HomeMy WebLinkAboutMINUTES - 01262010 - C.40RECOMMENDATION(S):
Approve the recommended changes to the specified medical privileges and the attached Medical Privileges Forms
which were approved by the Medical Executive Committee in December 2009, and as recommended by the Health
Services Director.
FISCAL IMPACT:
None.
BACKGROUND:
The Joint Commission on Accreditation of Healthcare Organizations requires Board of Supervisors approval criteria
that determine a practitioners’ ability to provide patient care, treatment, and service within the scope of the
privilege(s) requested.
These Medical Privileges Forms were reviewed by the Credentials Committee and approved by the Medical
Executive Committee. The new privileges will allow the following: (1) Anesthesiologists to do pre-operative History
and Physicals (H&Ps) (2) Certified Nurse Midwives to assist with Caesarian Sections and ante-partum fetal heart rate
monitoring third trimester ultrasounds; and (3) Obstetricians to do Dilation and Curretage for missed abortions (ie
Natural miscarriages).
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 01/26/2010 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYES 5 NOES ____
ABSENT ____ ABSTAIN ____
RECUSE ____
Contact: Steven Tremain, 370-5122
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 26, 2010
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc: Tasha Scott, Barbara Borbon, juana fon
C.40
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:January 26, 2010
Contra
Costa
County
Subject:Approval of Medical Privilege Forms
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