New Privilege List - DI / Radiation Oncology - Sutter Medical Center

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Sutter Medical Center, Sacramento Department Of Diagnostic Imaging & Radiation Oncology - Delineation Of Privileges NAME: Request Privilege Appointment Requirements Proctoring Required [ ] Endovascular Repair of Aortic Aneurysms Prerequisite: 1. Must currently hold all Interventional Radiology privileges (to include peripheral arteriography, angioplasty, intravascular stenting, and intravascular embolization). 2. Participation with physicians who are privileged to perform open repair of aortic aneurysms. 3. Intensive care admitting privileges Training/Documentation Requirement: 1. Completion of an interventional radiology fellowship program where endovascular aortic aneurysm repair was an integral part of the training. This training must have occurred within the previous two years. Verification of this training in the form of a letter from the fellowship director is required. - OR - 2. Documentation of prior experience in a Joint Commission accredited hospital in endovascular aortic aneurysm repair. This experience must have occurred within the previous two years. Documentation must include a letter from the Chief of the Department or Chief of Staff documenting experience in at least ten (10) cases. - OR - 1. Successful completion of an approved in-house teaching program at Sutter Medical Center. -AND- Compliance with FDA guidelines for deployment of stent-graft devices in use. First two (2) cases. Reappointment Requirements Minimum of ten (10) cases from a JC accredited hospital. ALSO Continuing education should be in accordance with the American College of Radiology Practice Guidelines for Continuing Medical Education (150 hours of CME every 3 years, 70% in specialtyspecific or related areas to include a minimum of 10 hours of category I CME specific to aortic pathology and endovascular repair). Number Performed Page 10 of 17 Note: Approval is subject to the terms of the hospital's exclusive contract for Radiology services, i.e., approval is for second opinion consultations only, it being understood that the hospital's contracting Radiologists are primarily responsible for these services.
Sutter Medical Center, Sacramento Department Of Diagnostic Imaging & Radiation Oncology - Delineation Of Privileges NAME: Request Privilege Appointment Requirements Proctoring Required III. DIAGNOSTIC NEURORADIOLOGY [ ] Core Diagnostic Neuroradiology Core Diagnostic Neuroradiology includes performance of diagnostic and image-guided diagnostic and therapeutic procedures related to the nervous system and head and neck. For example (not all inclusive): CT, MRI, myelography, spine injections, vertebroplasty, spine and maxillofacial biopsy. (Note: See separate multi-departmental privilege criteria for cerebral angiography.) [ ] Diagnostic Cerebral Angiography, Including WADA Test (This privilege is shared with another department) 1. Current certification by the American Board of Radiology; AND, 2. Completion of a neuroradiology fellowship and/or Certificate of Added Qualifications (CAQ) in Neuroradiology by the American Board of Radiology AND 3. Fifty (50) diagnostic neuroradiology cases in the previous two years as demonstrated by a letter from the Director of the training program or Department Chief. 1. Documentation of a formal training program in which diagnostic cerebral angiography was part of the training program. Documentation must be provided by the Director of the training program - OR- 2. Post Residency or Fellowship Training documentation of prior experience at another Joint Commission accredited hospital within the past three (3) years. Documentation must be provided by the Department Chief at the other hospital. - OR – 3. Successful completion of an approved in-house learning and teaching program. Documentation must be provided by the Preceptor at the end of the in-house training program. AND (Meet one of the following) 1. Interventional Radiologists who hold Peripheral Transluminal Angioplasty privileges are required to provide evidence of training/experience in a minimum of 50 cerebral angiographies. 2. Neuroradiologists with fellowship training in Neuroradiology or admissible for subspecialty Certificate of Added Qualification in Neuroradiology by the ABR or evidence of continuous practice in the field in the previous two years. First six (6) cases. Current senior staff members who qualify under these criteria and have been performing these procedures will be grandfathered in and proctoring will not be required. The first Six (6) cerebral angiography procedures. Proctoring will be performed by another Senior Staff physician who holds cerebral angiography privileges. Reappointment Requirements Twelve 12 different catheterizations in previous two years. Volume requirements can include cases the physician performed at other facilities and are not exclusive to SMCS patients. Twelve (12) cerebral angiography procedures. Should the applicant not attain the suggested number of procedures proctoring may be initiated as determined by the Department Q.I./Administrative Committee. Number Performed Page 11 of 17 Note: Approval is subject to the terms of the hospital's exclusive contract for Radiology services, i.e., approval is for second opinion consultations only, it being understood that the hospital's contracting Radiologists are primarily responsible for these services.
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New Privilege List - DI / Radiation Oncology - Sutter Medical Center

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