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

More documents

Recommendations

Info

Sutter Medical Center, Sacramento Department Of Diagnostic Imaging & Radiation Oncology - Delineation Of Privileges NAME: Request Privilege Appointment Requirements Proctoring Required [ ] Ultrasound guided thoracentesis [ ] Ultrasound guided Paracentesis [ ] CT guided thoracentesis [ ] CT guided Paracentesis [ ] CT, ultrasound or fluoroscopic guided placement to thoracostomy tube [ ] Ultrasound, CT or fluoroscopic guided drainage of abscess (lung, pancreatic, subdiaphragmatic, retroperitoneal, renal, perirenal and pelvic) [ ] Ultrasound, CT or fluoroscopic guided drainage of hepatic, renal or pancreatic cyst [ ] Ultrasound, fluoroscopic of CT guided sclerosis of hepatic, pancreatic or renal cyst [ ] Percutaneous drainage of pancreatic pseudocyst [ ] Percutaneous creation of pancreatic-gastric cyst Gastrostomy [ ] Transrectal or transvaginal drainage of pelvic abscess [ ] CT, ultrasound or fluoroscopic guided biopsy (thyroid, lung, liver, pancreatic, retroperitoneal, intraperitoneal, muscle, bone, lymphoid, breast and prostate) [ ] Transjugular liver biopsy [ ] Percutaneous placement of inferior cava filter [ ] Percutaneous retrieval of intravascular foreign body [ ] Vascular embolization for bleeding [ ] Vascular embolization for arterial venous malformation [ ] Vascular embolization for tumor [ ] Chemo embolization for tumor [ ] Visceral arterial infusion for ischemia [ ] Percutaneous fluoroscopic declotting of thrombosed arterial venous grafts or shunts created for dialysis using either balloon fogarty or non-balloon (thrombolytic) technique [ ] Percutaneous ethanol ablation of tumors [ ] Transluminal occlusion of ureter [ ] Ureteral angioplasty for strictures Reappointment Requirements Page 6 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. Number Performed
Sutter Medical Center, Sacramento Department Of Diagnostic Imaging & Radiation Oncology - Delineation Of Privileges NAME: Request Privilege Appointment Requirements Proctoring Required [ ] Percutaneous drainage of lymphocele [ ] Percutaneous celiac plexus blockade or ablation [ ] Percutaneous CT guided lumbar sympatholysis [ ] Percutaneous thrombectomy of pulmonary artery embolism [ ] Catheter directed intraarterial thrombolysis [ ] Catheter directed intravenous thrombolysis [ ] Peripheral Transluminal Angioplasty Peripheral angioplasty (PTA) is the percutaneous approach toArteriograph intervention by dilatation or atherectomy and may include stent placement. A diagnostic peripheral angiogram is any non-coronary or non-cerebral (intra/extra cranial) angiogram and is one that provides complete imaging of the entire vascular distribution and the runoff of the vessel(s) in question. (This privilege is shared with another department) (Continued on next page) Disciplines of Vascular Surgery, Radiology and Cardiology are eligible for credentialing. • Basic understanding of cardiovascular disease should be documented by eligibility or certification by any one of the following: • American Board of Radiology • American Board of Internal Medicine with special certification in Cardiovascular Medicine fellowship • American Board of Surgery with completion of a general vascular surgery one (1) year fellowship • Physicians seeking to qualify by having completed a training program shall have documentation of having performed 100 peripheral angiograms, 50 peripheral interventional procedures (counted per lesion) within the past three years and shall have a letter from the Chief of his/her training program stating that the applicant is competent to perform peripheral vascular interventions as a primary operator. – OR – Documentation of having performed 100 peripheral angiograms, 50 peripheral angioplasties within the past three years at another Joint Commission accredited hospital and documentation of attendance at a dedicated symposium on PTA, which has live case demonstrations, shall be documented. – OR – Documentation of successful completion of an approved in-house learning program under the First Five (5) Interventional procedures Reappointment Requirements Minimum of 50 therapeutic interventions (counted per patient) in a twoyear period Should an applicant not attain the suggested number of procedures proctoring may be initiated as determined by the Department Q.I./Administrative Committee. Page 7 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. Number Performed
Page 1 and 2: Sutter Medical Center, Sacramento D
Page 5: Sutter Medical Center, Sacramento D
Page 17: Sutter Medical Center, Sacramento D

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

Create successful ePaper yourself

Delete template?

Save as template?