Planning + Decisions
30%of exam
Organizing
25%of exam
Leading
30%of exam
Controlling
15%of exam
Quick Facts
- Exam
- CHL
- Credential
- Certified Healthcare Leader
- Owner
- HSPA
- Questions
- 150 MCQ
- Scored
- 125 scored
- Pretest
- 25 unscored
- Time
- 3 hours
- Fee
- $140
- Eligibility
- CRCST required
- Renewal
- Annual
- Pilot
- Oct 1-15 2026
- Relaunch
- Dec 15 2026
Risk Timing
RCA reviews; FMEA previews.
RCA afterFMEA beforePDCA loopsLean flows
RCA vs FMEA
RCA
- After event
- Find causes
- Correct system
FMEA
- Before failure
- Score risk
- Prevent harm
Past vs future
Improvement Picker
- Event already happened→RCA(Retrospective)
- Risk before launch→FMEA(Prospective)
- Small test cycle→PDCA(Iterate)
- Variation problem→DMAIC(Measure)
- Waste visible→Lean(Flow)
- Workspace disorder→5S(Organize)
Blueprint Map
- Planning
- Strategy decisions30%
- Organizing
- Resources workflow25%
- Leading
- People performance30%
- Controlling
- Monitor correct15%
- Current exam
- Through Sep 2026
- Pilot exam
- New outline
- Blackout
- No CHL testing
Exam Transition
Pilot October; regular resumes December.
Sep deadlineOct pilotBlackoutDec relaunch
Capital vs Operating
Capital
- Major asset
- Long useful life
- Approved purchase
Operating
- Routine cost
- Current year
- Supplies labor
Asset vs expense
Change
- SWOT
- Strategic scan
- Gap analysis
- Current vs desired
- Stakeholders
- Affected parties
- Standardization
- Reduce variation
- Restructuring
- Redesign roles
- Outsourcing
- External service
- Buy-in
- Adoption support
- Communication plan
- Message cadence
Workforce
- FTE
- 2080 paid hours
- Productive hours
- Worked time
- Nonproductive
- PTO education
- Capacity plan
- Match volume
- Skill mix
- Right competencies
- Succession
- Future leaders
- Retention
- Keep talent
- Engagement
- Motivation ownership
Finance
- Operating budget
- Routine expenses
- Capital budget
- Long-life assets
- Variance
- Actual vs budget
- Favorable
- Costs under budget
- Unfavorable
- Costs over budget
- Cost accounting
- Assign expenses
- ROI
- Benefit vs cost
- Forecasting
- Predict demand
Improvement Tools
- PDCA
- Iterative improvement
- DMAIC
- Six Sigma cycle
- RCA
- Find actual cause
- FMEA
- Prevent future failure
- Lean
- Remove waste
- 5S
- Organize workspace
- Kaizen
- Focused improvement
- Fishbone
- Cause categories
Dirty Clean Flow
Dirty moves forward; clean never backtracks.
DeconPrep packSterilizeStoreDistribute
Policy vs Procedure
Policy
- What rule
- Leadership intent
- Compliance standard
Procedure
- How steps
- Task sequence
- Staff action
Rule vs steps
Workflow Picker
- Soiled item arrives→Decon(PPE)
- Item cleaned→Prep pack(Inspect)
- Package ready→Sterilization(Validate)
- Cycle complete→Release criteria(Check)
- Sterile item held→Storage(Protect)
- OR needs tray→Distribution(Track)
Workflow
- Decon
- Soiled area
- Prep pack
- Clean assembly
- Sterilization
- Validated kill process
- Storage
- Maintain sterility
- Distribution
- Deliver ready items
- Unidirectional
- Dirty to clean
- Traffic control
- Limit cross-flow
- IFU
- Manufacturer authority
Decon vs Prep
Decon
- Soiled work
- Negative pressure
- Heavy PPE
Prep pack
- Clean assembly
- Positive pressure
- Inspection focus
Dirty vs clean
Staff Model
- Span control
- Manageable reports
- Shift overlap
- Handoff buffer
- Cross-training
- Flexible coverage
- Preceptor
- Structured coach
- Task analysis
- Break work down
- Competency
- Observed performance
- Customer service
- OR partnership
- Team cohesion
- Shared accountability
Standards
- AAMI ST79
- Steam sterilization
- AORN
- Perioperative guidance
- OSHA
- Worker safety
- CDC
- Infection guidance
- FDA
- Device regulation
- CMS
- CoP oversight
- TJC
- Accreditation survey
- Policy
- Facility rule
Leadership First
Listen, coach, document, escalate.
ListenCoachDocumentEscalate
Training vs Competency
Training
- Teach knowledge
- Introduce process
- Class evidence
Competency
- Verify skill
- Observe task
- Performance evidence
Taught vs proven
People Picker
- New technician→Preceptor(Structured)
- Skill uncertainty→Competency(Observe)
- Performance gap→Coaching(Improve)
- Career growth→Mentoring(Develop)
- Behavior violation→Counseling(Document)
- Team conflict→Mediation(Collaborate)
Leading People
- Orientation
- Role entry
- Onboarding
- Structured integration
- Return demo
- Show competence
- Recognition
- Reinforce behavior
- Empowerment
- Shared ownership
- Coaching
- Improve performance
- Mentoring
- Develop career
- Counseling
- Correct behavior
Coaching vs Discipline
Coaching
- Skill gap
- Supportive feedback
- Improvement plan
Discipline
- Rule violation
- Formal consequence
- HR process
Develop vs correct
Communication
- SBAR
- Structured handoff
- Active listening
- Confirm meaning
- Feedback
- Behavior specific
- Negotiation
- Reach agreement
- Mediation
- Facilitate resolution
- Handoff
- Transfer priorities
- Barrier
- Message blocker
- HIPAA
- Protect PHI
Leadership Models
- Situational
- Match readiness
- Transformational
- Inspire change
- Transactional
- Reward compliance
- Servant
- Support team
- Maslow
- Needs hierarchy
- Herzberg
- Hygiene motivators
- Theory X
- Control assumption
- Theory Y
- Trust assumption
Control Loop
Measure trends, correct causes.
KPITrendRoot causeCorrect
Audit vs Tracer
Audit
- Checklist review
- Evidence sample
- Compliance score
Tracer
- Follow item
- Process path
- System gaps
Sample vs journey
Control Picker
- BI positive→Recall(Quarantine)
- Device problem→MAUDE(Report)
- Survey readiness→Mock tracer(Audit)
- Budget miss→Variance review(Explain)
- Tray errors rise→Defect dashboard(Trend)
- Stock shortage→Par review(Adjust)
KPIs
- Tray defects
- Assembly misses
- IUSS rate
- Urgent sterilization
- Turnaround time
- Cycle duration
- Recall rate
- Failed release
- BI positive
- Sterility failure
- Washer checks
- Cleaning evidence
- Overtime
- Capacity pressure
- Scorecard
- Visual metrics
Favorable vs Unfavorable
Favorable
- Cost below budget
- Revenue above budget
- Positive variance
Unfavorable
- Cost above budget
- Revenue below budget
- Negative variance
Better vs worse
Inventory Control
- Par level
- Target stock
- Stockout
- Unavailable supply
- Substitute
- Compatible replacement
- Consignment
- Vendor-owned stock
- Loaner
- Temporary tray
- Shelf life
- Usable duration
- Tracking system
- Trace movement
- Recall
- Remove affected items
Events + Docs
- Incident report
- Event record
- Near miss
- Caught before harm
- Sentinel event
- Serious harm signal
- MAUDE
- FDA device reports
- Audit
- Verify compliance
- Tracer
- Follow process
- Record retention
- Keep evidence
- Corrective action
- Fix root cause
Common Traps
Experience Rule
Current: CRCST only ≠ Pilot: CRCST plus path
Pretest Questions
150 total questions ≠ 125 determine pass
RCA Timing
RCA after event ≠ FMEA before change
Competency Proof
Written test supports ≠ Observation proves skill
Workflow Direction
Decon stays dirty ≠ Prep pack stays clean
PHI Handling
Need-to-know use ≠ Social sharing violation
Variance Meaning
Lower cost favorable ≠ Higher cost unfavorable
BI Failure
Do not release ≠ Recall affected loads
Last Minute
- 1.Current weights: 30/25/30/15
- 2.CRCST required for CHL
- 3.150 total; 125 scored
- 4.Pilot uses new outline
- 5.RCA after; FMEA before
- 6.Training teaches; competency proves
- 7.Dirty to clean flow
- 8.IFU is primary authority
- 9.BI positive triggers recall
- 10.Annual CHL renewal required
- 11.Budget variance: actual minus budget
- 12.Protect PHI during handoffs
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