FAQs pdf

(updated 06/04/2014)

What is the purpose of this survey?

The purpose of the survey is to collect information about cytology laboratory workload practices, including how workload limits are establishing and assessed, the type of screening performed, how computer-assisted screening devices are used, how workload is recorded, how screening is defined and the time spent screening various types of specimens.

Why should I take the time to participate in this workload survey?

This is the first study sponsored by the government to assess cytology workload practices.  This is your opportunity to help provide valuable information to the government agencies (CDC, FDA and CMS) that will help them assess the current CLIA ’88 workload requirements and determine if they should be changed.

Cytology workload has been an on-going issue for the cytology community since maximum workload limits were mandated in the Clinical Laboratory Improvement Amendments (CLIA ’88) passed by congress in 1988.  Prior to this time, there were no workload restrictions and many cytotechnologists in the United States were required to screen large numbers of slides to earn a livable wage.  Many of the cytotechnologists at that time were paid by the slide.  This resulted in high false negative Pap tests, which resulted in death for some patients.  This was the focus of a series of articles written by investigative reporter, Walt Bogdanich and published in the Wall Street Journal.  These articles created an outcry throughout the country and lead to the congressional hearings, which then resulted in the passage of CLIA ’88.

With the introduction and implementation of computer-assisted screening devices, there has been significant concern within the cytology profession that the maximum workload limits for these devices may be too high.  The American Society for Cytopathology (ASC) convened the Productivity and Quality Assurance in the Era of Automated Screening Task Force to investigate this issue and develop recommendations.   The Task Force’s recommendations were presented to the Clinical Laboratory Improvement Advisory Committee (CLIAC) on February 14, 2012 and published in May 2012.  These recommendations were endorsed by most of the cytopathology professional societies in the United States.  (ASC Workload Recommendations for Automated Pap Test Screening: Developed by the Productivity and Quality Assurance in the Era of Automated Screening Task Force.   (http://www.cytopathology.org/wp-content/uploads/2013/05/6429.pdf).

In response, the CLIAC recommended conducting operational studies to determine if the maximum workload limit using semi-automated screening instruments is appropriate.  In addition, the CLIAC wanted to discourage the use of maximum workload limits as productivity expectations and asked that standardized criteria be developed for use in determining workload limits for each individual performing screening.

In response to CLIAC’s recommendations, the CDC convened The Workload in Image-assisted Gynecologic Screening Workgroup to provide CDC, CMS, and FDA with guidance on the type of operational study to conduct.  As part of this process, the workgroup developed a survey to assess cytology laboratory practices related to workload for cytotechnologists, which is included in this study.  The survey will help provide information on how cytotechnologists’ workload is assessed and how laboratories establish workload limits.

The CDC developed this study and contracted with ASCT Services in September 2013 to conduct the study.

If I take the survey do I have to participate in the time measure study?

No, if you participate in the survey you are not required to participate in the time measure study.  However, if you want to participate in the time measure study you do have to participate in the survey.  There are questions on the survey that ask if you are interested.   A small number of cytotechnologists/laboratories that indicate that they are interested in participating in the time measure study will be selected. 

How long will it take to complete the survey?

Based on results of pilot tests of the survey, the time will vary depending on whether you are a completing the survey as a cytotechnologist or as the cytology supervisor.  There are some questions that ask for specific data, so having the most recent workload records, workload assessments, and cytology statistics readily available will help minimize the time required to complete the survey.

For cytotechnologists, the survey should take 30 minutes or less.

For cytology supervisors, the survey may take about 30 minutes to complete since there are a few more questions requesting more specific data related to laboratory policies and procedures and cytology statistics.

Will my responses be confidential?

Yes, all individuals participating in the survey will remain completely anonymous.  All information collected from the survey will be summarized and reported in aggregate demographically.  All information will be de-identified before it is given to the CDC. 

Can I do the survey at someplace other than work?

Yes, if you have the information needed to complete the survey.  It will be helpful to have your laboratory CLIA number, cytotechnologists’ workload records and cytology statistics available to reference as you complete the survey.

Completing the survey at work is dependent on your laboratory’s policies for computer use.  If you are unsure of your laboratory’s policy, please check with your supervisor or manager.  Most importantly, the survey should be completed at a time and place most convenient to you, and in accordance with your laboratory’s computer use policies.

If I get interrupted and can’t finish the survey will the survey be saved on my computer?

Yes, you can exit the survey and resume at a later time to complete the survey as long as you use the same computer and browser to complete the survey.  Don’t clear your cookies!  The link MUST be accessed on the same browser.  If you use a computer with a different IP address, your previous responses will not be saved and you will have to re-enter the survey information.  The [Next] button on a page or the [Done] button at the end of the survey must be clicked to save the page(s) of answers.

Also, the system uses a cookie to save the response by page; therefore cookies must be enabled on your computer to resume the survey.  If your browser is set to dump cookies each time it is closed, the cookie will be refreshed.  In this case, a new or blank survey will open every time the survey is accessed.

Can the same computer be used by multiple people to complete the survey?

No, only one response is allowed per computer.  This is because respondents are able to exit the survey and resume it at a later time if interrupted or otherwise unable to complete the survey at one time (see Question above).  Since one person can access the survey multiple times on a computer, we cannot allow multiple people to access the survey from the same computer.

Our laboratory does not use any of the image-assisted screening devices, should I participate in the survey?

Yes, we encourage you to complete the survey, as the survey asks questions about workload limits and the laboratory practice for establishing and assessing workload limits.  This information is very valuable.  Based on your responses to various survey questions, you will not be asked certain questions that are only applicable to laboratories that use image-assisted screening devices.  If you are asked a question that includes responses for image-assisted screening devices one of the response options will be “Not applicable.” 

I only look at nongynecologic cytology cases, should I participate in the survey?

Yes, since current CLIA workload requirements include nongynecologic/FNA slides, there are questions in the survey that are pertinent to laboratories that only examine nongynecologic/FNA cytology specimens.   Therefore all cytology supervisors and cytotechnologists are encouraged to participate so that information on workload practices from all types of cytology laboratories can be obtained.

I am a cytotechnologist but do not currently perform microscopic evaluation of cytology specimens.  Should I participate in the survey?

No, the survey is specific to cytotechnologists who are currently performing microscopic evaluation of cytology specimens.  If you are working in another area of the laboratory performing tests other than cytological evaluation (e.g. molecular testing, histology) and no longer perform microscopic evaluation of cytology specimens then you would not need to take the survey.

Can I fill out the survey more than once?

Although you may receive the link more than once, you should only complete the survey only once if you screen slides at just one laboratory.  If you supervise cytology or screen slides at more than one laboratory, then you may want to complete the survey for each laboratory where you work.

How long do I have to complete the survey?

The survey will be open from March 10, 2014 – April 4, 2014.

Is this survey mandatory?

No, this survey is not mandatory.  Although we would like all cytology laboratories and cytotechnologists to participate, the choice to participate is entirely up to you.  

Our lab is extremely small, should I still participate in the survey?

Yes, the CLIA workload requirements and maximum workload limits affect all cytotechnologists working in small and large laboratories.  The CDC wants to gather information from all sizes and types of laboratories.  

Who is TMNcorp?

You may have received a telephone call and/or an email from the staff of TMNcorp, as they have been helping to obtain the email addresses necessary for us to distribute the cytology workload survey.   ASCT Services, Inc. contracted with The Media Network Corporation, which does business as TMNcorp, to assist ASCT Services in conducting the CDC Cytology Workload and Time Measure Study.

TMNcorp is a subcontractor for this contract and works for ASCT Services, Inc.  This company was chosen because they have been involved in numerous studies for various government agencies.  TMNcorp is listed on The General Services Administration (GSA), which is an independent agency of the United States government, established to help manage and support the federal agencies.

TMNcorp is experienced in conducting surveys, studies and analyzing data and are providing ASCT Services, Inc. additional support and expertise needed for us to conduct this study for the CDC.