OPERATIONS ORDER

| primary client NAVISION #: 100725 |
|CLIENT: Albert Einstein College of Medicine |CONTACT: Melanie Brown |
|1300 Morris Park Ave |Assistant Administrator |
|Bronx, NY 10461 |718-430-4152 |
| |Email: Melanie.brown@einstein.yu.edu |
|SECONDARY CLIENT #: (Location & Contact) |
|NAVISION #: 151776 |
|1300 Morris Park Ave |
|Bronx, NY 10461 |
| |
|Melanie Brown |
|Assistant Administrator |
|718-430-4152 |
|Email: Melanie.brown@einstein.yu.edu |
| |
|Set Code: ALEC01 |
|Work Order: 335870 |
|Test Date(s): June 10-11, 2014 |
|Unit: 8 |

CLIENT NUMBERS:

Client Numbers are in two parts:

Navision Primary Client Number (from above – 100725) Test Panel Number from following Panel pages - 01

The Client Number which consists of two-parts - the Primary Client Number and the Test Panel Number are to be printed together on the Administrative Page: (i.e., 10072501)

TOTAL # of LOCATIONS: 1
TOTAL # of PANELS: 3 (Panels 01, 02 & 03)

|TEST PANEL: 01 |
|Navision: 11304 |
|Corporate Consent: YES. (To Assistant Administrator of Albert Einstein College of Medicine.) |
|Employee ID Number: Collect Employee ID Number. (NOT Social Security Number) |
|Flow Rate: 1 every 2/15 minutes. |
|History: Examinetics Confidential Respirator Questionnaire. |
|Noise Exposure/Ear Protection: Ask the Hearing Protection questions on the Examinetics Hearing Test Case History. |
|Special Forms: Mobile Work Order Disposition Form |
|Hearing Conservation Program Attendance Record |
|Examinetics Hearing Test Case History |
|Examinetics Physician Examination Record |
|Examinetics Respirator Fit Test Record |
|Examinetics Fit Test Qualification Form |
|Examinetics Fit Test Cards |
|See Special Unit Procedures. |
|Unit Participation Sheet: Collect Employee ID Number. (NOT Social Security Number) |

|Audiometry: TO (500, 1000, 2000, 3000, 4000, 6000 + 8000Hz). |
|Blood Pressure: Standard. |
|Height/Weight: Standard. |
|MD Exam: Physician hands-on exam. Not to exceed 15 minutes. See Special Unit Procedures. |
|Otoscopic Examination: See Special Unit Procedures (Hearing Test Case History Section). |
|Qualitative Fit Testing: See Special Unit Procedures. |
|Quantitative Fit Testing: See Special Unit Procedures. |
|Resting Pulse: Standard. |
|Spirometry: Standard. |
|Urinalysis: Micro UA. See Lab Specimens below. |
|Vision: Standard. |

|Comparative Data: Done in DCP. |Respirator Clearance: Done in DCP. |

|LABORATORY SPECIMENS (Panel 01): LAB TO BE USED: Pactox |
|Type of Tube(s) |Tests |Order Lab Panel # |Special Instructions |
|One (1) Tiger top |Chem Screen/HDL/CBC |#HE08971 |If tiger only: #HE08966 |
|One (1) Lavender Top | | |If lavender only: #HE18957 |
|10 mil Urine Vial w/Preservative Tablet |Micro U/A |#HE15059 |See Special Unit Procedures. |

|TEST PANEL: 02 |
|Navision: 11305 |
|Corporate Consent: YES. (To Assistant Administrator of Albert Einstein College of Medicine.) |
|Employee ID Number: Collect Employee ID Number. (NOT Social Security Number) |
|Flow Rate: 1 every 2/15 minutes. |
|History: Examinetics Confidential Respirator Questionnaire. |
|Noise Exposure/Ear Protection: Ask the Hearing Protection questions on the Examinetics Hearing Test Case History. |
|Special Forms: Mobile Work Order Disposition Form |
|Hearing Conservation Program Attendance Record |
|Examinetics Hearing Test Case History |
|Examinetics Physician Examination Record |
|Examinetics Respirator Fit Test Record |
|Examinetics Fit Test Qualification Form |
|Examinetics Fit Test Cards |
|See Special Unit Procedures. |
|Unit Participation Sheet: Collect Employee ID Number. (NOT Social Security Number) |

|Audiometry: TO (500, 1000, 2000, 3000, 4000, 6000 + 8000Hz). |
|Blood Pressure: Standard. |
|Chest X-Ray: PA. (ILO Interpretation). See Special Unit Procedures |
|Height/Weight: Standard. |
|MD Exam: Physician hands-on exam. Not to exceed 15 minutes. See Special Unit Procedures. |
|Otoscopic Examination: See Special Unit Procedures (Hearing Test Case History Section). |
|Qualitative Fit Testing: See Special Unit Procedures. |
|Quantitative Fit Testing: See Special Unit Procedures. |
|Resting Pulse: Standard. |
|Spirometry: Standard. |
|Urinalysis: Micro UA. See Lab Specimens below. |
|Vision: Standard. |

|Comparative Data: Done in DCP. |Respirator Clearance: Done in DCP. |
|Asbestos Clearance: Done in DCP. | |

|LABORATORY SPECIMENS (Panel 02): LAB TO BE USED: Pactox |
|Type of Tube(s) |Tests |Order Lab Panel # |Special Instructions |
|One (1) Tiger top |Chem Screen/HDL/CBC |#HE08971 |If tiger only: #HE08966 |
|One (1) Lavender Top | | |If lavender only: #HE18957 |
|10 mil Urine Vial w/Preservative Tablet |Micro U/A |#HE15059 |See Special Unit Procedures. |

|TEST PANEL: 03 |
|Navision: 00002 |
|Corporate Consent: YES. (To Assistant Administrator of Albert Einstein College of Medicine.) |
|Employee ID Number: Collect Employee ID Number. (NOT Social Security Number) |
|Flow Rate: 1 every 2/15 minutes. |
|History: Examinetics Hearing Test Case History. |
|Noise Exposure/Ear Protection: Ask the Hearing Protection questions on the Examinetics Hearing Test Case History. |
|Special Forms: Mobile Work Order Disposition Form |
|Hearing Conservation Program Attendance Record |
|Examinetics Hearing Test Case History |
|See Special Unit Procedures. |
|Unit Participation Sheet: Collect Employee ID Number. (NOT Social Security Number) |

|Audiometry: TO (500, 1000, 2000, 3000, 4000, 6000 + 8000Hz). |
|Otoscopic Examination: See Special Unit Procedures (Hearing Test Case History Section). |

|Comparative Data: Done in DCP. |

special operations procedures

1 Employee ID Numbers Assigned to Each Participant

Account executive ensures that the Unit Manager and crew do not use Social Security Numbers on Unit Participation Sheet. Instead, use Employee ID numbers on Unit Participation Sheet.

3 CD Data Load

No less than three weeks prior to testing, request the client database, and get Set Code and Work Order Numbers from Navision. Ensure that the Unit receives and loads the CD no less than one week before testing.

4 Additional Supplies/Forms

All the items on the following list are shipped to the Unit two weeks prior to testing. Account executive ensures that the items are shipped to and received by the Unit and that the Unit manager is properly trained on their use.

1 Mobile Work Order Disposition Forms

2 Examinetics Hearing Test Case History

3 Hearing Conservation Program Attendance Records

4 Examinetics Physician Examination Record

5 Port-a-Count Plus (3)

6 Laptops and Printers for Fit Test station

7 Examinetics Respirator Fit Test Records

8 Examinetics Fit Test Qualification Forms

9 Examinetics Fit Test Cards

10 Qualitative Fit Test Kit (2) with Bitrex Solution

5 Early Blood Draw

This location will have Examinetics conduct early morning blood draws. Ensure sufficient staffing is available for this requirement. Follow all other procedures identified in Early Blood Draw Procedure (see attachment).

7 Workplace Survey Instructions

Account executives send a Workplace Survey to each client who participates in Examinetics’ Respiratory Program. Send with the Survey a cover letter explaining that, in accordance with OSHA’s CFR1910.134, Examinetics is required to collect certain information for each Job Category or employee, whichever is easier for the client.

8 Respirator Protection Program Procedure

Client must provide Examinetics with their company Respirator Protection Program Procedure in order for Examinetics to run the Respirator Clearance letters. Request their Procedure prior to the start of testing.

9 Physician

Contract with a physician to perform Physician Hands-On Exams. Exams are not to exceed 15 minutes

1 In advance of testing, send the following to the physician:

2 Physician Exam: Hands-On procedure

3 Examinetics Physician Examination Record

4 Examinetics Confidential Respirator Questionnaire

5 The purpose of the Physician exam is to perform Respirator and Asbestos Clearances.

6 Call the physician to review in detail the above documents. Thoroughly train the physician in advance.

10 Quantitative Respirator Fit Testing

Set-up Instructions

1 Obtain the Respirator Fit Testing information from client at least four weeks prior to testing.

2 Ensure that the Unit has all equipment required for program (refer to the Port-a-Count Plus with Computer procedure).

3 Refer to Respirator Fit Test Procedure. Review with Unit Manager. Ensure that the Unit Manager conducts crew training in advance.

Participants may be required to be fit tested in multiple masks. Ensure that sufficient time is allotted for each participant during the scheduling process.

Respirator Masks:

|Manufacturer(s) |Model |Size |Fit Factor |Type |
|3M |6000 Series |S, M, L |100 |Half |
|3M |7500 Series |S, M, L |100 |Half |
|3M |6800 Series |S, M, L |500 |Full |
|3M |7000 Series |S, M, L |500 |Full |

Albert Einstein College of Medicine will provide Respirator Masks and Examinetics will provide fit equipment and adapters.

11 Qualitative Respirator Fit Test

1 Set-up Instructions

Examinetics is required to provide Qualitative Respirator Fit Testing.

Obtain the Respirator Fit Testing information from client at least four weeks prior to testing.

Ensure that the unit has all equipment required for program

Refer to 3M Qualitative Respirator Fit Test Procedure. Review with Unit Manager. Ensure UM conducts crew training in advance.

2 Respirator Mask(s):

|Manufacturer(s) |Model |Size |Fit Factor |Type |
|3M |8247 |One Size |100 |Dust |
|3M |8271 |One Size |100 |Dust |
|3M |9210 |One Size |100 |Dust |

3 Albert Einstein College of Medicine will provide Dust Masks and Examinetics will provide fit test equipment.

Special Unit Procedures

1 Employee ID Numbers Assigned to Each Participant

Unit Manager ensures that crew does not use Social Security Numbers on Unit Participation Sheet. Instead, use Norlite Corporation Employee ID numbers on Unit Participation Sheet. Always use the format: LEADING ZEROS + EID.

3 CD Data Load

Verify that the client database for this client has been received and loaded. The name of the database folder for this client is ALEC000608.

4 Set Code

The Set Code for this location in vanSPRINT is ALEC01. Select this location in the vanSPRINT set up Session.

5 Additional Supplies/Forms

Ensure you have received all supplies/ equipment necessary for testing this client. Ensure all equipment is in proper working order. Discuss with your Account executive if you are unsure/unclear about supplies.

2 Mobile Work Order Disposition Forms

3 Examinetics Hearing Test Case History

4 Hearing Conservation Program Attendance Records

5 Examinetics Physician Examination Record

6 Port-a-Count Plus (3)

7 Laptops and Printers for Fit Test station

8 Examinetics Respirator Fit Test Records

9 Examinetics Fit Test Qualification Forms

10 Examinetics Fit Test Cards

11 Qualitative Fit Test Kit (2) with Bitrex Solution

6 Mobile Work Order Disposition Form

One Mobile Work Order Disposition Form is to be completed for each client that receives Audio service. Record the information as follows: 1. Test Numbers: Record the number of audio test vs. retests. If data was collected manually, record the number tested in the “manual” space provided. 2. Reports Left on Site: Check box if Audio reports were left on-site. 3. Reports not generated: This should only be checked if there was a problem that prevented printing of the above reports or letters.

7 Hearing Conservation Program Attendance Record

Complete the top of the form based on the information provided and the vanSprint service being provided: Company: CUSTOMER NAME Location: TEST LOCATION (CITY)___________ Instructor: TECH NAME Date: mm/dd/yy ____ Setcode: _____location specific setcode_____________

Fill out the Attendance Record according to the following example.

TEST ONLY (TO)
|( Service(s) |( Service(s) includes: |
|Provided: | |
| | |
|TEST |Employees have been notified of Examinetics Privacy Practices. |
| |Video Title: |Topics Covered: |
|TRAIN |Play It By Ear |The harmful effects of noise on hearing. |
| |Client specific video |The purpose of hearing protectors; the advantages, disadvantages and attenuation of |
| |Sounds Good To Me |various types; and instructions on selection, fitting, use and care. |
| |Other:______________ |The purpose of audiometric testing and an explanation of |
| | |the test procedure |
| | |
|COUNSEL |Proper use of HPDs: Group practice: Demonstration only: |
| | |
| |Types of hearing protection available for practice and/or use: |
| |Foam / moldable Pre-molded / flanged |
| | |
| |Canal Cap Custom molded Earmuffs Other |
| |____________________________________________________________________________________________________________________________|
| |_____________________________________________________________________________________________________________________ |
| | |
| |YES NO Employees received test results and explanation of results at time of test |
| | |
| |If no, reason why:__________________________________________________________ |
| | |
|NOTIFY |YES NO Employees received a copy of the test results at time of test |
| | |
| |If no, reason why:_______________________________________________________ |

As participants enter the Audio Station ask them to sign and print their name on the Hearing Conservation Program Attendance Record form.

8 Examinetics Hearing Test Case History

Each participant who receives Audiometry must complete the Hearing Test Case History Form.

1 Label form with a PID label in the upper right corner.

1. Pass form back to the Audio Station. 2. Enter data on the form into the vanSPRINT program. 3. Otoscopic Exam Perform Otoscopic Exam per standard procedure. Record results on the Hearing Test Case History and in VanSprint as follows: “N” = No Apparent Problem. “B” = Anything that obstructs the view of the eardrum including, a foreign body. “P” = Any problem with the ear canal or eardrum, other than wax or foreign body. “U” = Use this code if the Otoscopic Exam is not performed for any reason. 4. Stack Forms in the Audio Station in PID order.

9 Hearing Notification Letters

Two Hearing Notification Letters will print. No initials are required. The Participant’s signature is not required. Do not give a copy of the letter to the participant. Stack both unsigned copies in PID order.

10 Early Morning Blood Draws

1. Examinetics technician draws blood prior to testing, according to standard procedure (see attachment). 2. Communicate with Contact for location/set-up of off-Unit blood draw site. Ask the Contact prior to the first day of testing which employees (if any) will receive early blood draw. 3. For each participant who is receiving a blood lead test, draw an extra Lavender Top tube of blood. (Refer to appointment schedule) 4. Later, when participants arrive on the Mobile Unit for the remainder of their tests, ask if blood was drawn earlier. If participant answers “no, blood was not drawn”, do the following: a. Examinetics technician initiates Lab Requisition and performs blood draw, per standard procedure. 5. If a participant answers “yes, blood was drawn earlier”, do the following: b. Locate the participant’s blood specimen by last name and Social Security number. (Specimens drawn prior to testing will be in the Unit refrigerator in alphabetical order in the blood-tube rack.) c. Verify the participant’s name and Social Security number against the Unit Participation Sheet, and assign the correct PID number. d. Take precautions to label the specimens correctly. Ensure that all specimens have the participant’s name and Social Security number on them before labeling with his or her PID number. e. Place the blood PID label on blood tubes and place appropriately in blood rack f. Initiate a Lab Requisition for each participant for which there is a blood tube. Order the correct Lab Panel numbers, as specified on the appropriate panel-number page. g. After Steps a) through e) are completed, put blood sample in the refrigerator on the Mobile Unit. Note – Critically important: Collect the blood sample for end-of-day shipping.

11 Physician Supplies

Ensure the following supplies for the MD Examinations are available On-Unit in advance of the MD Exams:
|1. |Large gloves |9. |Clipboard |
|2. |Gowns |10. |Pens |
|3. |Portable BP cuffs (all sizes) |11. |Otoscope |
|4. |Table Paper |12. |Otoscope Specula |
|5. |Tongue Depressors |13. |Ophthalmoscope |
|6. |Kleenex |14. |Stethoscope |
|7. |Percussion Hammer |15. |Portable Exam Table |
|8. |Paper Towels |16. |Privacy Screens |

12 Physician Exam & Examination Record

A Physician Hands-On Exam will be performed and must not exceed 12 minutes. For special instructions, see “Physician Exam: Hands-On” procedure. 1. Receptionist initiates Examinetics Physician Examination Record. 2. Examinetics technician(s) record Height/Weight, BP, and Pulse results on Examinetics Physician Examination Record 3. Form is passed back with PID labels to physician exam station.

14 Snellen Vision

Administer the Snellen Vision Test to all participants that do not score at least 20/40 in the right eye, left eye and both eyes on the Titmus machine. Record results on MDAF per standard procedure. (For procedure see attachment E93)

15 Vision Testing - Manual

If for any reason the vision machine should malfunction administer the following vision tests. Record results on the MDAF per standard procedure: 1. Snellen Vision Test (see Attachment E93) 2. Manual Peripheral Test 3. Practical Color Test (red, green, yellow) 4. Notify the Account executive that manual vision testing was performed

A. Examinetics Respirator Fit Test Record

The Examinetics Respirator Fit Test Record is only used when there are no laptop and printer available to use with Port a Count or when doing Qualitative Fit Testing.

In the Reception station, initiate an Examinetics Respirator Fit Test Record for each participant. Attach the form to the PID labels and pass through the Unit with the participant to the Fit Test station

16 Examinetics Fit Test Qualification Form

1 In the Reception station, initiate an Examinetics Respirator Fit Test Qualification Form for each participant that is scheduled to have a Fit Test

2 Ask the participant to complete the form and sign it. If the participant indicates that they have not previously been medically cleared to receive a Fit Test, you may not Fit Test the participant.

3 If the participant has NOT been previously cleared to wear a respirator, fax the completed Respirator Questionnaire to (913) 748-2001 Attn: Clearance Review Nurse. Identify yourself and a number where you can be reached. The nurse will contact you with a Clearance decision regarding the Fit Test.

4 Notify Account executive immediately if any questionnaires are being faxed for the clearance process.

5 If you cannot get a clearance for Fit Testing from the nurse, list the participants name on the Test Not Performed List.

17 Fit Test Card

1 Fit Test Technician must initiate a Fit Test Card for each participant that passes the Fit Test.

2 Record all Administrative Information on the front of the card.

3 Record appropriate mask information on the reverse side of the card.

18 Quantitative Respirator Fit Testing

1 Perform Quantitative Respirator Fit Testing at this location.

2 Ensure that the unit has all equipment required for the program.

3 Unit Manager must ensure that crew training has been completed in advance using the following forms and procedures:

4 Calibration Check and Test Participant Procedure

5 Examinetics Respirator Fit Test Record (only if Laptop and Printer is not available)

6 Examinetics Fit Test Qualification Form.

7 Examinetics Instrument Operation (see PortaCount Plus Procedure).

2 When entering Respirator Mask information into the computer, information must be entered as it appears in the table below, i.e. capital letters, dashes, etc. The Examinetics computer will not recognize data if entered differently.

1 Respirator Masks:

|Manufacturer(s) |Model |Size |Fit Factor |Type |
|3M |6000 Series |S, M, L |100 |Half |
|3M |7500 Series |S, M, L |100 |Half |
|3M |6800 Series |S, M, L |500 |Full |
|3M |7000 Series |S, M, L |500 |Full |

2 Albert Einstein College of Medicine will provide Respirator Masks and Examinetics will provide fit equipment and adapters.

19 Qualitative Respirator Fit Test Procedure

1 Qualitative Respirator Fit Test Procedure located on Unit CD in Ops Order Attachments File.

2 Refer to Attachment A within the Qualitative Respirator Fit Test procedure, Instructions for Positive Pressure Face Fit Check.

3 Perform Bitrex Aerosol Method (see attachment C) Fit Testing as defined within the Qualitative Respirator Fit Test Procedures

4 Initiate a Respirator Fit Test Record for each participant (to record results).

20 Qualitative Respirator Fit Test (Bitrex Aerosol Method)

Refer to the Qualitative Respirator Fit Test procedure, Instructions for Positive Pressure Face Fit Check.

1 Perform Qualitative Respirator Fit Testing at this location.

2 Ensure that the unit has all equipment required for the program.

3 Unit Manager must ensure that crew training has been completed in advance using the following procedures and forms:

1 Qualitative Respirator Fit Test Procedures using the Bitrex Aerosol Method.

2 Examinetics Fit Test Qualification Form

3 Examinetics Respirator Fit Test Record

4 Respirator Mask(s):

|Manufacturer(s) |Model |Size |Fit Factor |Type |
|3M |8247 |One Size |100 |Dust |
|3M |8271 |One Size |100 |Dust |
|3M |9210 |One Size |100 |Dust |

5 Albert Einstein College of Medicine will provide Dust Masks and Examinetics will provide fit test equipment.

21 Consultant Time Sheet

Unit Manager gives a Consultant Time Sheet to the physician to record his or her hours, per standard procedure. Physician must record only the actual hours worked. The physician must record lunch/dinner breaks as well. If physician refuses to log the correct hours, do not sign the time sheet. At the end of each week, send original copy of completed Consultant (MD) Time Sheet in an Accounting envelope via the day’s Data Box. Give a copy of the time sheet to the physician.

22 Test(s) Refused/Test Not Performed IMPORTANT!!!

Keep a list of Test(s) Refused/Test Not Performed per standard procedure. If a test is contraindicated, do not list the reason that the test was contraindicated on the Test(s) Refused/Test Not Performed form. Instead list the QCS Code that corresponds to the reason the test was refused or not performed in the “Reason” column on the Tests Refused/Test Not Performed form. See Unit CD for list of QCS codes.

Notify the Site Contact periodically (as soon as possible) throughout the day of any tests being refused or not performed. The contact will try to “coach” and educate employees as to why they should have the test(s). If an employee returns to the unit for a test that he previously refused, try to accommodate and administer the test (unless, of course, you are experiencing major flow problems.). If test is administered annotate Test Not Preformed List to update participant test status.

end of day unit procedures

1 Give to Contact Daily

1 Copy of Appointment Schedule, including all No Shows

2 Copy of Test(s) Refused / Test(s) Not Performed form(s)

3 Copy of all Examinetics Respirator Fit Test Records

2 Send to Examinetics Daily

1 Copy of Appointment Schedule

2 Copy of Tests Refused / Tests Not Performed form(s)

3 All copies of On-Unit Special Notifications

4 Examinetics Physician Examination Records

5 Examinetics Respirator Fit Test Records

3 End of Job

Send to Examinetics at End-of-Job:

a) Copy of Hearing Conservation Program Attendance Records.

b) Copy of Examinetics Audiometric Calibration Form

Give to Location Contact at end of job:

Print End-of-Day Reports. Generate two copies of Calibration Reports. Place one copy of reports in Binder with tab dividers. Send second copy of reports to the office.

Print End-of-Job Reports. End-of-Job reports consist of: Statistical Summary, STS Retest Results, and Possible Recordable Reports. Place reports in Binder with tab dividers.

Insert the signed copies of the Hearing Notification Letters, in alphabetical order, into the Binder

Place all Examinetics Hearing Test Case Histories in binder pocket(s)

Place top (white) copy of Hearing Conservation Program Attendance Records in binder.

|STACKING OF REPORTS: |

Stack Employee Hearing Test Notification reports in PID order - If this is checked, MDP must mail reports (Office instructions) Stack audio reports in Alpha Order

|REPORT ASSEMBLY: |

No binder needed. Stack audio reports. Place all reports in tabbed binder

|WHAT TO DO WITH REPORTS: |

Leave binder on site with site contact or verify designated alternate if site contact is not available. Please have recipient sign work order disposition acknowledging receipt of binder. Mail all reports back to the office at the end of the job. Mail all reports back to the office on a daily basis.

|AUDIO SERVICE EXCEPTIONS or SPECIAL INSTRUCTIONS: |

No exceptions. Yes:

|OFFICE INSTRUCTIONS: |

MDP mails Audio reports Audio DP mails audio reports

|HEARING CONSERVATION: |

Yes – Audiology to conduct full review and send review reports to client No – Audiology to review data for tech QC only No – Audiology to review data for tech QC only. In addition, data disk needs to be created for shipment to _____________________________________

Make two copies of the End-of-Job diskette for the audio data generated for this client.

Label both disks with a vanSPRINT label. On the label, record the following information:

1) Test date range 2) Computer number 3) Set Code as ALEC01 4) Work Order number as 335870 5) Unit number 6) Number of tests and retests

Include both disks in the last day’s data box.

Include Mobile Work Order Disposition Forms.

4 Follow All Other Standard End of Day Procedures As Outlined In On-Board Procedure Manuals

THIS CONCLUDES UNIT INSTRUCTIONS

X-RAY PROCESSING REQUIREMENTS

Chest X-rays are stored at Examinetics per standard process.

REPORT PROCESSING

1 Hearing Conservation

MMP Data Coordinator will forward Audio data to Audio Data Coordinator.

2 Two Copies of the End-of-Job Audio Data Diskettes

3 Mobile Work Order Disposition Form

4 Examinetics Audiometric Calibrations Reports

5 Copy of Hearing Conservation Program Attendance Records

2 Admin Process

Examinetics Physician Examination Record

Make two copies of the Examinetics Physician Examination Record.

File in datapack until reports are ready to be collated.

3 Minimum Clearance Level Requirement

Panels 1 & 2 require a Level “B” Clearance

4 Physio Process

Enter results manually per standard procedures.

5 Proofing

1 Generate 1 copy of the Participant Comp Data Reports.

2 Ensure comparative data reports for participants with 2 or more years of service.

3 All X-ray panels get an ILO interpretation. Ensure the appropriate reading was performed and the results appear in the report.

4 When all reports are proofed and all changes are made to the database:

Generate Clearance Worksheets

Prepare and give the clearance package to the Clearance Review Nurse.

6 Clearances

When the reports are returned from the Clearance Review Nurse:

1 Update the Medical Clearance Database with the letter changes and comments.

2 Generate the Employee and Employer Respirator and Medical Clearance Summary Letters

3 Attach Employee and Employer letters according to the mailing instructions.

4 File the Medical Review Records in the data pack.

When all test dates are complete, generate a “Medical Clearance Alpha List”. This must be mailed along with the reports from the last test day.

PLHCP Follow-UP

Participants must be cleared to a “B” level.

MAILING INSTRUCTIONS

1 Client Copy

This client does not receive any Participant Comp Data Reports. When last test date is complete, generate and mail the following:

1 Employer copy of Medical Clearance Letters

2 Respirator Fit Test Summary

3 Medical Clearance Alpha Listing

MAIL All Items TO:

Melanie Brown
Assistant Administrator
1300 Morris Park Ave
Bronx, NY 10461
718-430-4152
Email: Melanie.brown@einstein.yu.edu

3 Participant Copy

1 Mail participant copies of Participant Comp Data Reports to employees’ home address

2 Attachments:

|PANELS 01 & 02 |PANEL 03 |
|Employer Respirator Letter |Hearing Notification Letter |
|Fit Test Report | |
|Medical Clearance Summary | |
|Examinetics Physician Exam Record | |

SPECIAL NOTIFICATION

If Special Notification is for X-ray, generate Special Notification X-ray Letters; Do Not Send Chest X-ray Image.

1. Special Notification must be communicated by Data Processing to:

Melanie Brown
Assistant Administrator
1300 Morris Park Ave
Bronx, NY 10461
718-430-4152
Email: Melanie.brown@einstein.yu.edu

2. In addition, a copy of the Special Notification Letter must be sent to the participant’s home address

COST PAYMENT

ACCOUNTING TO BILL:

Bill by location:

Melanie Brown
Assistant Administrator
1300 Morris Park Ave
Bronx, NY 10461
718-430-4152
Email: Melanie.brown@einstein.yu.edu

ATTACHMENTS:
Attachment E20: Examinetics Physician Examination Record

Attachment E21: Examinetics Physician Exam: Hands on Procedure

Attachment E41: Examinetics Respirator Fit Test Record

Attachment E42: Examinetics Fit Test Qualification Form

Attachment E71: Early Blood Draw Procedure

Attachment E93: Examinetics Vision Test_10 Foot Snellen Chart_ Procedure