Organizations Flashcards

1
Q

Centers for Medicare and Medicaid Services (CMS)

A
  • enforces CLIA

- proxy through CAP and JCAHO to inspect and accredit for CLIA certification

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2
Q

Clinical Laboratory Improvement Amendments (CLIA)

A

CLIA certification required for repayment for Medicare/Medicaid testing

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3
Q

College of American Pathologists (CAP)

A
  • CMS proxy

- regulate proficiency testing for labs

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4
Q

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

A
  • CMS proxy
  • regulate proficiency testing for labs and hospital
  • more recognized by nurses than clinical labs
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5
Q

CLIA requirements for Waived Tests

A

Only requirement - follow manufacturer’s written instructions

  • changes invalidates test
  • changes makes test a high complexity test
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6
Q

CLIA requirements for Moderate Complexity Tests

A

Accuracy
Precision
Reportable range
Reference interval

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7
Q

CLIA requirements for High Complexity Tests

A
Accuracy
Precision
Reportable range
Reference interval
Analytical sensitivity (detection limit)
Analytical specificity (interference and recovery)
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8
Q

Non-waived tests are divided into

A

Moderate Complexity Test

High Complexity Test

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9
Q

CAP requirements for Waived Tests

A

None, except verification of reference range if practical (manufacturer’s document)

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10
Q

CAP requirements for Moderate Complexity Tests

A
Accuracy
Precision
Reportable range
Reference interval
Sensitivity
Specificity (interferences)
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11
Q

Define Individualized Quality Control Plans (IQCP)

A

Standards that must be followed and risk factors checked in order to use an analyzer’s internal QC

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12
Q

Define Equivalent Quality Control (EQC)

A

2 levels of external QC checks everyday

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13
Q

IQCP vs EQC - which one is more expensive?

A

EQC

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14
Q

CAP proficiency testing rules (4)

A
  • test samples as you would any patient sample
  • do not communicate results or share with other labs
  • do not send test out if you normally do
  • must not test sample in multiple labs
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15
Q

CAP proficiency testing - cannot fail how many consecutive surveys? Cannot fail how many surveys per year?

A

2

2

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16
Q

CAP proficiency testing - what do you do if you fail testing?

A

Document corrective action

-keep records for 2 years

17
Q

Which organizations have different requirements for moderate and high complexity testing and which group them together?

A

CLIA and JCAHO = different for moderate/high complexity

CAP = same for moderate/high complexity

18
Q

Why might we want to do a EQC over an IQCP

A

IQCP cannot account for human/tech error

-a lot of POC devices have internal QC that cannot account for tech error = pre-analytical error

19
Q

JCAHO requirements for Waived Tests

A

Require evidence of data for:
Accuracy
Precision
Reportable Range

Verify:
Reference Range

20
Q

JCAHO requirements for Moderate Complexity Tests

A

Accuracy
Precision
Reportable Range
Reference Range

21
Q

CAP requirements for High Complexity Tests

A
Accuracy
Precision
Reportable range
Reference interval
Sensitivity
Specificity (interferences)
22
Q

JCAHO requirements for High Complexity Tests

A
Accuracy
Precision
Reportable range
Reference interval
Analytical sensitivity
Analytical specificity (interferences)

Same requirements for modified moderate complexity or in-house tests

23
Q

Which organization administers Proficiency Testing? How many samples do they send per year for testing? What is the passing score?

A

CAP

3 sets of 5 samples

80% (4 out of 5 samples must pass)
-except blood bank, which is 100%

24
Q

Proficiency Testing is also a form of this type of QC check

A

External QC