Medical Staff Forms | Huntington Hospital

WELCOME

On behalf of Huntington Health, the Medical Staff would like extend a warm welcome. Huntington Health stands on its commitment to our community and aims to serve each of our patients with compassion and world-class care. We are happy to have you join our mission. As part of our commitment to quality care, we ask you to carefully read the proctoring information below. It is important that you complete your proctoring requirements on your first patient encounters. Everything you need to do so is on this page. If you have any questions or concerns, please do not hesitate to reach out to the Proctoring Coordinator, Tess Arellano, CPCS – [email protected].

Requirements:

As a newly appointed provider, your first patient encounters (admissions, consults or surgical procedures) must be proctored in accordance with your delineation of privilege form. If you fail to satisfy your department’s proctoring requirements, the privileges will be deemed expired. A copy of the proctoring policy, a list of eligible proctors and the proctoring evaluation forms are located below. It is the physician’s responsibility to contact the proctor and assure the proctor forms have been submitted to the Medical Staff Office.

Guidelines:

Privilege specific proctoring requirements are listed on the delineation of privilege form sent to you with your Board of Trustees approval letter.
Proctoring shall consist of concurrent/direct as well as retrospective/indirect review.
Proctoring must be performed by at least two (2) different proctors, with no more than 50% by practice associates. Only Active Staff members are eligible to proctor. See below for a list of eligible providers.
Fifty percent (50%) of satisfactory reciprocal proctoring from another hospital is acceptable IF the proctor has privileges at the Hospital for privilege(s) being proctored, and is not subject to proctoring for the privileges he/she is proctoring at HH. Proctoring completed at the Huntington Ambulatory Surgery Center (HASC) is acceptable.

Submission:

Please have your proctors submit to [email protected] for review and approval by the Section/Department Chair. If you have any questions or concerns, please contact Tess Arellano in the Medical Staff Office 626.397.8725 or email [email protected].

Proctor Policy:

Proctor Policy
AHP Rules and Regulations – Proctoring (Section 32)

Proctor Evaluation Forms:

AHP Evaluation Forms

Eligible Proctors:

Physicians: Roster by Department
Allied Health Professionals – AHPs are proctored by the supervising physician

Additional Proctor Forms:

Proctor Extension Form