CMRP Overview Session Dave Hinkle, FACHE, CMRP Michael Moore,
CMRP
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Your Presenters Dave Hinkle Principal, Healthcare Supply Chain
Education & Consulting AHRMM Approved CMRP Presenter Director,
Supply Chain Outreach, Providence Health & Services Senior
Director, Supply Chain Operations Practice, VHA Performance
Services Supply Chain Operations Assessments and Operations
Redesign Interim Materials Management Services Materials Management
Leadership Program (Outsourcing) [email protected][email protected] 425-525-3242 (office), 856-816-7150
(cell) Michael Moore Director of Sales / National Accounts, Welmed
Inc. President-Elect, WSHMMA / Newsletter Editor Previous Surgical
Solutions Specialist, PHS [contracts, inventory planning, sales]
Product Manager, Devon OR Products, Covidien [product development,
contracts, logistics, marketing, profit management] 2
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Disclaimer Please be advised that this is only an overview of
the Materials Management Review Guide. It should not be inferred
that test items in the examination are selected from any single
reference or set of references or that participation in this review
session guarantees a passing score on the examination. No portion
of this presentation may be reproduced by an attendee without the
expressed written permission of the presenter.
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A Mark of Distinction CMRP status allows you to: Have a premier
credential based on a sound assessment to distinguish yourself in
an increasingly competitive marketplace. Enjoy the pride of
recognition and knowing you are among the elite in the field of
healthcare materials management.
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Administration American Hospital Association Eligibility
[education + experience] Application for exam Fees Schedule Exam
Computer-based 2 hours, 110 questions [10 pretest] Immediate
results [upon completion]
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Exam Specifications The AHRMM role delineation study identified
real-world tasks that were grouped into categories and weighted to
produce exam specifications. 1. Purchasing, Procurement and Product
Value Analysis 2. Inventory Distribution Management 3. Information
Systems and Data Management 4. Finance 5. Strategic Planning and
Leadership (Support Services) 6. Materials Management Definitions
(non-AHRMM)
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Exam Categorized Recall The ability to recall or recognize
specific information Application The ability to comprehend, relate
or apply knowledge to new or changing situations Analysis The
ability to analyze and synthesize information, determine solutions
and/or to evaluate solutions
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Purchasing, Procurement and Product Value Analysis Administer
and direct the program to purchase materials, supplies, and capital
equipment 25 items Recall 5 items Application 15 items Analysis 5
items
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Purchasing, Procurement and Product Value Analysis 4 Steps of
Act of Purchasing 1. Requisitioning 2. Sourcing 3. Negotiating 4.
Ordering
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Purchasing, Procurement and Product Value Analysis Requisition
/ Purchase order types Stock Non-stock Electronic Traveling Blanket
Standing Open
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Purchasing, Procurement and Product Value Analysis Freight
terms and title of goods FOB destination FOB shipping point FOB
destination, prepay freight, and add FOB shipping point, freight
allowed Payment terms and conditions 2% 10 days, Net 30 COD Credit
card / purchase card
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Purchasing, Procurement and Product Value Analysis Legal
aspects of purchasing Product liability Wrongful rejection Failure
to deliver Liabilities and warranties Uniform Commercial Code (UCC)
Robinson-Patman Act
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Purchasing, Procurement and Product Value Analysis Right of
possession Absence of rightful rejection noted by agreement,
delivery, use or payment Unconscionable contracts Unfair, one-sided
but NOT illegal Liabilities and warranties Implied Expressed
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Purchasing, Procurement and Product Value Analysis Safe Harbor
Published in 1991 as an Amendment to the 1972 Medicare Fraud
regulation Prohibits: Knowing and willful solicitation, receipt,
offer, payment of remuneration in return for referral of Medicare
patient Knowing, willful, payment, receipt remuneration to induce
the purchase of goods/services which will be paid for by
Medicare
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Purchasing, Procurement and Product Value Analysis Safe Harbor
requires hospitals to: Report all discounts, free goods, warranties
in cost report, submitted to Medicare. Discounts are acceptable as
rebates, credits. Must involve goods sold. Cannot rebate one item
based on purchase of another. Cannot link incentive to furnish
goods at no charge if another item is purchased.
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Purchasing, Procurement and Product Value Analysis Uniform
Commercial Code (UCC) Established in 1952 Governs purchases in 49
states Excludes services associated with products Purchase of goods
> $500 must be confirmed in writing to be enforceable under the
law Statute of limitations is 4 years
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Materials Managers Tool Bag Activity Based Costing (ABC) A cost
management tool to identify and allocate overhead costs Activity
Based Management (ABM) Minimize costs, eliminate duplication
Continually evaluate new supply chain process Using ABC/ABM
procedures will help ensure maximum returns for efforts expended
and costs that have been incurred.
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Materials Managers Tool Bag Value Added Opportunities
Additional services offered as incentives Value Analysis
Functionally oriented process Best and most economical procedures,
products, equipment, or services Meet the needs of the user while
reducing the overall cost involved
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Materials Managers Tool Bag Total Delivered Costs All aspects
of the product cycle purchase price, receiving, warehousing,
delivery holding, value of money, pilferage, obsolescence
Outsourcing Reduce the overall cost Increase the quality
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Lets Take 5 Its time for a Quick Break!
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Info & Data Information Systems Data Management Numbers,
Numbers and more Numbers Systems [technology]
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Information Systems and Data Management Direct acquisition and
implementation of an automated, system-wide materials management
information system 15 items Recall 3 items Application 9 items
Analysis 3 items
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Information Systems and Data Management Materials Management
Information System (MMIS) includes: Purchasing, Receiving,
Inventory Interfaces to: Accounts payable General ledger Patient
accounts Surgery Other clinical departments (as determined)
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Information Systems and Data Management Selection Process
Multi-disciplinary taskforce Identified processes Research
marketplace Determine functionality requirements Develop RFP
Demonstrations Develop project plan
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Information Systems and Data Management Electronic Data
Interchange Transmit data between computer systems Standard
communication protocols Health Industry Business Communication
Council (HIBCC) American National Standards Institute (ANSI) ANSI
x.12 File Transfer Protocol (FTP)
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Information Systems and Data Management Bar-coding standards
adopted by HIBCC Code 39 or Code 3 of 9 EDI data sets most commonly
used: 832-price catalog 850-purchase order 855-PO confirmation
856-advance ship notice / auto receipt 810-invoice
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Information Systems and Data Management The Internet and
Business WWW World Wide Web XML Extensive markup language HTTP
Hypertext transfer protocol UML Unified modeling language URL
Uniform resource locator LAN Local area network ERP Enterprise
resource planning
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Purpose of CMRP Certification Recognize individuals who meet
eligibility. Encourage continued personal and professional growth
in the practice. Provide a national standard of requisite knowledge
required for certification. Our Standard of Excellence Be Proud of
It!
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Questions?
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Samples Questions Which of the following is the correct
sequence of stages in the process improvement cycle? Improve
Measure Control Define Analyze A. 1,4,5,3,2 B. 2,1,5,3,4 C.
4.2.5.1.3 D. 5,1,4,2,3
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Sample Questions The Joint commission standards for Environment
of Care require that the Materials Management department have which
of the following? A cost reduction plan A value analysis program An
employee development plan An emergency management plan
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Sample Questions An effective linen management program includes
1. monitoring and modifying linen PAR levels. 2. eliminating linen
services on weekends and holidays. 3. tracking linen loss rates. 4.
reporting linen utilization to customer departments. A. 1, 2, and 3
only C. 1, 3, and 4 only B. 1, 2, and 4 only D. 2, 3, and 4
only
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Sample Questions EXPLANATIONS: (c) 1. Monitoring and
periodically modifying periodic automatic replenishment (PAR)
levels are essential to assuring customer departments have the
appropriate selection and quantity of items given changes in
demand. (u) 2. Eliminating may be an option, but an effective linen
management program would be adjusted based on demand and related
cost/benefit analysis. (c) 3. Tracking linen loss rates by linen
item type, and understanding the means whereby items are lost, are
pivotal to developing a loss minimizing or lost linen recovery
program. (c) 4. Reporting linen line item costs and utilization
reports are key elements of an effective linen management
program
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Sample Questions In the event of a positive biological
indicator in a sterilized load, which of the following steps must
be followed? 1. Check wrapping for integrity. 2. Isolate the load.
3. Rewrap and reprocess the load. 4. Notify infection control and
risk management if any sets were used before the test was read. A.
1, 2, and 3 only C. 1, 3, and 4 only B. 1, 2, and 4 only D. 2, 3,
and 4 only
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Sample Questions EXPLANATIONS: (u) 1. Instrument wrapping will
not affect the biological indicator. (c) 2. Load isolation is part
of the recall process. (c) 3. Isolation and reprocessing of the
load contents are parts of the recall process. (c) 4. Notification
of a positive biological indicator is part of the recall
process
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Sample Questions Which organization develops manufacturing
standards for surgical instrumentation? A. AHA B. AORN C. ASHCSP D.
AAMI
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Sample Questions EXPLANATIONS: (u) A. The American Hospital
Association (AHA) develops policies and standards, but not those
related to instrumentation. (u) B. The Association of Operating
Room Nurses (AORN) develops sterilization standards, and may make
recommendations about instrumentation, but does not set
instrumentation standards. (u) C. The American Society for
Healthcare Central Service Professionals (ASHCSP) does not develop
instrumentation standards. (c) D. The Association for the
Advancement of Medical Instrumentation (AAMI) sets instrumentation
standards
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Sample Questions Specify the parameters required to assure
sterilization has been met. A. temperature, time, and pressure B.
steam, pressure, and chemical indicator C. pressure, contact, and
packaging D. heat, humidity, and time
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Sample Questions EXPLANATIONS: ( c) A. Time, temperature, and
pressure are parameters indicated on the sterilization chart/graph
for each type of sterilizer for each cycle. (u) B. Time, in
addition to steam and pressure, is required for a complete
sterilization cycle. (u) C. Although pressure is required, there is
not a manner in which contact can be determined, packaging is not
required for flash sterilization. (u) D. Heat is equivalent to
temperature, humidity is not a measurable parameter, and time is
required
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Sample Questions A Health Insurance Portability and
Accountability Act (HIPAA) compliance program for a purchasing
department should include a 1. vendor confidentiality statement
covering protected information. 2. clause inserted into every
contract that covers protected information. 3. statement reflecting
the facility gifting policy. 4. statement describing actions taken
if a policy is violated. A. 1, 2, and 3 only C. 1, 3, and 4 only B.
1, 2, and 4 only D. 2, 3, and 4 only
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Sample Questions EXPLANATIONS: (c) 2. Hospitals must protect
themselves from disclosure of protected information that a vendor
may acquire. They must also articulate and disclose action steps
for failure to comply with HIPAA-related policies. While a gifting
policy should be part of a hospital's code of employee conduct, it
is not essential and does not pertain to HIPAA..
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Samples Questions The highest level of infection control that
can be achieved with peracetic acid is A. sterilization. B.
high-level disinfection. C. decontamination. D. disinfection.
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Sample Questions EXPLANATIONS: (c) A. Peracetic acid kills
gram-positive and gram- negative bacteria, fungi, and yeast in
fewer than 5 minutes of processing time. The FDA has approved
peracetic acid as a sterilant. (u) B. See Explanation A. (u) C. See
Explanation A. (u) D. See Explanation A
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Sample Questions If a vendor representative is involved in a
surgical case, which of the following information may not be
disclosed to the vendor's company under the Health Insurance
Portability and Accountability Act (HIPAA)? A. items used in case
B. physician's name C. case date D. patient diagnosis
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Sample Questions EXPLANATIONS: (u) A. The vendor representative
will need the items used in order to bill the facility for the
items used and restock the vendor-managed inventory (VMI). (u) B.
The physician's name is not considered confidential under HIPAA.
(u) C. The case date is not covered under HIPAA. (c) D. Under
HIPAA, patient information is considered confidential, and may only
be disclosed to the particular parties involved
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Which of the following waste separation strategies in the
operating room will result in the lowest amount of red bag waste
and be in compliance with (OSHA) Bloodborne Pathogens Standards? A.
All waste coming out of an operating room suite must be contained
in a red bag. B. Waste from an operating room suite that is
generated before a patient enters the room can go in regular trash,
but all waste generated after the patient comes into the room must
be contained in a red bag. C. Waste from an operating room suite
that is soiled, but not dripping, with blood or body fluids must be
contained in a red bag and all other waste can go into regular
trash. D. Waste from an operating room suite that is saturated with
blood or body fluids must be contained in a red bag and all other
waste can go into regular trash.
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Sample Questions EXPLANATIONS: (u) A. See Explanation D. (u) B.
See Explanation D. (u) C. See Explanation D. c) D. According to
OSHA Standards, only waste that is saturated with blood or body
fluids must be contained in a red bag. Even if there is evidence of
blood or body fluids on the items, they do not automatically need
to be disposed in red bags. The amount of blood or body fluids must
be enough that the item is completely saturated so that the fluid
may drip off or flake off once dried
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Sample Questions Corporate compliance is a program that relates
closely to an organization's A. ethics. B. mission. C. goals. D.
finances.
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Sample Questions EXPLANATIONS : ( c) A. The intent of a
corporate compliance program is to observe the spirit of the law,
and therefore closely relates to the ethics of the organization.
(u) B. Corporate compliance does not directly affect the mission of
the organization. (u) C. Corporate compliance does not directly
affect the goals of the organization. (u) D. Corporate compliance
does not directly affect the finances of the organization although
it influences the prevention of fraud.
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Sample Questions According to Dr. W. Edwards Deming, quality
transformation rests on which of the following key tenets? 1.
Decisions must be based on fact. 2. The people who know the work
best are the ones who perform it. 3. Graphically displayed
information determines best course of action. 4. Groups of people
working in teams can be more successful than individuals working
alone. A. 1, 2, and 3 only C. 1, 3, and 4 only B. 1, 2, and 4 only
D. 2, 3, and 4 only
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Sample Questions EXPLANATIONS: (c) 1. Deming's work focuses on
people, processes, and workflow. (c) 2. Deming's work focuses on
people, processes, and workflow. (u) 3. Graphically displayed
information is a tool to illustrate concepts and is not a key
tenet. (c) 4. Deming's work focuses on people, processes, and
workflow.
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Sample Questions The purpose of a SWOT analysis is to A.
understand current strategic position. B. identify safety hazards
in the environment. C. determine appropriate staffing levels. D.
assess the needs of customers.
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Sample Questions EXPLANATIONS: (c) A. Examining the aspects of
an institution's strengths, weaknesses, opportunities, and threats
during a SWOT analysis is intended to give information about
strategic positioning and possible tactics to attain objectives.
(u) B. See Explanation A. (u) C. See Explanation A. (u) D. See
Explanation A.
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Sample Questions Which of the following is a strategic
objective? A. Reduce inventory by the end of the fiscal year. B.
Reduce inventory by 15% and maintain customer satisfaction. C.
Reduce inventory by 15% by the end of the fiscal year. D. Reduce
inventory by 20% and increase customer communication
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Sample Questions EXPLANATIONS: (u) A. This response lacks a
quantitative standard. (u) B. The inventory reduction target is
clear and measurable, but there is no time reference. (c) C. The
objective and the time frame are clear and able to be measured. (u)
D. The objective of reduction is clear, but there is no time
reference.
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Sample Questions Total capital equipment life cycle costs
include the: A. Depreciation expense B. Initial purchase price C.
Future replacement price D. Manufactures standard warranty
price.
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Sample Questions What does FOB destination mean? The buyer pays
all freight charges The seller pays all freight charges The seller
retains ownership in transit The buyer retains ownership in
transit
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Sample Questions A basic stock out ratio is calculated by
dividing the Reorder point by the lead time Average usage by the
monthly receipts Number of lines out by the number of lines ordered
Number of stock outs by the number of receipts
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Samples Questions To maximize return on investment for a new
MMIS, implementation processes should do which of the following?
Encourage and act on user feedback Utilize the systems best
practices. Incorporate customization of the system as part of the
overall plan Map business processes to system processes immediately
after activation
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Sample Questions Which of the following is the LEAST effective
strategy for a hospital surviving a prospective payment system?
Laying off staff Increasing efficiencies Reducing budgetary costs
Maximizing payment from contractual payers
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Sample Questions A hospital is considering developing a sterile
custom pack program. To help offset initial start-up costs, the
hospital may market its services to smaller facilities within a
50-mile radius. The hospitals MM department should consider which
of the following before making this decision? A market review of
other facilities to determine if there is interest A cost analysis
of equipment, supplies and labor needed for the venture A
comparative analysis of in-sourcing and out-sourcing to determine
cost benefit ratio A report stating how much expansion would be
possible for the MM department
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continued A. 1,2 and 3 only B. 1,2 and 4 only C. 1,3 and 4 only
D. 2,3 and 4 only
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Samples Questions Turns are defined as a basic measure of
efficiencies in: A. Management B. Vendor delivery C. Financial
control D. Inventory control
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Sample Questions To establish accurate product data in the
MMIS, data synchronization requires common manufacturer name,
manufacturer product number and Expiration date Packaging data
Latex indicator Lot number
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Sample Quesitons Early Steps when choosing a replacement
computerized MMIS are to Define current cost of operations Select a
task force Define functional requirements Select a vendor 1,2 and 3
only 1,2 and 4 only 1,3 and 4 only 2,3 and 4 only
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Sample Questions When a capital requisition has been generated,
a buyer needs to take which of the following criteria into account
to determine the best method of procurement? Shortages in the
industry Lease or purchase decision Whether an item is in stock
Economic events in the industry
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How did you do? Questions?
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Additional Ways to Prepare for the Exam AHRMM CMRP Candidate
Handbook and Application (Light Blue Book, free)
http://www.aha.org/aha/Certification-Center/files/2008CMRPhandbook.pdf
http://www.aha.org/aha/Certification-Center/files/2008CMRPhandbook.pdf
AHRMM Materials Management Review Guide/CMRP Examination Review
Guide, third edition, 2009, (Dark Blue Book, $$) VHAs proprietary
instruction presentation [or check with your GPO] CMRP presentation
[this presentation will be posted on-line] AHRMM, National Meetings
AHRMM Webinars Other AHRMM Regional Chapters Optional purchase of
the pre-test from AHRMM Optional purchase of the Webinar CD Develop
internal study sessions (brown-bag-lunch) with your peers or at
your member site Contact either of us or any WSHMMA board
member