HomeMy WebLinkAboutMINUTES - 01122010 - C.50RECOMMENDATION(S):
Approve the list of providers and their privileges as recommended by the Medical Executive Committee at their
December 21, 2009 meeting, and by the Health Services Director.
FISCAL IMPACT:
None
BACKGROUND:
The Joint Commission on Accreditation of Healthcare Organizations has requested that evidence of Board Approval
for each Medical Staff member will be placed in his or her Credentials File. The above recommendations for
appointment/reappointment were reviewed by the Credentials Committee and approved by the Medical Executive
Committee.
**Needs additional justification re: new privledges
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 01/12/2010 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYES 5 NOES ____
ABSENT ____ ABSTAIN ____
RECUSE ____
Contact: Anna Roth, 370-5101
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of
the Board of Supervisors on the date shown.
ATTESTED: January 12, 2010
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: Katherine Sinclair, Deputy
cc: Tasha Scott, Barbara Borbon
C. 50
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:January 12, 2010
Contra
Costa
County
Subject:Medical Staff Appointments and Reappointments – December 2009
MEC Recommendations – December 2009 Page 2 of 2
A. Request to add new privileges
Ob/Gyn - Attachment 1
Certified Nurse Midwife – Attachment 2
Anesthesia – Attachment 3
B. New Medical Staff Members
Richard Chang, MD Internal Medicine
Gerald Dalgleish, MD Pathology
Sandhya Nair, MD Psychiatry/Psychology
C.T. Nicholas, MD Surgery
Joyce Tang, MD Family Medicine
C. New Affiliated Staff
Christine Costa, NP Family Medicine
Pascale Coucy, NP Family Medicine
Constance Dimidjian, NP Family Medicine
Jenya Dvorkin, NP Family Medicine
Gina Medina, NP Family Medicine
D. David Grant Medical Center – Travis AFB Family Medicine Residents
Tyler Buser, MD
Julie Jeyaratnam, MD
Gregory Trifilo, MD
E. Advance to Non-Provisional
Andrea Bates, MD Psychiatry/Psychology C
Jonathan Kalkstein, MD Psychiatry/Psychology C
F. Biennial Reappointments
Scott Akin, MD Internal Medicine A
Suzan Goodman, MD Ob/Gyn C
Stephen Kalkstein, MD Family Medicine C
Shahbaz Khan, MD Psychiatry/Psychology A
Sarah Kuhl, MD Internal Medicine P/C
Terry Maher, MD Internal Medicine C
James Pehling, MD Family Medicine A
Thomas Ports, MD Internal Medicine C
Denise Ricker, MD Internal Medicine C
Jessica Roberts, MD Family Medicine A
Jaime Tannenbaum, MD Pediatrics C
Stephen Taylor, MD Surgery C
Dawn Wadle, MD Family Medicine A
G. Biennial Renewal of Privileges
Lolita Adona, NP Family Medicine Aff
Deborah Nix, NP Family Medicine Aff
H. Voluntary Resignation
David Adams, MD Family Medicine
Attachment 1
Contra Costa Regional Medical Center
Privileges Request Form
Practitioner: ________________________________
Department(s) Number Privilege Description
D=With Direct Supervision
C=With Consultation
U=Unrestricted D/C/U Training/ Education Experience Current Competence Requested Granted D =Denied P =Pending CNM =Criteria Not Met Ob/Gyn
CNM
OBG
5 Antepartum fetal heart rate monitoring
D
CA Lic.
FNP, or
CNM
N/A N/A
U
CA Lic.
FNP, or
CNM
30
8
cases
in last
4 yrs.
CNM OBG
6
Basic 3rd trimester Obstetrical ultrasound,
including viability, placenta location, fetal
number, and amniotic fluid index*
D
CA Lic.
FNP or
CNM
N/A N/A
U
CA Lic.
FNP or
CNM
10
4
cases
in last
2 yrs.
OBG
22
Diagnostic D&C, incomplete or missed
abortion*
D
CA Lic
or FNP
N/A N/A
C
CA Lic
or FNP
10 N/A
U
CA Lic
or FNP
20
1case
in last
4 yrs.
Attachment 2
Contra Costa Regional Medical Center
Privileges Request Form
Practitioner: ________________________________
Department(s) Number Privilege Description
D=With Direct Supervision
C=With Consultation
U=Unrestricted D/C/U Training/ Education Experience Current Competence Requested Granted D =Denied P =Pending CNM =Criteria Not Met Ob/Gyn - CNM
Assist at C-Sections U CNM N/A N/A
` Attachment 3
Contra Costa Regional Medical Center
Privileges Request Form
Practitioner: ________________________________
Department(s) Number Privilege Description
D=With Direct Supervision
C=With Consultation
U=Unrestricted D/C/U Training/ Education Experience Current Competence Requested Granted D =Denied P =Pending CNM =Criteria Not Met Anesthesia
Pre-operative Histories and Physicals.
(for providers without inpatient, medicine,
surgery, or Ob/Gyn privileges, or general
outpatient privileges).
C
CA Lic
or
FNP
N/A N/A
U
CA Lic
or
FNP
N/A
1 yr in
last
4 yrs.
I certify that I have reviewed the Contra Costa Regional Medical Center Privilege Criteria, and that I meet the specified criteria
for education/training, experience, and current competence for the privilege, which I have indicated above.
________________________________________ _______________________
Signature of Requesting Practitioner Date
________________________________________ _______________________
Signature of Department Chairperson Date