1 / 44

Clinical Laboratory Management Indicators

Clinical Laboratory Management Indicators. CLMI. MSgt Christopher A. Bartley AF DoD CLIP Program Manager 202-782-2585/DSN: 662 Christopher.bartley@afip.osd.mil. Overview. Why CLMI? Data Requirements Problem Areas Fixes CLMI Data: Where were we?. Overview (continued).

jaden
Télécharger la présentation

Clinical Laboratory Management Indicators

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Clinical Laboratory Management Indicators CLMI MSgt Christopher A. Bartley AF DoD CLIP Program Manager 202-782-2585/DSN: 662 Christopher.bartley@afip.osd.mil

  2. Overview • Why CLMI? • Data Requirements • Problem Areas • Fixes • CLMI Data: Where were we?

  3. Overview (continued) • CLMI Data: Where are we? • Quarterly Summary Report • How do I use CLMI? • Point of Contact • Questions

  4. Why CLMI? • CLMI is the laboratory benchmarking system in use by the Air Force and Navy • Army uses ASAMS • It Provides tools to: • Evaluate operational and financial performance • Improve utilization of services, productivity, and cost effectiveness

  5. Data Requirements • Report due by the 15th of the next month • Facility and General Information • Bed size • Facility type (medical center, hospital, clinic) • Month, FY, FY Quarter, End Date of report • Clinical Lab • Workload Data • In-house Reportable Tests (RT) for each lab section • Broken down by CPTsuffix • 00 – Tests performed in-house • 26 – Pathology Consults • 32 – Tests performed for another lab (shipped-in)

  6. Data Requirements • Clinical Lab • Off-Site Workload • Clinical Lab, Histopathology and Cytology RTreferred out • To Civilian Labs (including monthly cost) • To Military Labs • Utilization Data • Outpatient RT • Outpatient Visits • Inpatient RT • Admissions

  7. Data Requirements • Clinical Lab • Staffing/Productivity Data • Full time equivalents (FTE) by Grade • O-6, O-4/5, O-3, O-1/2 • E-9, E-8, E-6/7, E-5, E-1/4 • GS-13/14, GS-10/12, GS-7/9, GS-4/6, GS-1/3 • Used with RT to calculate productivity • Cost Data • Supply costs (EEICs 600-619)

  8. Data Requirements • Histology • Surg Path, EM, Cytogen and Autopsies • In-house, referred-in • Specimens referred • AFIP, Other Federal and Civilian Agencies • Blocks • HE Stains • Special Stains • Immuno-Histo

  9. Data Requirements • Histology • Frozen Sections • Autopsy Backlog • FTE – same breakouts as clinical • Supply money spent

  10. Data Requirements • Cytology • Slides Examined (Gyn/Non-Gyn) • Cytotechnologist • Pathologist • FTE – same breakouts as clinical • Total cases (Gyn/Non-Gyn) • Normal DXS (Gyn/Non-Gyn) • Abnormal Gyn

  11. Data Requirements • Cytology • Slides • Unsat • Limited • QA • Average in-house TAT (Gyn/Non-Gyn) • Supply Money Spent

  12. Problem Areas • 1500 duplicate entries between FY07-FY09 • Example: one base had 34 entries for FY08 • Most didn’t duplicate all data fields-blanks/nulls • Database didn’t recognize/restrict duplicate months and gave each entry a unique number • Duplicate entries included in CLMI calculations • Wrong date for end of month • Example: 10/30/2008 instead of 10/31/2008 • Entry not included in CLMI calculations

  13. Problem Areas • Wrong year format • Example: 09 or 9 for 2009 • Entry not included in CLMI calculations • Wrong quarter • Oct-Dec=1, Jan-Mar=2, Apr-Jun=3, Jul-Sep=4 • Entry not calculated in correct quarter

  14. Problem Areas • No easy way to import data • Website entries stored on one table • Report generated from local table • Importing difficult, handled by network person • Copy/paste ignored blank areas; data filled in from left to right • No way to specify quarter or year for report • Discovered during calculation validation • Generated report for 2nd Qtr 2008, next day generated 3rd Qtr 2008

  15. Problem Areas • Unbundled chemistry data • Data collected since 2005 • Calculations not updated • CLMI reported bundled chemistry number • No archival system • All entries from 1999-2008 stored on website table and local table

  16. Fixes • Duplicate Entries • Removed duplicate entries • Website allows duplicates • BRAC – losing website, at least temporarily • Changed Local table - only allows one entry per month (Checks End Date) • Wrong date • No automated fix – each month table scrubbed manually for wrong end dates

  17. Fixes • Wrong year format • No automated fix – each month table scrubbed manually for wrong end dates • Wrong quarter • No automated fix – each month table scrubbed manually for wrong end dates

  18. Fixes • Data import • Email form – 4 mouse clicks CLMI Form • Can be automated • Report generation • Asks for Qtr/Year each time generated – printed in header of report • Can generate multiple quarters/years sequentially

  19. Fixes • Unbundled chemistry • All formulas updated • Report shows which areas use unbundled data • Archived data • Archived by year • 1999-2006 now stored in separate table • Speeds up database, report generation

  20. Where were we? • May – Dec 09 – identified/fixed problems • 14 Dec – started testing email form to replace website (Travis/Buckley) • 25-29 Jan 10 – server maintenance at AFIP • 29 Jan – sent out 2009/2010 data entry statistics

  21. Where were we? (2009 Data) As of 29 Jan 2010 • 80% of entries needed before report generated • Total Lab Entries per Quarter 219 • Total Cytology Entries per Quarter 120 • Total Histology Entries per Quarter 120

  22. Where were we? (2010 Data) As of 29 Jan 2010 • 80% of entries needed before report generated • Total Lab Entries per Quarter 219 • Total Cytology Entries per Quarter 120 • Total Histology Entries per Quarter 120

  23. Where were we? • 3 Feb – trouble ticket for CLMI website • 5 – 11 Feb – DC blizzard Blizzard • 1 Mar – website still down email form live

  24. Where are we? • 1 Mar – 19 Mar • 91 entries for 09 10% of 09 data • 119 entries for 10 14% of 10 data • Email form has to be viewed as HTML • Must press “reply” to enter data • Cyto/Histo forms have to be designed

  25. Where are we? • Data needs to be validated at base level • Compare data entered each month • Use instrument test counts (if your instrument keeps this data) to validate test counts on the SDR • Use the Issue/Turn-In Summary Report in DMLSS to validate supply charges • Use current recall roster to validate number of military personnel/ranks • Talk to person in charge of timecards to validate number of civilian personnel/GS levels

  26. Where are we? (2009 Data) As of 19 Mar 2010 • 80% of entries needed before report generated • Total Lab Entries per Quarter 219 • Total Cytology Entries per Quarter 120 • Total Histology Entries per Quarter 120

  27. Where are we? (2010 Data) As of 19 Mar 2010 • 80% of entries needed before report generated • Total Lab Entries per Quarter 219 • Total Cytology Entries per Quarter 120 • Total Histology Entries per Quarter 120

  28. Quarterly Summary Report • Clinical Lab • 1-1: RT, FTE, productivity, and supply cost • Added “Months Entered” • Removed “Total Budget”, “Total $/RT”, “Salary” and “Salary $/RT” • 1-2: RT by section • Added “Months Entered” • Removed all section “RV”

  29. Quarterly Summary Report • Clinical Lab • 1-3: Civilian referrals/cost, Military referrals • Added “Months Entered” • 1-4: Utilization (outpatient, inpatient) • Added “Months Entered”

  30. Quarterly Summary Report • Histopathology • 2-1: In-house, referred-in, referred out workload • Added “Months Entered” • 2-2: Procedures, FTE, productivity and supply cost • Added “Months Entered” • Removed “Total Budg $”, “Total $/Spec”, “Salary $” and “Salary $/Spec”

  31. Quarterly Summary Report • Cytology • 3-1: workload and productivity • Added “Months Entered” • 3-2: QA data and costs • Added “Months Entered” • Removed “Total Budg $”, “Total $/Slide”, “Salary $” and “Salary $/Slide”

  32. How do I use CLMI? • Data comparison between labs of similar size • RT/FTE (Section 1-1) is a gauge of how well personnel are utilized • $/RT (Section 1-1) can indicate need for a new/modified reagent contract • The individual RTs (Section 1-2) show how your Total RT breaks down

  33. How do I use CLMI? • Section 1-3 shows Clinical, Cytology and Histology Civilian/Military Reference Lab Costs/Totals • An increase here could indicate a need for a new/modified testing contract, need to refer test(s) to a military reference lab or a need to bring a test in-house • Section 2-1 provides the same data for Histology (Total RT and Civilian/Military Reference Lab)

  34. How do I use CLMI? • Section 2-2 provides the same data for Histology (RT/FTE, $/RT and Individual RT) • Section 3-1 provides the same data for Cytology (Total RT and RT/FTE) • Section 3-2 provides the same data for Cytology ($/RT) • It also can indicate a QA issue (Unsat, Limited, QA) showing a need to evaluate technique/additional training

  35. How do I use CLMI? • Using Total RT (Section 1-1) in the manpower calculation (AFMS 5512) • Linear Equation using Reportable Test Volume • Step 1. Refer to the standard manpower equation for formula • Formula: X + Y + (R/1100) = Authorizations

  36. How do I use CLMI? • Step 2. Determine positions requirements Base Cost (X) based on MTF Peer Group start-up cost • Peer 1 Facilities: 2 authorizations • Peer 2 & 3 Facilities: 3 authorizations • Peer 4 Facilities: 4 authorizations • Peer 5 Facilities: 7 authorizations • Peer Rating comes from Max Available Enrollment's • Clinics • PG 1 - less than 10,000 • PG 2 - 10,000 - 15,000 • PG 3 - greater than 15,000 • Bedded Facilities • PG 4 - Non-GME Hospitals • PG 5 - Grad Med Ed Hospitals

  37. How do I use CLMI? • Step 3. Determine positions requirements earned from Additives (Y) • Overseas: 1 authorization (overseas readiness manpower additive) • Isolation/BAT: 1 authorization (high readiness/BAT in isolation, Kunsan only) • Split Operations: In-house: 1 authorization (open door cost), maximum of 2 labs • 24 hr STAT Lab: 3 authorizations (open door cost), maximum of 1 lab

  38. How do I use CLMI? • Step 3. Determine positions requirements earned from Additives (Y) • Shared Ops: 1 authorization (tech commitment to sharing facility) • Free Standing Lab: 2 authorizations (open door cost - outside main MTF), maximum of 4 labs • Active BDC: 4 authorizations open door cost + 1/50 units monthly • Consultant/Flt CC: 1 authorization (activities must consume >50% of time), maximum 1/MTF

  39. How do I use CLMI? • Step 4. Obtain a 12-month average for Reportable Tests (R) using data from the Clinical Laboratory Management Indicators (CLMI) • Step 5. Compute authorizations using the equation • Step 6. MAJCOMs may submit proposed variances to AFCQMI for review

  40. How do I use CLMI? • When do I bring a test in-house or decide to refer it out? • $/RT • Productivity (RT/FTE) • Add/reduce authorizations (RT) • Instrumentation • All tests counted equal • Changes to authorizations start with Sq/CC

  41. Point of Contact MSgt Christopher A. Bartley christopher.bartley@afip.osd.mil DSN: 662-2585 Commercial: (202) 782-2585 Fax: x6022

  42. Questions?

  43. CLMI Form Fixes Reference sheet for email form has instructions/formats for End Date, Year and Quarter

  44. Blizzard Where were we?

More Related