clmi msgt christopher a. bartley af dod clip program manager 202-782-2585/dsn: 662...

CLMI

MSgt Christopher A. BartleyAF DoD CLIP Program Manager202-782-2585/DSN: [email protected]

Why CLMI? Data Requirements Problem Areas Fixes CLMI Data: Where were we?

CLMI Data: Where are we? Quarterly Summary Report How do I use CLMI? Point of Contact Questions

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

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 CPT suffix

00 – Tests performed in-house 26 – Pathology Consults 32 – Tests performed for another lab (shipped-in)

Clinical Lab◦ Off-Site Workload

Clinical Lab, Histopathology and Cytology RT referred out

To Civilian Labs (including monthly cost) To Military Labs

◦ Utilization Data Outpatient RT Outpatient Visits Inpatient RT Admissions

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)

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

Histology◦ Frozen Sections◦ Autopsy Backlog◦ FTE – same breakouts as clinical◦ Supply money spent

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

Cytology◦ Slides

Unsat Limited QA

◦ Average in-house TAT (Gyn/Non-Gyn)◦ Supply Money Spent

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

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

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

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

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

Wrong year format◦ No automated fix – each month table scrubbed


Wrong quarter◦ No automated fix – each month table scrubbed


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

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

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

Quarter Clinical Lab Cytology Histology

1st Quarter 71% 20% 23%

2nd Quarter 70% 33% 40%

3rd Quarter 62% 20% 33%

4th Quarter 53% 13% 20%

Annual 64% 22% 29%

As of 29 Jan 2010

80% of entries needed before report generatedTotal Lab Entries per Quarter 219Total Cytology Entries per Quarter 120Total Histology Entries per Quarter 120


1st Quarter 43% 10% 10%

2nd Quarter 0% 0% 0%

Annual 11% 3% 3%

As of 29 Jan 2010


3 Feb – trouble ticket for CLMI website

5 – 11 Feb – DC blizzard Blizzard

1 Mar – website still down email form live

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

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


1st Quarter 78% (+7) 20% 23%

2nd Quarter 77% (+7) 33% 40%

3rd Quarter 73% (+11) 20% 33%

4th Quarter 70% (+17) 13% 20%

Annual 74% (+10) 22% 29%

As of 19 Mar 2010



1st Quarter 67% (+24) 10% 10%

2nd Quarter 30% (+30) 0% 0%

Annual 24% (+13) 3% 3%

As of 19 Mar 2010


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”

1-1

1-2

Clinical Lab

◦ 1-3: Civilian referrals/cost, Military referrals Added “Months Entered”

◦ 1-4: Utilization (outpatient, inpatient) Added “Months Entered”

1-3

1-4

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”

2-1

2-2

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”

3-1

3-2

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

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)

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

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

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

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

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

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

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

MSgt Christopher A. [email protected]: 662-2585Commercial: (202) 782-2585Fax: x6022

CLMI email update form

Type only in the areas designated for data entry. Your reply will be automatically processed. Therefore, it is important that the form or the message is not altered in any other way. For more information about filling out this form, see the following:

Facility ID:

Type any combination of numbers and letters up to 50 characters.

End Date (Last Day of Month, ex. 7/31/2009):

Type either a date, a time, or a combination of both in the following format: 3/9/2010

Month (1-12):

Type a numeric value.

Year (Format: XXXX, ex. 2009):


Quarter (1-4, Oct-Dec=1, Jan-Mar=2, Apr-Jun=3, Jul-Sep=4):


Chemistry, In-House:


Chemistry, Pathology Consult:


Chemistry, Shipped-In:


Unbundled Chemistry:


Hematology, In-House:


Hematology, Pathology Consult:

Reference sheet for email form has instructions/formats for End Date, Year and Quarter

Where were we?

clmi msgt christopher a. bartley af dod clip program manager 202-782-2585/dsn: 662...

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