HomeMy WebLinkAboutMINUTES - 05052015 - C.22RECOMMENDATION(S):
Approve medical staff appointments and reappointments, privileges, advancements and voluntary resignations as
recommend by the Medical Staff Executive Committee at their April 20 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 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.
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.
CHILDREN'S IMPACT STATEMENT:
Not applicable.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 05/05/2015 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
ABSENT: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: May 5, 2015
David Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc: T Scott, C Rucker
C. 22
To:Board of Supervisors
From:William Walker, M.D., Health Services Director
Date:May 5, 2015
Contra
Costa
County
Subject:Medical Staff Appointments and Reappointments – April 2015
ATTACHMENTS
Attachment
Midwife
Attachment
MEC Recommendations – April 2015 Definitions: A=Active
C=Courtesy Aff=Affliate P/A= Provisional Active P/C= Provisional Courtesy Page 1
A. New Medical Staff Members
Linda Copeland, MD Pediatrics
Lilia de Jesus, MD Pediatrics
Kenneth Etefia, MD Psychiatry/Psychology
Aram Millstein, MD Pathology
Zulfikar Rasool Vali, MD Psychiatry/Psychology
Joahn Roar, MD Internal Medicine
Sunpreet Singh, MD Psychiatry/Psychology
Ashely Tyrrel, MD Pediatrics
Rachel Winer, MD Psychiatry/Psychology
B. New Teleradiologist Staff Members
Mailan Cao, MD Diagnostic Imaging
William Whetsell, MD Diagnostic Imaging
C. Request for Additional Privileges
Nicole Brito, NP Family Medicine
Patricia Hill, FNP Family Medicine
Sandra Murguia, NP Family Medicine
Lauren Pak, NP Family Medicine
Anthony Pizzo, FNP Family Medicine
D. Advance to Non-Provisional
Andrea Durant, MD Emergency Medicine A
Jessica Hamilton, MD Emergency Medicine A
Frederick Houts, MD Psychiatry/Psychology C
Harvey Olsen, MD Internal Medicine A
Kiran Narsinh, MD Internal Medicine A
Rawel Randhawa, MD Internal Medicine A
Leah Schweid Romito,MD Family Medicine A
Erin Stratta, MD Family Medicine A
Danny Wu, MD Internal Medicine C
Monte Wu, MD Internal Medicine A
E. Biennial Reappointments
Francis Barham, MD Psychiatry/Psychology C
Ramon Berguer, MD Surgery A
Amy Buoncrisiani, MD Emergency Medicine A
Nusrat Chaudhry, MD Internal Medicine A
Andrea Durant, MD Emergency Medicine P
Julie Freedman, MD Internal Medicine A
Asha Gandhi, MD Psychiatry/Psychology C
Richard Kops, MD Internal Medicine C
Susan Kulovsky, DO Psychiatry/Psychology A
Joseph Macedo, MD OB/GYN A
David MacDonald, MD Surgery A
Harvey Olsen, MD Internal Medicine P
MEC Recommendations – April 2015 Definitions: A=Active
C=Courtesy Aff=Affliate P/A= Provisional Active P/C= Provisional Courtesy Page 2
Rawal Randhawa, MD Internal Medicine C
Shaista Rauf, MD Internal Medicine A
Patrice Ringo, MD Emergency Medicine A
Mary Beth Ruiz, PhD Psychiatry/Psychology A
Will Sheldon, MD Family Medicine A
Temre Uzuncan, PsyD Psychiatry/Psychology A
Stephen Weiss, MD Surgery A
F. Biennial Renewal of Privileges
Adam Danko, NP Psychiatry/Psychology
Brandy Danison, NP Family Medicine
Barbara Griesau, NP Family Medicine
Laura Keels, NP Family Medicine
Leigh Pierson-Brown, NP Family Medicine - FNP
G. Teleradiology Renewal of Privileges
Michelle Goni Diagnostic Imaging C
H. Voluntary Resignations
Peter Broderick, MD Family Medicine
Pascale Coucy, NP OB/GYN
John Hadley, MD Internal Medicine
Varujan Keledjian, MD Internal Medicine
T Rich McNabb, MD Family Medicine
Jasdeepa Nagi, MD Internal Medicine
Robert Pollard, MD Emergency Medicine
Shahid Rehman, MD Internal Medicine
I. Approval of Midwifery privileges
See attached
Contra Costa Regional Medical Center
Privileges Request Form
C CNM, CPM,
LM N/A N/A
U CNM, CPM,
LM 30 10 cases in last 4
years
C
CNM, CPM,
LM, and "U"
MID 1
N/A N/A
U CNM and "U"
MID 1 30 10 cases in last 4
years
C CNM or CPM N/A N/A
U CNM or CPM 30 1 year in last 4
years
C CNM or CPM N/A N/A
U CNM or CPM 30 1 year in last 4
years
D
CNM
Recommend
NRP
certification
N/A N/A
U
CNM
Recommend
NRP
certification
100
8 cases in last 2
years & CME in
fetal monitoring
within last 2 years
or written test Departments (s) NumberPrivilege Descriptions D/C/U ExperienceOutpatient management of high
risk prenatal patients
MID
1
MID
2
Women's Health Care Maintenance
Health care maintenance of women
including pre-op histories, physical
exams and contraception, vaginitis,
and STD's (for FNPs or CNM, CPM,
without adult medicine)
General Women's Health Care
Women's health problems usually
cared for by a generalist such as,
irregular bleeding, evaluation of
pelvic pain, GU, and breast problems
(for FNPs or CNM, CPM, without
adult medicines)
MID
3 Current Competence RequestedName and Date of CME course which included Fetal Monitoring:
__________________________________________
***If you have not completed a course in the last 2 years, please contacr the Medical Staff Office for a written exam.
Practitioner Name: _______________________
MID
5
Antepartum, intrapartum and
postpartum management of
pregnancy with minor
complications (such as mild pre-
eclampsia, prior cesarean section)
and uncomplicated vaginal delivery
including amniotomy, episiotomy,
second degree laceration repair and
manual removal of placenta*
MID
4
Midwifery GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ EducationOutpatient management of low
risk prenatalpatients
D= With Direct Supervision
C= With Consultation
U= Unrestricted
* Separate proctoring required
AFF MID Updated JAN 2015 Page 1 of 5
Contra Costa Regional Medical Center
Privileges Request Form
Departments (s) NumberPrivilege Descriptions D/C/U Experience Current Competence Requested Practitioner Name: _______________________
Midwifery GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ Education
D= With Direct Supervision
C= With Consultation
U= Unrestricted
D CNM N/A N/A
U CNM 30 8 cases in last 4
years
D CNM, CPM,
LM N/A N/A
U CNM, CPM,
LM 10 4 cases in last 2
years
C CNM N/A N/A
U CNM 10 1 case in last 2
years
MID
9 U
CNM &
Company
Training
N/A N/A
D CNM, CPM,
LM N/A N/A
U CNM, CPM,
LM 5 N/A
D CNM N/A N/A
U CNM 5 N/A
MID
7
Basic 3rd trimester Obstetrical
ultrasound including viability,
placenta location, fetal number,
and amniotic fluid index*
Nexplanon insertion and removal
MID
10 IUD insertion and removal
MID
11 Suction Endometrial Biopsy
MID
6
Antepartum fetal heart rate
monitoring
MID
8
Induction of augmentation of
labor
* Separate proctoring required
AFF MID Updated JAN 2015 Page 2 of 5
Contra Costa Regional Medical Center
Privileges Request Form
Departments (s) NumberPrivilege Descriptions D/C/U Experience Current Competence Requested Practitioner Name: _______________________
Midwifery GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ Education
D= With Direct Supervision
C= With Consultation
U= Unrestricted
D CNM N/A N/A
U CNM
50 cases
or 30
cases
with
formal
course
5 cases in last 2
years
D CNM N/A N/A
C CNM 10 N/A
U CNM 20 1 case in last 4
years
D CNM N/A N/A
C CNM 10 N/A
U CNM & "U"
MID 13 20 8 casesin last 2
years
C CNM N/A N/A
U CNM 50 20 cases in last
2 years
MID
15
MID
14 Abortion during 1st trimester
Caring for and discharging
uncomplicated post partum
patients (for providers without
delivery privileges)
MID
13
Diagnostic D&C incomplete or
missed abortion*
MID
12
Colposcopy, Cervical Biopsy and
Endocervical Curettage
* Separate proctoring required
AFF MID Updated JAN 2015 Page 3 of 5
Contra Costa Regional Medical Center
Privileges Request Form
Departments (s) NumberPrivilege Descriptions D/C/U Experience Current Competence Requested Practitioner Name: _______________________
Midwifery GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ Education
D= With Direct Supervision
C= With Consultation
U= Unrestricted
D CNM, CPM,
LM N/A N/A
U
CNM, CPM,
LM 4hrs
training in
residency or
ultrasound
course
15 10 cases in last
2 years
MID
17 U CNM N/A N/A
C CNM N/A N/A
U CNM 20 3 cases in last 2
years
D CNM N/A N/A
U CNM 10 N/A
D CNM N/A N/A
U CNM 20 N/A
MID
21 U
CA State
Furnishing
License
N/A N/A
MID
18
Inpatient uncomplicated newborn
care (e.g. normal term newborn
and those with indirect billirubin
<15)
MID
16
Basic 1st and 2nd trimester
ultrasound for dating, viability,
and location of pregnancy
Bedside testing in the OB/GYN
(POCT): KOH & Saline Prep,
Vaginal pH, Fern Test &
Amniotest, Pregnancy Test &
Urine Dipstick
MID
19
Basic diagnosisof general
women's' health issues:
Furnishing According to Protocol
Assist at surgical deliveries including
cesarean sections, vacuum-assit
delivery, forceps, etc.
MID
20 Breast biopsy, vulvar biopsy, fine
needle biopsy, core needle biopsy,
simple incision and drainage
* Separate proctoring required
AFF MID Updated JAN 2015 Page 4 of 5
Contra Costa Regional Medical Center
Privileges Request Form
Departments (s) NumberPrivilege Descriptions D/C/U Experience Current Competence Requested Practitioner Name: _______________________
Midwifery GrantedD= Denied P= Pending CNM=Criteria Not Met Training/ Education
D= With Direct Supervision
C= With Consultation
U= Unrestricted
D CNM N/A N/A
C CNM 30 6 mos in last 2
years
MID
22
Inpatient Histories and Physicals
for women and infants less than
29 days old
_________________
Emperical treatment of male and
female partners of patients with or
exposed to STIs.
Partner treatment of STIs N/A
30
Procedures: if the privilege is granted “with consultation,” it means that the procedure needs to be discussed¬ with a provider who has that
particular unrestricted privilege(s) prior to performing the procedure. A procedure log may be kept by the Midwife to document the
procedures performed.
Date
____________________________________________________
Signature of Department Chairperson Date
Outpatient: if the privilege is granted “with consultation,” it means that the Midwife needs to discuss each patient with a provider who has
unrestricted privileges in the area of consultation. It is at the discretion of that provider to determine what the level of detail this discussion
needs to be.
Inpatient Rounding: : if the privilege is granted “with consultation,” it means that the Midwife needs to discuss the patient’s care with an
attending staff physician. It is at the attending staff physician’s discretion to determine what the level of detail this discussion needs to be.
This is to clarify what is meant by "with consultation"
Signature of Requesting Practitioner
MID
23
C
U
CNM
CNM
N/A
10 cases in last 4
years
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 privileges that I have indicated above
___________________________________
* Separate proctoring required
AFF MID Updated JAN 2015 Page 5 of 5