Get Md Johns Hopkins Medical Laboratories Point-of-care Testing New Test Request Form 2018-2025

Completing the MD Johns Hopkins Medical Laboratories Point-of-Care Testing New Test Request Form online can streamline the process of initiating new test requests. This guide provides clear instructions to assist you in effectively filling out the necessary sections of the form, ensuring that all critical information is accurately conveyed.

Follow the steps to successfully submit your request.

1. Press the ‘Get Form’ button to access the form and launch it in the editing interface.
2. Begin by filling in the date at the top of the form. This will indicate when the request is being submitted.
3. Enter the department or unit requesting the test in the designated field to clarify who is responsible for the test request.
4. Provide the name of the requester in the corresponding field, ensuring that you identify the individual initiating the request.
5. Include the title of the requester below their name. This provides context regarding their role within the organization.
6. Fill in the telephone number and email address of the requester to facilitate communication regarding the test request.
7. Identify the test procedure by writing its name clearly. Make sure this matches any existing documentation.
8. Specify the instrument or kit name being used for the test to ensure clarity on the equipment involved.
9. Indicate the manufacturer's name in the space provided to verify the source of the testing materials.
10. Complete section A by specifying the locations where the tests will be performed, and select the appropriate options for inpatient or outpatient testing.
11. In section B, provide the hours of operation during which tests will be conducted, ensuring to outline availability.
12. Select the appropriate CLIA test complexity level in section C, choosing from the provided options that reflect the test type.
13. Respond to section D regarding the availability of the service through the central laboratory by selecting ‘Yes’ or ‘No’.
14. In section E, indicate the desired turnaround time for this test if it is performed in the central laboratory.
15. Provide a brief explanation in section F on why current services do not meet your needs, ensuring clarity and thoroughness.
16. In section G, describe how quickly results will be utilized for clinical decision-making if the test is made available at the point-of-care.
17. Answer section H by indicating whether patient treatment decisions will be based solely on the point-of-care test results, elaborating as necessary.
18. Estimate the number of tests to be performed in section I by specifying daily, weekly, and monthly figures.
19. In section J, outline the staff levels that will perform the test and the number who will require training.
20. Provide a summary in section K of the expected patient care benefits and potential cost savings, including evidence of clinical utility where available.
21. Indicate in section L whether funds are approved for the costs associated with the new test request.
22. Provide the designated cost center or budget number for Point-of-Care Testing costs in section M.
23. Ensure that the required signatures are obtained in section N, including the medical director, finance administrator, and testing personnel manager.
24. Fill in the date the Point-of-Care Testing request is received and any required approvals before submission.
25. Finally, save changes, download or print the completed form to maintain a copy for your records, and share it as needed.

Begin filling out the MD Johns Hopkins Medical Laboratories Point-of-Care Testing New Test Request Form online today.