CMRP CERTIFICATION
Overview Session
A Mark of DistinctionCMRP 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.
CMRP Overview Session 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.
American Hospital Association Certification Center
• Governed by a Board of Directors• An independent body affiliated with the AHA• Certification Program Committee
– Content experts– Test development– Scoring and analysis
• Designed to test full scope competency of individuals involved in materials management
Eligibility - Concept In 2003, the CMRP eligibility requirements changed. The requirements continue to blend experience and education and are designed to include experienced healthcare resource and materials managers. (There is no membership requirement.)
CMRP Eligibility• Baccalaureate degree plus three (3) years of
associated healthcare resource and materials management* experience; or
• Associate degree or equivalent plus five (5) years of associated healthcare resource and materials management* experience; or
• High school diploma or equivalent plus seven (7) years of associated healthcare resource and materials management* experience.
CMRP Eligibility
* Associated healthcare resource and materials management includes persons who are involved in the materials functions of healthcare facilities; or are active in the healthcare materials supply chain, including manufacturers, vendors, distributors, consultants, and employees of group purchasing organizations.
Administration• Application for examination processed• Eligibility confirmation sent to candidate• Fees
– Members - $275– Non-members - $425
• Schedule appointment; reschedule once within 4 business days at no charge
• Reschedule within 90 days - $100 rescheduling fee
Administration
• Reschedule after 90 days must resubmit application and pay a fee of $275/members or $425/nonmembers
• Certification Valid for three (3) years
Administration
• Selected H&R Block computer centers• Photo ID (2 forms of ID)• Paper and pencil or computer-based
– 2 hours, -110 questions ( 10 pretest)• Results upon completion of computer-based• Certification
– Letter– Lapel pin– Renewal Application and Employer Notification Form
Exam SpecificationsThe AHRMM role delineation study identified real-world tasks that were grouped into categories and weighted to produce exam specifications.
1. Purchasing/Product Value Analysis – 25%2. Inventory Distribution Management – 20%3. Support Services – 10%4. Information Systems – 13%5. Finance – 12%6. Strategic Planning/Leadership – 20%
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
Test ItemsTo ensure reliability and validity, test items are: Written by experienced healthcare
resource and materials managers; Geared to test application of knowledge
- not just recall of facts; and, Reviewed annually to ensure clarity.
Measurement ExpertiseTo ensure the highest standards in testing, the AHA Certification Center engaged Applied Measurement Professionals, Inc. (AMP) to assist with: Test development; Test administration; and Scoring, score reporting, and analysis.
AdministrationThe CMRP Examis offered on computer at over 110 secure test centers throughout the U.S.
Scores are private. Only the test taker receives the scores.
Administration
Examination application is contained inside the CMRP Handbook and is available by downloading a copy from:
• The AHA Certification Center,www.aha.org then click on “Certification”; or
Administration (cont.)
• AHRMM’s Web site, www.ahrmm.org;or
•Call Applied Measurement Professionals, Inc. (AMP) at 913/541-0400
Healthcare Overview
• Reimbursement History– 1960/70’s “the good old days”
• Cost Plus– 1980’s
• DRG’s• Medicare Prospective Payment• HMO’s
– 1990’s• Healthcare Reform
Healthcare Overview
• Reimbursement History– 2000 - 2007– Healthcare Reform– Rising costs; % of GNP > 14%– Decreasing Reimbursement– Critical Access: reimbursement of cost– Physician Crises– Decreasing Access/Universal Access
Purchasing/Product Value Analysis
25 items ( Recall-10, Application- 10, Analysis-5 )
Administer and direct the program to purchase materials, supplies, and capital equipment.
Purchasing/Product Value Analysis
Act of Purchasing involves 4 steps:
1. Requisitioning2. Sourcing3. Negotiating4. Ordering
Purchasing/Product Value Analysis
• Requisition/Purchase Order Types– Stock– Non-stock– Electronic– Traveling– Blanket– Standing– Open
Purchasing/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
Purchasing/Product Value Analysis
• Legal Aspects of Purchasing– Product liability– Wrongful rejection– Failure to deliver– Liabilities and warranties– Universal Commercial Code (UCC)– Robinson-Patman Act
Purchasing/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
Purchasing/Product Value Analysis
• Safe Harbor– Published in 1991 as an amendment to the 1972
Medicare Fraud regulation• Prohibits the following:
» Knowing and willful solicitation, receipt, offer, payment of remuneration in return for referral of Medicare patients
» Knowing, willful, payment, receipt renumeration to induce the purchase of goods/services which will be paid for by Medicare
Purchasing/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.
Purchasing/Product Value Analysis
• Universal 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
Materials & Resource Manager’s “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.
Materials & Resource Manager’s “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
Materials & Resource Manager’s “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
Inventory Distribution Management
20 items(Recall – 10, Application – 6, Analysis – 4)
Assure that the organization’s acquisition and distribution strategies and practices improve the overall healthcare supply chain system.
Inventory Distribution Management
Inventory control should:Provide monetary savings Improve service levelsImprove internal operationsReview supply utilizationReduce wasteFully utilize MMIS
Inventory Distribution Management
Inventory – product on-handTurns – current asset that has been acquired by
cash and is yet to be consumedStock – may also be used to describe inventoryDetermined by dividing the total annual inventory
purchases by the end inventory valuePhysical inventory is the actual counting of supplies
and comparing the amount on hand with the amount on the financial statement
Inventory Distribution Management
Inventory can be counted two ways:Periodic countingDone at regular intervals (usually 6 or 12 months)
Cycle countingContinuously selecting subgroups to count Typically 10% of stock per month
Inventory Distribution Management
Successful Inventory Control is to achieve balance between stock on-hand and need
Basic components to assist this are:Order quantityLead timeSafety stock
Inventory Distribution Management
ABC analysis – highest to lowest dollar “A” 10% inventory account for 70% of dollars “B” 20% inventory account for 20% of dollars “C” 70 % of inventory account for 10% dollars
“A” items are given the highest priority
Increasing the order frequency of “A” items has the same effect as increasing turn rate
Inventory Distribution Management
Lead time = require/order/receive/distribute Safety stock- protection against stock-outSupply level calculations
Maximum/minimumEconomic order quantity
The greater the order quantity, larger the inventory. The longer the lead time, the greater the inventory. The higher the safety stock, the greater the inventory.
Inventory Distribution Management
Inventory ValuationLast in, First out (LIFO)Newest define cost
First in, First out (FIFO)Oldest define cost
Average costing inventoryWeighed average cost
Inventory Distribution Management
Carrying Costs includes such areas as:Invested capitalHandling chargesStorageInsuranceCost of moneySpoilageData processing
Inventory Distribution Management
3 Different Types of InventoryOfficialMaintained as assets on balance sheets
UnofficialExpenses upon receipt
ConsignmentHoused by the facility, purchased when used
Inventory Distribution Management
Inventory StrategiesConsolidation ReductionStorage space
Inventory RatiosNot-In –StockFill-Rate% of Back-Orders
Inventory Distribution Management
Distribution MethodsRandom requestEmergencyPARExchange cartsCase cartsJITStockless
Inventory Distribution Management
Inventory management in the ORIntense needDiverse usersLargest dollar volume“Unofficial”Preference itemsLow turn rate(out of control)
Typical Operational Supply Spend
Ancillary22%
Clinical38%
Support40%
Ancillary
- Lab Supplies- Radiology- Blood- Drugs
Clinical / Medical
- Anesthesia Supplies- Cardiac Implants & Supplies- IOL’s- IV’s- Med/Surg Supplies- Orthopedic Implants & Supplies- Pacers- Packs & Gowns - Prosthesis Other- Suture, Syringes & Needles
Support / Non Medical
- Dues and Subscriptions- Environmental- Food- Freight- General Supplies- Office Supplies- Purchased Services- Repairs & Maintenance- Service Contracts- Telecommunications- Transportation- Travel- Utilities
Changes due to Inpatient/Outpatient Mix???
Time for a Break• Take 5…………..
Support Services
10 items(Recall - 6, Application – 2, Analysis –2)
Sterile ProcessingLinen Management
Food ServicesPatient Transport
Universal Precautions
Support Services
Overview of Hazardous Materials & WasteGovernment guidelines that control the handling and
transportation include:OSHA
Occupational Safety & Health AdministrationEPA
Environmental Protection AgencyJC (JCAHO)
Joint Commission & Accreditation of Healthcare OrganizationsDOT
Department of Transportation
Support Services
Chemical Hazards Communication Standard (CHCS) spells out employee “right to know” regulations
Education and trainingMaterial Safety and Data Sheets (MSDS)Use and location of safety equipmentPolicies and proceduresDocumentation and labeling
Support Services
Classification of Hazardous Materials/WasteSix specific classifications of waste
Non-hazardous, general solidHazardous
Corrosives, Flammables, Reactive/toxic chemicalsCytoxicMedicalPhysical hazardous
Sharps, Needles, GlassRadioactive
Support Services
Medical Waste Disposal Steam sterilization Dry Heat Sterilization EtO sterilization Incineration Off-site disposal (landfill) Microwave techniques
Support Services
Linen SelectionSize (cut/finish)Fiber content (cotton, blend)Thread count (density of fiber)Weight of fabricColor (steadfastness)Quality/cost recovery (washing cycle)
Support Services
Surgical Linen Standards (AORN)Blood and aqueous fluid resistantAbrasive resistantLint freeMeet NFPA requirements Eliminate heat build upBe easily draped
Support Services
Linen generalFlame retardant fabricsSecurity and identificationTransportation and storageChemicals and launderingInventory and trackingPounds per patient day/charge backOrdering and cycling
Support Services
Overview of Sterile ProcessingDecontamination process:
Thorough cleaning procedureSortingPre-cleaningTransportationDisassemblyCleaningDecontamination
DisinfectionChemicalsUltrasonic
Support Services
SterilizationThermal is steam or dry heatSteam safest, most practicalDry heat slower less even
Ethylene Oxide (EtO) Gas Require proper aeration
Maintenance of equipment by a professionalPackaging should allow max penetration
Support Services
Sterilization cont.Monitoring
MechanicalChemicalBiological
Documentation (Joint Commission)Maintenance recordsMonitoringStaff educationPolicies and procedures
Information Systems
13 items(Recall – 5, Application – 4, Analysis – 4)
Direct acquisition and implementation of an automated, system-wide materials management information system.
Information Systems
Materials Management Information System (MMIS) includes: Purchasing, receiving, inventory Interfaces to:
Accounts payable General ledger Patient accounts Surgery Other clinical departments as determined
Selection Process Multi-disciplinary taskforce Identified processes Research marketplace Determine functionality requirements Develop RFP Demonstrations Develop project plan
Information Systems
Information Systems
Electronic Data Interchange (EDI) Transmit data between computer systems Standard communication protocols HIBCC (Health Industry Business Communication Council)
ANSI (American National Standards Institute)
ANSI x .12File Transfer Protocol (FTP)
Information Systems
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
Information Systems
The Internet and Business WWW – world wide web XML – standard for internet communication HTTP – hypertext transfer protocol UML – unified modeling language URL – uniform resource locator LAN – local area network ERP – enterprise resource planning
Time for a Break• Take 5…………..
Finance
12 items(Recall – 5, Application – 4, Analysis – 3)
Finance and Accounting Principles used to better understand an organization’s
financial culture.
Finance
Balance SheetAssetsCurrent assets and fixed assets
LiabilitiesCurrent and long term
Owner’s equity or fund balancesMoney to fund future programs
Assets=Liabilities+Owner’s Equity
Finance
RatiosLiquidity ratioThe ability to pay bills
Leverage ratiosMeasure ability to meet long-term needs
Efficiency ratiosHow well assets are managed to produce a profit
Finance
Break-Even AnalysisRevenueFixed costsVariable costsVolume
( V x R = FC + VC x V )
Return on Investment (ROI)Revenue from investment resulting in profit
Finance
Value AnalysisLooks at the reduction of non-salaried expenses from a
multidisciplinary or team approachSome quantitative techniques used are:
Cost benefit analysis Life cycle ForecastingUnit cost In-use cost Environmental cost Impact of staff productivity
Finance
Value Analysis Application includes:Multidisciplinary approachUtilize brainstorming to problem solveBreaks down functionsIdentifies potential alternativesReviews the total delivered costPatient focused high quality approach
Finance
Retention of Health Information / RecordsLegal regulatory include:HCFAMedicareOSHAJC (JCAHO)Specific state regulation
Finance
Record Retention SchedulesPatient records adult 10 yearsPatient records minor statute of limitationsDiagnostic images 5 yearsFetal heart monitor 10 yearsRegister of birth permanentRegister of death permanentRegister of surgery permanent
Finance
Records for Materials Management:Capital budget purchasing 10 yearsConsultant contracts permanentLeases and rentals 5 yearsMaintenance and service 5 years Warranty contracts permanentPurchase orders 2 yearsRequisitions 1 year
Finance
Corporate Compliance ProgramsConflict of interest policyBackground check on employeesGuidelines for ethical behaviorState and federal statute associated with
Medicare and Medicaid
Finance
Asset Management ProgramFinancial analysisAcquisition vs. RentReceiptDistribution and trackingChargingMaintenanceReplacementDisposal
Strategic Planning/Leadership
20 items(Recall – 8, Application – 8, Analysis – 4)
Overview of using the principles of strategic planning and quality management to
manage customer services.
Strategic Planning/Leadership
Plan – Control – ImproveSet goalsProvide infrastructureProvide resourcesQuality leadership and support
JC (JCAHO) Requirement for FacilitiesAlso need to know Patient Safety StandardsKEY TO YOUR FUTURE SUCCESS
Strategic Planning/Leadership12 STEPS
Identify customers Determine customers
needs Respond to customer
needs Quality goals to meet
customer needs Produce product/process Prove process
Measure and control Establish standards Identify problems Solve problems Measure success On-going process plan
CUSTOMER/PATIENT PROCESS
Strategic Planning/Leadership
FrameworkVision – Mission – Principles
ImplementationGoals – Objectives - Strategies
ProcessAnnual Plan – Evaluation – Performance Reports
Frequently Asked Questions
Why is a true certification program important?
– Certification is important as it recognizes a level of competency. It is a way to express value to your employer.
– It encourages continued personal and professional growth in the practice of healthcare materials and resource management.
Frequently Asked Questions
What makes this certification different from AHRMM’s Fellow of the Association for Healthcare Resource & Materials Management (FAHRMM)?– The American Hospital Association’s Certification
Center is independent of AHRMM and administers the certification.
– The CMRP is the recognized credential for the profession. Passing the CMRP demonstrates a mastery of a well-defined body of knowledge and is based on national standards.
Frequently Asked Questions
– Fellow status is presented to Certified Senior or Certified Materials and Resource Professional (CMRP) members in good standing, who have met specified achievement criteria, and have submitted an acceptable, original unpublished paper on a current aspect of materials management.
– The requirements for Fellow are designed so that those who apply and attain this level must be persons of exceptional achievement as judged by their peers.
Frequently Asked Questions
Certification is valid for three years. What happens after that?
– Renewal is obtained through 45 contact hours of continuing professional education or successful re-examination, at the option of the certificant.
For InformationObtain a Candidate Handbook by:
Visiting the AHA Certification Center at www.aha.org/certification; orCalling AMP (913-541-0400); or
Visiting www.ahrmm.org.
Distinguish Yourself
800+ individuals have the CMRP designation and the number continues to rise monthly.
AHRMM 2009 Test
• No Test this year at AHRMM• Test is being revised
Distinguish Yourself
SUCCESSFUL CANDIDATESwill be recognized at AHRMM’s Annual Conference, and a letter will be sent to candidate’s employer by the AHA-CC, if requested.
Recognizing our Region CMRPs
WASHINGTON
• Jack Gallagher* ● Tom Guthrie*• Kevin Burns ● Adrian Paul Cushman• Kathi Pressley** ● Jason Moulding• Nancy Chester ● Tamie Stonke• Tony Carrillo ● Janelle Monell*
Recognizing our Region CMRPs
WASHINGTON• Roberta J. Wilson* ● Don Wolfe• Martina Blackett ● Ray Moore*• Max F. Rothwell ● Kelly O’Connell*• Scott Bradley Coleman*• Kristy L. Dawson ● Helene M. Schultz• George T. Ott ● Rick Swangwan*• Kevin Hunt ● Patricia A. Van Effen*
Recognizing our Region CMRPs
OREGON• Lisa M. Atkins* •Susan J. Gardner•Valerie A. Bailey** •Brett E Still•Shanna Oberbeck* •Gary Rakes•Tammie A. Shultz* •John Frasso •Kevin Swartout •Kevin Madison •Elizabeth F. Urbancic • Ernest C. Monts
Recognizing our Region CMRPs
ALASKA• Susan M. Turley• Christopher M Rutz• Cynthia Leeann Cohen•Lee M. Erickson •Mark Robert Lamey
Recognizing our Region CMRPs
IDAHO• Donna Bean** • Karen Heileson•Terri Hull
MONTANA• Kathy S Tokar •Bryan D. Buckridge•Stephen V. Redgate •Gerry L. Slingsby
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