Policy and Procedure Manual Flashcards

1
Q
A
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2
Q

statement or memo that outlines the institutions position on an administrative or operational issue

A

Policy

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3
Q

instructional document that provides explanations and step by step directions

A

Procedure

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4
Q

Manual that contains policies

A

Policy Manual

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5
Q

Manual containing procedures

A

Procedure Manual

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6
Q

general policies that are relevant to the whole institution

A

Hospital Policy Manual

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7
Q

topics that may have particular relevance to the area, specific departmental policies

A

Laboratory Policy Manual

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8
Q

two types of policy manual

A

Hospital Policy Manual
Laboratory Policy Manual

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9
Q

Procedures are often referred to as “SOP”, a term adopted from military

A

Procedure Manuals

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10
Q

meaning of ‘SOP’

A

Standard Operating Procedure

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11
Q

examples of technical manuals

A

Procedure for Performing test
Operating Test
Processing quality control information

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12
Q

primary objective of procedure manual is

A

STANDARDIZATION OF THE WAY THAT TASKS AND TESTS ARE PERFORMED

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13
Q

represent a major investment of time and effort and are in constant need of revision

A

laboratory procedure manuals

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14
Q

Laboratory procedure manuals are in constant need of revision because of?

A

continually evolving work situation

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15
Q

two types of policy and procedure manuals

A

external manual
internal manuals

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16
Q

two types of external manual

A

specimen collection manual
laboratory service manual

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17
Q

required by inspection agencies to be distributed to all areas in which specimens are collected for submission to the laboratory

A

specimen collected manual

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18
Q

include policy statements concerning hours of operation for outpatients, collection and courier pick ups, etc

A

Laboratory Service Manual

19
Q

4 types of internal manuals

A

administrative manuals
technical manuals
safety manuals
quality management manuals

20
Q

policies that apply to the entire lab

A

administrative manuals

21
Q

work scheds, vacation, holiday staffing, dress codes

A

administrative manuals

22
Q

maintains plans and procedures for purchasing and ordering supplies

A

administrative manuals

23
Q

step by step instruction for operating instruments

A

technical manuals

24
Q

organized according to discipline

A

technical manuals

25
includes procedure for calibration, specimen collection, quality control, safety, etc
technical manuals
26
ease and access and regulatory requirements
safety manuals
27
procedural precautions
safety manuals
28
contains overall policies
Quality Management Manuals
29
address issues of specimen acceptability, administrative and technical review of quality data
Quality Management Manuals
30
coordination and integration with institutional quality plan
Quality Management Manuals
31
assignment of authority and responsibility for ensuring quality standards
Quality Management Manuals
32
organized by topic and composed accdng to standard writing styles
POLICY MANUAL FORMAT
33
presented using an outline model, with subject headings highlighting the relationship of the material
POLICY MANUAL FORMAT
34
written and organized with topic and subject headings
POLICY MANUAL FORMAT
35
detailed and comprehensive documents
PROCEDURE MANUAL FORMAT
36
specific guidelines governing the information that must be provided
PROCEDURE MANUAL FORMAT
37
must adhere to the rules and guidelines of a variety of agencies governing the hospital and laboratory itself
PROCEDURE MANUAL FORMAT
38
JCAHO
Joint Commission on Accreditation of Hospitals
39
CAP
COLLEGE OF AMERICAN PATHOLOGISTS
40
AABB
AMERICAN ASSOCIATION OF BLOOD BANK
41
CLIA'88
CLINCAL LABORATORIES IMPROVEMENT AMENDMENT
42
OSHA
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
43
NCCLS
National Committee for Clinical Laboratory Standards
44