The URL can be used to link to this page

Home My WebLink AboutMINUTES - 04092013 - C.36RECOMMENDATION(S): Approve new medical staff members, add and remove privileges, advancements to permanent staff, biennial re-appointments, biennial renewal of privileges, voluntary resignations and updated approval form, as recommended by the Medical Executive Committee at the February 25, 2013 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 of Supervisors approval for each medical staff member be placed in the medical staff member's Credentials file. The above recommendations for appointment/re-appointment were reviewed by the Credentials Committee and approved by the Medical Executive Committee. CONSEQUENCE OF NEGATIVE ACTION: If this action is not approved, Contra Costa Regional Medical and Contra Costa Health Centers' medical staff would not be appropriately credentialed and not be in compliance with the Joint Commission on Accreditation of Healthcare Organizations. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 04/09/2013 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor 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: April 9, 2013 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: T Scott, D Gary, Joanna Fon C. 36 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:April 9, 2013 Contra Costa County Subject:Medical Staff Appointments and Re-appointments – February 2013 CHILDREN'S IMPACT STATEMENT: Not applicable. ATTACHMENTS Attachment A Attachment #1 Attachment #2 Attachment #3 Page 1 of 2 Definitions: A=Active C=Courtesy Aff=Affiliate P/A=provisional Active P/C=Provisional Courtesy A. Primary Department Approval for Reappointment to Medical Staff and Renewal of Privileges – Attachment # 1 B. Emergency Medicine Department. Request to add CC6 – Attachment #2 Request to remove ANE 5 - Attachment #3 C. New Medical Staff Members Nicole Allaire, DO Department of Pediatrics Zahida Azam, MD Dept. of Psychiatry/Psychology Brea Bondi-Boyd, MD Dept. of Family Medicine Jennifer Liu, DDS, MD Dept. of Dentistry Joseph Mega, MD Dept. of Family Medicine Karen Peterson, MD Dept. of Psychiatry/Psychology D. New Affiliated Staff Members Rebecca Arcos, NP Dept. of Family Medicine Lorraine Romero, NP Family Medicine E. Advance to Non-Provisional Nusrat Chaudhry, MD Internal Medicine A Myhoang Nguyen, MD Family Medicine A F. Biennial Reappointments Brian Blaisch, MD Pediatrics C Peter Broderick, MD Family Medicine C Kenneth Brooks, MD Family Medicine A Charles Crane, MD Family Medicine C Gupta Etwaru, MD Surgery A Stuart Forman, MD Critical Care A Gwendolyn Hamilton, MD Pediatrics A David Huang, MD Psychiatry/Psychology P/C Anthony Jones, MD Internal Medicine A Rudy Leong, MD Family Medicine C Stuart Lovett, MD Ob/Gyn C Teresa Madrigal, MD Family Medicine A Thomas McDonald, MD Surgery A Rich McNabb, MD Family Medicine C Natasha Pinto, MD Family Medicine A Deborah Raphael, MD Psychiatry/Psychology A Malaika Scott, MD Family Medicine A Page 2 of 2 Zakaria Siddiqui, MD Psychiatry/Psychology C Lynette Stromberg, MD Internal Medicine A Tara Vijayan, MD Internal Medicine C Gila Wildfire, MD Family Medicine A Eve Yalom, MD Ob/Gyn C G. Biennial Renewal of Privileges Anthony Longoria, NP Family Medicine Aff Laura Miller, NP Family Medicine Aff H. Voluntary Resignations Gary Cecchi, MD Internal Medicine Louay Toma, MD Surgery Christopher Zamani, MD Family Medicine *************************************************************************** Contra Costa Regional Medical Center and Health Centers PRIMARY DEPARTMENT APPROVAL FOR REAPPOINTMENT TO MEDICAL STAFF AND RENEWAL OF PRIVILEGES PRACTITIONER’S NAME: PRIMARY DEPARTMENT: STAFF STATUS: PROVISIONAL ACTIVE COURTESY AFFILIATE Recommendation for renewal of attached privileges: Approve ________ Modify* ________ Deny* ________ *Please attach explanation of any modification or denial of privileges. I can personally attest that this practitioner has satisfactory medical/ clinical knowledge, technical and clinical skills, clinical judgment, interpersonal skills, communication skills, and professionalism. Yes ______ No ______ If “no”, I spoke with: on (date) who attests to satisfactory performance in the above areas. (If no one can attest to this, please comment.) Is this practitioner able to perform all the procedures for which he/she has requested privileges, with or without reasonable accommodation, according to accepted standards of professional performance and without posing a direct threat to patients? Yes ______ No ______ (If ‘No”, please comment.) I have reviewed this practitioner’s reappointment application, including the Medical Quality Assurance Assessment and/or Medical Quality Assurance Profile where applicable, and hereby recommend reappointment to the medical staff. I have approved privileges based on my evaluation of the practitioner’s current clinical competence. Comments: Division/Section Chair or Designee: Date: Department Chair: Date: Attachment #2 Contra Costa Regional Medical Center Privileges Request Form Practitioner: ________________________________________ *Separate proctoring required. EM 02/2013 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 Meet EMERGENCY MEDICINE MED ANE CC 6 Request to add CC6 to the Emergency Medicine list Adult central venous placement, monitoring, and management* D FP or IM or Sur or AN 5 N/A C FP or IM or Sur or AN 10 5 cases in the last 4 yrs U FP or IM or Sur or AN 20 5 cases in the last 2 yrs. 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 Meet EMERGENCY MEDICINE EME DEN OBG SGN ANE 5 Request to Delete ANE 5 from Emergency Medicine list Nitrous oxide. D CA lic. or DDS or DMD N/A N/A C CA lic. or DDS or DMD 5 N/A U CA lic. or DDS or DMD 10 2 cases or orientation class in last 2 yrs.