Single middleware/competency software + Multiple CLIA#'s?

We use UniPOC and have the one middleware but 5 CLIA licenses.  All sites use the same glucometers so I use the same training, same test and competency forms for all sites.   Individuals get a 30 day notice on the glucometer before their competency expires so they know to line up with a class to get that renewed.  It works well.  Even though it is multiple sites, it is managed very much like they are all one.   UniPOC has their locations in it so if I need to check competencies for one location, I can pull it that way. 

For waived tests, like the glucometer, you only have to do competency assessment once annually, regardless of the location.  I would utilize the auto recertification feature in RALS.  Have them complete a set of QC and take a quiz. 

WAIT!!!  THAT IS NOT TRUE!!! 

 POC.06875

Records of competency assessment may be retained centrally within a healthcare system, but must be available upon request. The laboratory director may determine how competency will be assessed for personnel performing waived testing at multiple test sites (same CAP/CLIA number) or laboratories within the healthcare system (different CAP/CLIA numbers). If there are variations on how a test is performed at different test sites or laboratories, those variations must be included in the competency assessment specific to the site or laboratory.

I called cap last week and had this discussion with them already.  Personnel may be trained at one central location but competency must be assessed at each different site...reason being that each CAP/CLIA number may vary on who to contact when there is a problem or how critical results are documented.

Hi Kammy,

Do your sites share a middleware? How do you set up separate competency for each site?

Thanks

My understanding is that the Medical Director May decide how to assess WAIVED competency at multiple sites. It can be done at one location.

Non-waived has to be done on site at each location.

Many of our clinical staff float between locations. For waived glucose they do a health stream module and run QC annually.

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Stephen,

I do not have multiple CLIA licenses for my facilities.  So far everyone operates under one license.  So sorry  I don't know how to answer that question.  You could call RALS and ask customer support.  I've had a lot of help setting things up with them for other issues I've had.

Kerri- yes it is up to the medical director.  But if there are ANY differences in sites  or how they report and whom to report to then you can receive a deficiency unless the personnel is informed and it's documented that they know the who, what, when, where, how, and why or each different facility.

Here is the background story as to why I had CAP clarify this for me...

Our Corporation wants to streamline all education demands for nurses.  They want all nurses to be trained the same way though out the corporation.  Nursing is complaining about having to do things the same way year after year.  They want access to run it all with out proving they can do it every year.

We have a group of Corporate traveling Nurses that can be called and go work a shift at any facility over a multitude of states.  They are trained at Corporate then sent to hospital to work.  Corporate seems to think they don't need to know the ins and outs of each facility.  Each facility has their own way of handling critical, who to contact if a meter doesn't seem to be operating appropriately, what to do if a meter is broken, or how to document a critical.  Those decision have been made by the facilities Lab Director...not some suit sitting at a desk who is clueless as to why something is being done a certain way and why it's done that way. 

As you all know there is a legitimate reason as to why things are done a certain way.  Lab isn't being "mean" and making the nurse do extra for sport.  We are following rules and regulations that give them the rights to operated a certain device so harm will not befall a patient. 

Kammy, that's a great description of why site specific competency for waived testing is appropriate and necessary in some cases. It's crazy to me to hear how all systems are so different. I have multiple sites but they are all "Children's" and have the same HIS so the process is the same thankfully. So for my waived testing everyone does one elearn and can demonstrate competency at whichever site they choose to attend.

For non-waived, I still have only one elearn as I do not have differences in the process. I only have a small group of RTs that go to both campuses so we let them choose to attend a competency event and then just follow up with that small group to do another short demonstration on the opposite campus. I have Telcor and could lock them out of testing per campus if necessary if not completed.

It’s sometimes difficult to decide to ‘meet CLIA’, meet Accreditation for whichever one we run under (or elect to change Accreditation) and State regs,  setting up our best practices and what is doable with the staffing to perform and to oversee/manage/assess.

I myself am still recovering from a new Director level in the lab (I don’t work/report to ‘the lab’) who joined our system then announced ‘we will move to set up all POC regardless of waived or nonwaived in order to be Standardized’. However that Director level wasn’t the one who had to change that through multiple hospitals and 100 testing sites outside of the hospitals at 40 CLIAs in a 400 mile geographic distance from his office.

Happy Friday, early!