Late Career Practitioner Policy | Slides Nursing

This policy applies to:

 Stanford Hospital and Clinics

 Lucile Packard Children’s Hospital Stanford

Last Approval Date:

Aug 2017

Name of Policy:

SHC/LPCHS Late Career Practitioner Policy

Page 1 of 5

Departments Affected:

All Medical Staff

This document is intended for use by staff of Stanford Hospital & Clinics and/or Lucile Packard Children’s Hospital. No

representations or warranties are made for outside use. Not for outside reproduction or publication without permission.

I. PURPOSE

Clinical excellence is a complex composite of performance in many domains, including, among

others, cognitive ability, technical proficiency, communication skills, professional judgment,

productivity, and stamina. As individuals age, both the natural aging process and specific medical

conditions and medications have the potential to adversely affect the capacity of practitioners to

carry out their clinical responsibilities. Given this reality, it is imperative, from the point of view of

patient safety as well as physician well-being to establish a process by which late career clinicians’

performance and capacities can be fairly and accurately evaluated. The purpose of this policy is to

establish this evaluation process.

Key elements of this policy are to assure high quality care for the patient, to be supportive of the

practitioner and to address issues that the individual may not recognize.

The Medical Staff of Stanford Health Care (SHC) and Lucile Packard Children’s Hospital

Stanford (LPCHS) adopt this policy in order to:

• Provide patients with medical care of high quality and safety and protect them from harm

• Identify issues that may be pertinent to the health and clinical practice of medical staff

members

• Support members of the medical staff

• Apply evaluation criteria objectively, equitably, respectfully, and confidentially

II. SCOPE

This policy applies to all members of, and applicants to, the Medical Staff of Stanford

Health Care (SHC) and Lucile Packard Children’s Hospital Stanford (LPCHS) excluding

anyone in the Affiliate Category, Refer and Follow Category (LPCHS), and the

Administrative Category (SHC). This amendment is effective August 2017 and

supersedes any previous policy in this area.

III. POLICY

Any practitioner aged 74 ½ or older who applies for appointment to the Medical Staff

will complete, as a part of the application process, a peer clinical skills assessment and

health screening that address his/her capacity to competently perform the clinical

privileges requested. Physicians who are currently on the medical staff who are 75 or

older will be asked to complete these assessments every 2 years. In addition, the

SHC/LPCHS Credentials and Privileging Committee (“Credentials Committee”), may

request that any practitioner regardless of age complete this skills assessment and these

screenings.

The clinical skills assessment and health screening described in this policy must indicate

that the practitioner has no detected problem(s) that might interfere with the safe and

effective provision of care permitted with the clinical privileges requested (for applicants)

or currently in effect (for current members of the medical staff). Adverse findings that

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This policy applies to:

 Stanford Hospital and Clinics

 Lucile Packard Children’s Hospital Stanford

Last Approval Date: Aug 2017

Name of Policy: SHC/LPCHS Late Career Practitioner Policy

Departments Affected: Page^1 of^5

All Medical Staff

I. PURPOSE Clinical excellence is a complex composite of performance in many domains, including, among

others, cognitive ability, technical proficiency, communication skills, professional judgment, productivity, and stamina. As individuals age, both the natural aging process and specific medical

conditions and medications have the potential to adversely affect the capacity of practitioners to carry out their clinical responsibilities. Given this reality, it is imperative, from the point of view of

patient sa performance and capacities can be fairly and accurately evaluated. The purpose of this policy is tofety as well as physician well-being to establish a process by which late career clinicians’

establish this evaluation process.

Key elements of this policy practitioner and to address issues that the individual may not recognize. are to assure high quality care for the patient, to be supportive of the

The Medical Staff of Stanford Stanford (LPCHS) adopt this policy in order to: Health Care (SHC) and Lucile Packard Children’s Hospital

members

II. SCOPE This policy applies to all members of, and applicants to, the Medical Staff of Stanford

Health Care anyone in the (SHC) Affiliate Category, and Lucile Packard Children’s Hospital Stanford (LPCH Refer and Follow Category (LPCHS), and Sthe) excluding

Administrative Category supersedes any previous policy in this area. (SHC). This amendment is effective August 2017 and

III. POLICY Any practitioner aged 74 ½ or older who applies for appointment to the Medical Staff

will complete, as a part of the application process, a peer clinical skills assessment and health screening that address his/her capacity to competently perform the clinical

privileges requested. Physicians who ar older will be asked to complete these assessments every 2 years. In addition, thee currently on the medical staff who are 75 or

SHC request that any practitioner regardless of age/LPCHS Credentials and Privileging Committee (“Credentials Committee”), may complete this skills assessment and these

screenings.

The clinical skills assessment and that the practitioner has no detected problem health screening described in this policy must indicate(s) that might interfere with the safe and

effective provision o or currently in effect (for current members of the medical staff). Adverse findings thatf care permitted with the clinical privileges requested (for applicants)

This policy applies to:

 Stanford Hospital and Clinics

 Lucile Packard Children’s Hospital Stanford

Last Approval Date: Aug 2017

Name of Policy: SHC/LPCHS Late Career Practitioner Policy

Departments Affected: Page^2 of^5

All Medical Staff

indicate potential interference with the safe and effective provision of care with the clinical privileges requested (for applicants) or currently in effect (for current members of

the medical staff) will be assessed along with other pertinent factors by the applicable Service Chief and Credentials Committee in formulating their recommendations

re Committee [hereafter MEC] as provided in the SHCgarding appointment and clinical privileges to the applicable Medical Executive/LPCHS Medical Staff Bylaws. The

Service Chief/Credentials Committee has the right to request additional information for further evaluation, if necessary.

IV. PROCEDURE A. Components of the assessment: For any practitioner aged 74 ½ or older at the time of his/her

application for appointment or who is otherwise asked by the Credentials Committee to undergo evaluation (including the biennial assessment of current members of the medical

staff aged 75 or older), the Medical Staff Services Department will notify the practitioner of the assessment and screenings required by this policy. These are as follows:

1. A peer assessment of the applican members, trainees, advanced practice professionals, nurses and other hospitalt’s clinical performance by medical staff

staff The applicable Service Ch who are in a position to evaluate the applicant’s clinical performance.ief will identify the individuals to conduct the

assessment Services Department and forward them directly or designee. A modified version of the to the Director of Medical Clinical Staff

Excellence Core Competencies Evaluation will be used for this purpose (Appendix A). The Medical Staff Services Department will directly contact

each of the form. individuals selected to request that they complete the evaluation

A comprehensive history and physical examination, to be arranged and paid for by the practitioner using the forms provided in Appendix B. The practitioner being

evaluated must provide the name of the evaluating physician in advance. The Director of Medical Staff Services Department or designee in consultation with

the chair of the Cr H&P. edentials Committee will approve the provider performing the

B. Notification to the practitioner will include:

1. The required elements of the evaluation (Appendices A and B)

2. The request for the name of the physician of choice for the and the date when that name in addition to email address and phone number health screening

must be submitted to the Medical Staff Services Department

This policy applies to:

 Stanford Hospital and Clinics

 Lucile Packard Children’s Hospital Stanford

Last Approval Date: Aug 2017

Name of Policy: SHC/LPCHS Late Career Practitioner Policy

Departments Affected: Page^4 of^5

All Medical Staff

p of which would be determined by the MEC upon recommendation of itsroctoring of the practitioner’s clinical performance, the scope and duration

Credentials Committee, with input from the Service Chief. Specific findings that would identify potential concerns include low ratings (ratings less than

3) significant health issues that would interfere with the ability to practice on any Clinical Excellence Core Competencies Evaluation form or

medicine in the physician’s specialty. The complete evaluation/findings be maintained by the Medical Staff Services Department. will

a. If the Credentials Committee concludes that the practitioner is able to safely and competently perform the privileges requested, not

either after the initial evaluation or after undergoing fur evaluation as in C.3 or D.2 above, a representative of the committeether

and/or the Chief of Staff will discuss alternative practice patterns or modification of requested (SHC) or Medical Staff President (LPCHS)

privileges, including the possibility of re the practitioner. The goal of such discussion is to be supportive and vocation of privileges, with

respectful of the practitioner and to suggest resources to assist the practitioner.

b. If the committee recommends modification, restriction or revocation of clinical privileges to the MEC, and if that recommendation is

approved by the MEC, the practitioner may request a hearing under the Medical Staff Bylaws.

V. Throughout this process practitioner and assist in any resulting changes in practice patterns or transitions. This process is, the intent of each step is to protect patient safety, provide support, to the

also available to individual practitioners who, on their own, express concerns. Inquiries by such practitioners should be directed to the Chief of Staff (SHC) or Medical Staff President (LPCHS)

or designee.

VI. • APPENDICES Appendix A – Clinical Core Competencies Evaluation

This policy applies to:

 Stanford Hospital and Clinics

 Lucile Packard Children’s Hospital Stanford