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Peer Review Policy and Procedure/Hendricks...

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Peer Review Policy and Procedure/Hendricks...

Medical Staff Peer Review Policy. Subject: Peer Review Activity. Policy: Review of circumstances as outlined in this policy will be conducted by a peer physician(s ...

http://www.hendricks.org/upload/docs/MedStaff/PeerReview.doc

Date added: August 21, 2016 - Views: 3

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Sample Format for Peer Review Letter - Penn State...

Sample Format for Peer Review Letter Author: Berks - Lehigh Valley College Last modified by: Berks-Lehigh Valley College Created Date: 9/17/2007 1:02:00 AM Company:

http://www.bk.psu.edu/Documents/SampleFormatforPeerReviewLetterFinalDraft_v01.doc

Date added: August 20, 2016 - Views: 1

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Peer Reference Letter - Kathy Matzka

Medical Staff Coordinator Sample Peer Recommendation Form. CONFIDENTIAL Professional Peer Reference & Competency Validation. Page 1 of 2. Name of Applicant: ...

http://www.kathymatzka.com/Downloads/Peer_Reference_Letter.doc

Date added: August 18, 2016 - Views: 2

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THE JOURNAL OF THE AMERICAN BOARD OF FAMILY...

Peer Review Volunteer Form . Journal of the American Board of Family Medicine. Name, Academic Degrees: Email (preferred, then alternate, if any): Phone:

http://www.jabfm.org/site/misc/PeerReviewForm.doc

Date added: August 27, 2016 - Views: 1

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FACULTY PEER REVIEW FORM - uscupstate.edu

Faculty Peer Review Form April 2000. Title: FACULTY PEER REVIEW FORM Author: Academic Affairs Last modified by: Network Services Created Date: 4/9/2003 6:52:00 PM

https://www.uscupstate.edu/uploadedFiles/Faculty_and_Staff/Faculty_Governance/library_review.doc

Date added: August 27, 2016 - Views: 1

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Physician Peer Review in a Just Culture -...

Disruptive Physician Policy. Physician Peer Review. It is important to realize that Physician Peer Review does not replace the managerial responsibilities of the HCO.

http://www.mha-apps.com/media/maps/Physician%20Peer%20Review%20in%20a%20Just%20Culture.doc

Date added: August 20, 2016 - Views: 1

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North County Health Services - ATSU

NORTH COUNTY HEALTH SERVICES. Physician/Mid-Level Provider Peer Review Audit Form. Center: Chart#: Provider: Date of Index Visit: Date of Audit:

https://www.atsu.edu/wcn/provider%20peer%20review/nchs_peer_audit_tool.doc

Date added: August 23, 2016 - Views: 1

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Sample Peer Review Questions - Amazon Web Services

Sample Peer Review Questions. by Ann Bomberger. ... Fill out a form for each paper you read. 3. Read the entire peer review sheet before doing anything else. 4.

http://sitesmedia.s3.amazonaws.com/facultyresources/files/2012/10/Sample-Peer-Review-Questions-2.doc

Date added: August 18, 2016 - Views: 3

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Peer Review for Group Presentation

Peer Review for Group Presentation. Your name: _____ Your. Team: _____ F. ormat for scoring group members

http://wweb.uta.edu/management/Dr.Quick/courses/3318/Quick%20Presentation%20Rubric%20Peer.docx

Date added: August 18, 2016 - Views: 1

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Physician Performance Evaluation - ww2.nasbhc.org

Physician Under Review: Date of Review: / / Section 1 ... Physician Date. Form originally supplied by PhysiciansPractice.com. Title: Physician Performance Evaluation

http://ww2.nasbhc.org/RoadMap/HumanResources/Physician%20Review%20Form.doc

Date added: August 18, 2016 - Views: 1

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QA/I QUARTERLY PEER REVIEW WORKSHEETS - Ohio

QA/I QUARTERLY PEER REVIEW WORKSHEETS Author: Humenay Last modified by: Dietz Created Date: 7/19/2011 3:30:00 PM Company: ODADAS Other titles:

http://mha.ohio.gov/Portals/0/assets/Regulation/LicensureAndCertification/approvedForms/2012%20Peer%20Records%20Review%20Worksheet.doc

Date added: August 20, 2016 - Views: 1

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Peer Review letters - Oregon State University

BASICS. In general, students find peer letters extremely helpful to the development of their essays. In order for the peer review process to work it’s best, it is ...

http://people.oregonstate.edu/~petersp/ORST/WR121_files/Course%20Resources%20Documents/Guidelines%20for%20writing%20Peer%20Review%20letters,%20Kathryne%20TafollaYoung.doc

Date added: August 20, 2016 - Views: 1

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The Orthopedic Surgery Center of Orange County

PEER REVIEW surgeon. 9/21/2010. Source: Alan Beyer, Orthopedic Surgery Center of Orange County. Adapted and reprinted with permission. Title:

http://www.beckersasc.com/docs/accreditation/Surgeon%20medical%20chart%20peer%20review.doc

Date added: August 27, 2016 - Views: 1

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www.med.umich.edu

The manager will review the peer review form, peer summary and self-evaluation and then complete the manager section of the evaluation form.

http://www.med.umich.edu/umhshr/doc/RN_LEVEL_A_PERF_EVAL_FORM.doc

Date added: August 18, 2016 - Views: 2

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Should we include something about the Board...

Cardiac Electrophysiology Facility. Peer Review Quality Improvement (QI) Form. Reviewing Physician (Initials): Date of Completion: PHYSICIAN REVIEW Criteria Procedure ...

http://www.intersocietal.org/ep/forms/cardiac_electrophysiology_peer_review_qi_form.doc

Date added: August 27, 2016 - Views: 1

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Trauma Center Performance Improvement and Patient...

Trauma Center Performance Improvement and ... systematic and objective data analysis and multidisciplinary peer review to ... Trauma Director/Other Physician Review:

http://www.healthy.arkansas.gov/programsServices/injuryPreventionControl/TraumaticSystems/Documents/trauma/Resources/StateTraumaPerformanceImprovementSafetyPlan.doc

Date added: August 18, 2016 - Views: 3

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INSTRUCTIONS - Texas Medical Board

Instructions. The 82nd Legislature ... and enforce policies to ensure that a physician employed by the health organization exercises independent medical judgment when ...

http://www.tmb.state.tx.us/idl/144984FD-5240-FF53-A360-19AA44C5AD0A

Date added: August 18, 2016 - Views: 1

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shp.utmb.edu

Record of Peer Review and Faculty Response. ... describing what the faculty member has learned from the peer observation process and any plans for improvement of ...

https://shp.utmb.edu/Dean/FacultyHandbook/PeerObservation/Current/SHP-Peer-Observation-Report-Form.docx

Date added: September 21, 2016 - Views: 1

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NEW PHYSICIAN - c.ymcdn.com

Physician Preceptor . Checklist ... Inform Medical Staff/Peer Review Coordinator and Director of Managed Care that new physician has signed contract for ...

http://c.ymcdn.com/sites/www.aspr.org/resource/resmgr/imported/Form-New%20Physician%20Orientation%20Checklist.doc

Date added: August 18, 2016 - Views: 2

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Drug Regimen Review Request Form

... Review, Peer to Peer Outreach provides a telephonic meeting with the treating prescriber(s) by a specialist physician to review therapy ... Review Request Form

http://painmanagement.pmsionline.com/Documents/MedAssess_Care_Management_Services%20Request_Form_8-24-2012_(Locked).docx

Date added: August 27, 2016 - Views: 2

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Physician Performance Evaluation

Physician Under Review: Date of Review: / / Section 1 ... Physician Date. Form originally supplied by PhysiciansPractice.com. Title: Physician Performance Evaluation

http://imaging.ubmmedica.com/all/p2files/tools/phyeval.doc

Date added: August 27, 2016 - Views: 2

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Chart Review Template - NYU Langone Medical Center

The protocol must be reviewed and approved by the NYU Cancer Institute Protocol Review and Monitoring Committee (PRMC) and NYU Institutional Review Board ...

http://webdoc.nyumc.org/nyumc/files/ci/assets/PRMC-Non-Interventional-Protocol-Template.doc

Date added: August 21, 2016 - Views: 1

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FLORIDA - flatherapy.com

Physician Peer Review Form Date: _____ Revised 11/09/12. Page 1 of 1. FLORIDA. Therapy Services, Inc. Title: FLORIDA Author: Jennifer Last modified by: Anita Meeks

http://www.flatherapy.com/therapy/wp-content/uploads/2010/05/Physician-Peer-Review-Form-11-12.doc

Date added: September 21, 2016 - Views: 1

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COMMUNITY HEALTH CARE, INC - Aspirus Medical Staff

Peer Review: The term “peer ... (e.g., physician, ... documentation will include the elements described in 8.2 accompanied by a final copy of an Initial Review form ...

http://www.aspirusmedicalstaff.org/media/MedicalStaffPeerReviewProcess2011.doc

Date added: August 27, 2016 - Views: 1

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Model SOP - Quality Assurance/Quality Improvement...

Quality Assurance/Quality Improvement Program Procedures. ... peer review, indicators, ... Review results will be recorded on the appropriate QA/QI review form ...

https://phc.amedd.army.mil/PHC%20Resource%20Library/PHC_Model_SOP_QA-QI%20_Final.docx

Date added: August 18, 2016 - Views: 2

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Chart Review Template - Oregon Health & Science...

Chart Review Protocol Template Instructions. The protocol template is a tool to facilitate protocol development. It is not intended to supersede the role of the ...

http://www.ohsu.edu/xd/health/services/cancer/research-training/shared-resources/upload/Chart-Review-Template.doc

Date added: August 20, 2016 - Views: 2

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Provider Competency Evaluation and Documentation

Documenting Provider Competency for Low-and No-Volume ... Credentialing & Peer Review Legal ... Recommendation and Approval Form for Medical Staff Appointment and ...

http://www.namss.org/LinkClick.aspx?fileticket=__HnYATX7C4%3d&tabid=237&portalid=0&mid=917

Date added: August 19, 2016 - Views: 1

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PEER REVIEWER IDENTIFICATION SURVEY - TOA

The form . MUST. be completed by the physician as there are questions that only the ... Peer Reviewer Name: ... Did the Peer Review explain rationale for denying or ...

http://www.toa.org/ecard/2006/09-2006/5th/Forms/PEER%20REVIEWER%20ID%20Survey-printout-form.doc

Date added: August 27, 2016 - Views: 1

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HOSPITAL CHART REVIEW FORM - National POLST

I want tube feedings only as my physician recommends. ... HOSPITAL CHART REVIEW FORM: page 1. Created on 12/14/2012 . Title: HOSPITAL CHART REVIEW FORM Author: hickmans

http://www.polst.org/wp-content/uploads/2013/02/Instrument-V-WI-Hospital-Chart-Review-Form.doc

Date added: August 21, 2016 - Views: 1

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physiciansmedicalreview.com

REFERRAL FORM. www.pmrfa.com Service Requested Rush Service ... Physician Peer Review Pharmacological Review Lien Verification CMS Submission Case Type

http://physiciansmedicalreview.com/pdfs/pmr_referral_form.doc

Date added: August 27, 2016 - Views: 1

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UMHS Performance Expecation

UMHHC Performance Expectations For All Employees For behavioral descriptions of performance ratings go to (form must be ... plans for the purposes of peer review, ...

http://www.med.umich.edu/umhshr/doc/NP_Perf_Eval_Form_2009.doc

Date added: August 18, 2016 - Views: 3

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SANTA CLARA COUNTY

medical examiner-coroner office. performance appraisal (appendix a) _____autopsy report physician peer review_____ physician of record _____

https://www.sccgov.org/sites/led/appraisal/Documents/Medical-Examiner_Coroner-Office-(UAPD)-Peer-Review-Attachment-A.doc

Date added: September 21, 2016 - Views: 1

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New Physicians Application Form - IDPH

Health Care Professional Credentialing and Business Data Gathering Form. The Health Care ... review or an adverse decision ... physician/health care provider who ...

http://www.idph.state.il.us/about/IDPH_credentialing_form_97_pro.doc

Date added: August 18, 2016 - Views: 3

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Annual Review for Michael Watson Rural Health...

Annual Review for Michael Watson Rural Health Clinic Author: Alice Makela Last modified by: Marsha Marze Created Date: 10/15/2009 4:58:00 PM Company:

http://adph.org/ruralhealth/assets/AnnualEvaluationFacility.doc

Date added: August 18, 2016 - Views: 1

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ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK

EXTERNAL PEER REVIEW NETWORK. PHYSICIAN REPORT FORM - RADIOLOGY CONFIDENTIAL. Part I – to be completed by the requesting hospital and ICAHN office and sent to the ...

http://www.icahn.org/files/EPRN_Library/radiologist_eprn_report_form.doc

Date added: September 21, 2016 - Views: 1

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St

St. Joseph’s / Candler Health System. The Care Network. Medical Staff Policy. Title: Peer Review Process. Section: Medical Staff Services. Policy Number:

http://www.sjchs.org/media/file/Peer%20review%20policy%20Final%2008%2007.doc

Date added: September 21, 2016 - Views: 1

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ED PHYSICIAN PEER EVALUATION - Jay A. Kaplan

ED PHYSICIAN PEER EVALUATION. Date ... Review of this physician’s charts when performing follow ... Please comment on the back of this form any concerns or problems ...

http://www.jaykaplanmd.com/tools-files/ed_physician_peer_evaluation_kaplan.doc

Date added: September 7, 2016 - Views: 1

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Policy and Procedure Approval Form - HCA...

It is inappropriate for Coders to ask multiple questions on one physician query form ... CMS memorandum to the Peer Review ... Policy and Procedure Approval Form ...

http://ec.hcahealthcare.com/CPM/REGSDOC002.doc

Date added: August 18, 2016 - Views: 3

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MEDICAL RECORD REVIEW WORKSHEET - KDHE

Medical Record Review Worksheet-Con’t. OBSTETRICS/NEWBORN RECORDS: (Pick Mom with her newborn if possible) ... Patient’s name Physician A257) H & P ...

http://www.kdheks.gov/bhfr/download/HOSPITAL_3_Medical_Record_Review_Worksheet.doc

Date added: August 21, 2016 - Views: 1

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Policy and Procedure Approval Form - HCA...

CMS memorandum to the Peer Review ... CMS memorandum to the Peer Review Organizations entitled “Use of Physician Query Form ... Policy and Procedure Approval Form ...

http://ec.hcahealthcare.com/CPM/REGSCOD012%20Rev%2012-1-2007.doc

Date added: August 22, 2016 - Views: 1

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360-DEGREE EVALUATION FORM - umm.edu

PEER-ASSESSMENT. For Use by Resident ... This profile provides a more balanced overview than self-evaluation or peer/supervisor review. ... 360-DEGREE EVALUATION FORM ...

http://umm.edu/~/media/UMM/Office%20Docs/for%20health%20professionals/graduate%20medical%20education/360_peer.ashx

Date added: August 23, 2016 - Views: 2

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Confidential For Peer Review Purposes Only - GCRAC

form:_____ MR Number ... **ALL “YES” RESULTS ARE FALLOUTS AND REQUIRE REVIEW. Physician reviewer ... Confidential For Peer Review Purposes Only ...

http://www.gcrac.org/wp-content/uploads/2009/05/stroke_pi_indicators_12-09.doc

Date added: September 21, 2016 - Views: 1

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www.icahn.org

Peer Review Case Rating Form. MR#_____ D/C Date: _____ Referral Date:_ _____ Provider #:_____ _____ Referral Source: ... (CONTINUE PHYSICIAN REVIEW ON NEXT PAGE)

http://www.icahn.org/files/Policy_Bank/Attachment_D__Peer_Review_Case_Rating_Form.docx

Date added: September 7, 2016 - Views: 1

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PROJECT GOALS - ICAHN

Reviewing practitioners must complete the Peer Review Form, ... that would ordinarily require detailed review by a physician peer(s) ... PROJECT GOALS Author: CHS ...

http://www.icahn.org/files/Quality/Quality_Resources/Tab_1_Toolkit.doc

Date added: August 18, 2016 - Views: 2

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Chart Review Protocol Template - IRB

Appendix A: Data Collection Form (This form should list the data elements that will be collected from the medical record. ... Chart Review Protocol Template ...

http://irb.northwestern.edu/sites/irb/files/templates/chart-review-protocol-1336679827.doc

Date added: August 18, 2016 - Views: 5

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RSO PEER REVIEW RECORD - public.navy.mil

Physician Supervisor SignatureIDC Signature ... Created Date: 01/31/2016 17:16:00 Title: RSO PEER REVIEW RECORD Last modified by: HMCS Borjon, Reymundo Jr USN ...

http://www.public.navy.mil/surfor/cds-15/Documents/ID_%20MONTHLY_QA_Form.docx

Date added: September 21, 2016 - Views: 1

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HOSPITAL PERFORMANCE IMPROVEMENT - Deaconess...

Trauma cases are screened for physician review by the Trauma Program ... In addition, a physician trauma peer review committee ... Performance improvement ...

http://www.deaconess.com/getattachment/ed8abc3c-cc26-4c01-a819-8e38e8d3c88e/Trauma-PI-Plan.aspx

Date added: August 19, 2016 - Views: 1

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Trauma Case Review - MTPIN

Trauma Case Review. ... Physician / Surgeon Time: ... Refer to Multidisciplinary Trauma Committee or Medical Staff Peer Review Process)

http://www.mtpin.org/docs/Peer%20Review%201%20Trauma%20Case%20Review%20Form.doc

Date added: August 20, 2016 - Views: 1

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POLICY: Operative & Invasive Procedures...

The reviews shall be conducted as part of the peer review and quality ... The initial review is completed by a non-physician, ... External Cardiovascular Review Form

https://www.tenethealth.com/docs/default-source/policies/policies---mn/policy---co-5-006_policy_operative_and_invasive.doc?sfvrsn=6

Date added: September 19, 2016 - Views: 1