinking?
Any activity or process that is unneeded, unwanted, or involves excess effort
All of the following are responsibilities of a clinical laboratory director, EXCEPT?
Attending all Florida Board of Clinical Laboratory Personnel meetings.
What are the steps of Root Cause Analysis?
Collect the information, identify reasons, chart the factors, and generate recommendations
Which one of the following statements is correct in regard to the Health Insurance Portability and Accountability Act (HIPAA)?
Confidential medical information should never be discussed outside of the laboratory.
Risk management as it applies to the clinical laboratory is most accurately defined in which of the following ways?
Creation of policies and procedures and the implementation of practices that focus on prevention of future events that could result in negative patient outcomes.
All outpatient tests are reimbursed according to a group of code numbers which are called:
Current Procedural Terminology (CPT) codes
An example of a laboratory test that can be performed and interpreted by individuals who are not trained laboratory personnel is:
Dipstick urinalysis
What is the intent of the Health Insurance Portability & Accountability Act (HIPAA) of 1996?
Establish security and privacy standards
Which of the following is used to analyze risk and highlight aspects of a process that should be targeted for improvement?
Failure mode and effects analysis (FMEA)
Which of the following terms is used to identify an individual who has enough Six Sigma training to participate on a performance improvement team or lead small-scale projects within his/her work unit, but does not work on Six Sigma projects full-time?
Green belt
All of the following are examples of entities covered by the HIPAA Privacy Rule, EXCEPT?
Hospital and laboratory accrediting agencies
A new clinic in the area is sending a very large number of additional chemistry tests to the laboratory. The existing chemistry instrument is only 2 years old and works well, however, there is a need to acquire a high throughput instrument. Which one of the following is the appropriate "Justification Category?"
Increased testing volume
Which of the following is the main function of the ASCP Board of Certification?
Maintain a registry of certified personnel
In the DMAIC (Define, Measure, Analyze, Improve, Control) process improvement, which of the following would belong to the measure step?
Map and analyze current process
Which of the following are violations of Board rules?
Not protecting PHI (protected health information)
When can a doctor order a panel made up of tests he/she specifically wants?
Only if the laboratory ensures the ordering physician knows what tests are included in the panel or profile and has the appropriate procedure and diagnostic codes for each test.
A patient event occurs that results in a "near miss" (an event that was averted, but may have resulted in death or serious injury). The error was caught in time before serious injury occurred. Which of the following is an appropriate response to improve the process involved and patient safety?
Perform a risk assessment which includes performing a root cause analysis, document investigation, and implement appropriate risk-reduction processes
Which of these methods should be used when an adverse event occurs that results in patient injury (negative patient outcomes) to prevent a recurrence?
Perform a root cause analysis.
Which of the following is a violation of billing requirements for laboratory services?
Performing testing on verbal order from the nursing assistant.
Other than credentialed clinical laboratory personnel, non-laboratory healthcare personnel may perform low complexity laboratory tests within the:
Point-of-care-testing area.
What is the focus of both Lean principles and the Six Sigma methodology?
Process improvement
What is the Health Insurance Portability and Accountability Act (HIPPA) requirement?
Protect the confidentiality of patient information.
CPT (Current Procedural Terminology) codes:
Provide a uniform method of coding medical, surgical, and diagnostic services
All of the following are responsibilities of a clinical laboratory supervisor, EXCEPT?
Providing clinical consultation to physicians about patient care
Which of the following actions should be taken during the "Define" phase of the DMAIC (Define, Measure, Analyze, Improve, and Control) process?
Review the current process.
A medical event occurs that results in serious injury to a patient. All systems, processes, and common causes that were involved in the adverse event should be evaluated. A method that can be implemented to effectively study the underlying causes is known as:
Root cause analysis
The HIPAA Privacy Regulations includes standards pertaining to:
Safeguards protecting PHI
When evaluating the throughput of a particular method you should consider all of the following except:
Sensitivity of technique
All of the following are types of quality and process improvement tools, EXCEPT:
Sentinel events
Which of the following is considered a HIPAA violation?
Sharing your login information with a coworker or another health care worker
What is considered a Lean principle?
Streamlines a process to reduce wait times
Which of the following methods may be used by a laboratory to document and analyze all of the steps that bring a laboratory test result to the customer (eg, physician, nurse, and/or patient)?
Value stream mapping
Under CLIA '88, which of the following levels of testing complexity does not mandate specific certification or licensure requirements for testing personnel?
Waived tests
Which of the following are appropriate ways to dispose of unneeded patient reports containing PHI?
Wipe, shred, or in some manner destroy any paper reports or electronic media.