Domain 6:

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?

Fishbone diagram 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

Which of the following is a data collection tool that records the workflow of current processes?

Flow chart 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

Position descriptions, policies and procedures, training checklists, and performance standards are all examples of:

Staffing tools 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

What kind of planning addresses long-term needs and sets comprehensive plans of action?

Strategic 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

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?

"Discharged, not final billed" and accounts receivable days can be improved because of workflow efficiencies. 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

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?

1 FTE 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

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?

100 hours 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

Which of the following would be an indicator of process problems in a health information department?

18% error rate on abstracting data 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

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?

2.85 385 charts per week / 5 days / 27 standard charts per day = 2.85

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?

22.5 hours per day 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

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?

25 hours per day 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

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.

3 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

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?

360 performance appraisal 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

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?

76 pages 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

Coding accuracy is best determined by:

A predefined audit process 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

A comprehensive retrospective review should be conducted at least once a year of what aspect of the clinical documentation improvement program?

All query opportunities A standard should be set that all query opportunities within a CDI program should undergo comprehensive review retrospectively at least once a year

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?

Benchmarking 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

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?

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. 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

Quality standards for coding accuracy should be:

As close to 100 percent as possible Quality coding is an important component of coding compliance. Standards for coding accuracy should be as close to 100 percent as possible

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?

Ask current staff members to keep a diary for a certain period of time on how they spend their time 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

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?

Avoid displaying the number on any document, screen, or data collection field 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

Clinical documentation policies and procedures should:

Be created by and specifically for each organization 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

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?

Behavior 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)

A standard of performance or best practice for a particular process or outcome is called a(n):

Benchmark 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

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?

Benchmarking 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

Managing the adoption and implementation of new processes is called:

Change management Change management is the formal process of introducing change, getting it adopted, and diffusing it throughout the organization

What is the formal process of introducing change, adopting the change, and diffusing it throughout the organization?

Change management Change management is the formal process of introducing change, getting it adopted, and diffusing it throughout the organization

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?

City Hospital should obtain a business associate agreement with Community Hospital. In this situation, the smaller hospital should obtain a business associate agreement with the facility providing the information services

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?

Classroom-based learning 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

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?

Clearly define what is to be studied and accomplished by instituting benchmarks. 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

Performance standards are used to:

Communicate performance expectations 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

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:

Competency 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

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?

Computer-based Computer-based training is a form of self-directed learning, an approach that allows learners to control their own education at their own pace

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?

Controlling 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

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?

Critical incident method 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

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:

Dashboard 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

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?

Dashboards 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

Which HIM role works with patients to help them understand health data?

Data translator Correct Answer: 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

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?

Database management system 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

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?

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. 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

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?

Determine whether the source of the benchmark data is from a comparable institution 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

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?

Discuss this issue and the importance of compliance with the chief of surgery 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

Dr. Smith wants to use a lot of free text in his EHR. What should be your response?

Dr. Smith, we recommend that you use little, if any, free text in the EHR. 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

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?

Early adopter 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

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?

Flow chart 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

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?

Form an EHR steering committee 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

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?

Health Insurance Portability and Accountability Act 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

Clinical documentation improvement staff members must work directly with this department to obtain data about retrospective physician queries:

Health information management 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

After an outpatient review, individual audit results by coder should become part of the:

Individual employee's performance evaluation 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

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?

Insufficient knowledge of team members 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

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?

Internal 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

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?

Investigate whether there are factors contributing to the low productivity that are not reflected in the national benchmarks. 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

What document outlines the work to be performed by a specific employee or group of employees with the same responsibilities?

Job description A job description, sometimes called a position description, is a written explanation of a job and the duties it entails and is based on information provided by the job analysis. A job description helps the human resources department, hiring manager, the employee's direct supervisor and the employee understand the job duties and expectations

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?

Leading 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

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?

Maintaining all interim reports provides the greatest measure of security. 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

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:

Middle managers 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

Which of the following behaviors is an early indicator of resistance to change that an employee might exhibit when presented with a new project?

Missing planning meetings to determine the implementation schedule for the new project 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

In a management sense, controlling means:

Monitoring performance 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

Which of the following is one of the four criteria describing the basics of best of practice clinical documentation improvement (CDI) programs?

Must be supported by research and actual application by multiple healthcare systems 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

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?

New employee training 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

Which of the following is a problem-solving technique that focuses on working with individuals to find a mutually acceptable solution?

Nominal group technique 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

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?

Nonexempt Nonexempt employees are covered by FLSA overtime provisions; this includes hourly-paid jobs

A coding supervisor who makes up the weekly work schedule would engage in what type of planning?

Operational 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

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?

Organizing 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

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?

Parallel work division 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

Before the actual job analysis process begins, an HIM manager must complete the following:

Perform a needs assessment 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

Which of the following items on Abigail's to do list is most likely to require a critical conversation?

Place Daniel on probation due to continuing problems with decreasing coding productivity and coding accuracy 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

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?

Planned Planned change is a formal process that is introduced methodically and is actively influenced by manager or change agents

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?

Planning 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

Which of the following is a written description of an organization's formal position?

Policy 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

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:

Policy 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

A statement or guideline that directs decision making or behavior is called a:

Policy A policy is a statement that describes general guidelines that direct behavior or direct and constrain decision making in the organization

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?

Policy 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

A document that describes the steps involved in performing a specific function is a:

Procedure A procedure is a document that describes the steps involved in performing a specific function

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?

Procedure 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

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:

Productivity standards 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

Which policy ensures that the minimum penalty appropriate to the level of employee offense is applied?

Progressive penalties 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

Coding productivity is measured by:

Quantity and quality 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

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?

Scanning all documents at the time of patient discharge 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

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?

Secondary 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

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?

Serial work division 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

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?

Set clear goals and productivity standards and see that these are met 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

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?

Set productivity standards for the area, and review results on a regular basis. 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

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?

Speech recognition 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

Incorporating a workflow function in an electronic information system would help support:

Tasks that need to be performed in a specific sequence Workflow and process designs ensure the most efficient and effective use of electronic information systems

Which of the following is an alternate work schedule option that has been made possible by the growth and development of technology?

Telecommuting 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

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:

That access be granted that is view-only 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

Which of the following is a positive aspect of using employee self-appraisal as a source of data for performance appraisal?

The supervisor is kept informed of the employee's accomplishments 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

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):

Threat 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

Which of the following is one of the five best practices for management of financial measures in the CDI program?

Track and report on CC capture rates across the organization and by service 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

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?

Training will provide $146,000 savings in help desk support and can be justified. 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

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:

Turnaround time 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

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:

Using external sources 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

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?

Variance analysis 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

When a meaningful ________ is developed, an organization is more likely to achieve its goals and be profitable.

Vision statement 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

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):

Weakness 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

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?

Work imaging 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

The manager calculated a unit and time productivity statistic based on employee self-reported data. He used the ________ method to develop this performance standard.

Work measurement 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

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?

Work sampling 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

Which of the following can assist managers with the tasks of monitoring productivity and forecasting budgets?

Workload statistics Workload statistics can assist managers with the tasks of monitoring productivity and provide data regarding resources used, such as equipment, personnel, services, and supplies