Healthcare Risk GroupProj

My Part:

Section B (Verification and Review): Simulate the process of obtaining and verifying information. Use online resources to validate data, documenting findings on the checklist.

Note: When verifying the educational qualifications of a job applicant, it is essential to ensure that the information provided in their resume is accurate. For instance, if the resume claims that the applicant attended Florida State College or the University of Texas School of Medicine, you can cross-check this information by visiting the official website of the institution in question. Suppose the website clearly states that the institution does not have a School of Medicine. In that case, you should proceed to element B of the verification process and deny the applicant’s hiring.

Do not call institutions for verification purposes. In real life, the institution would provide certified documents to confirm the applicant’s education.

Review each resume’s checklist sections, documenting actions taken in the “Note” column with a maximum of two (2) sentences. If unable to perform a specific activity, describe the appropriate process.
Include initiation and finalization dates for each action, demonstrating the timeline of the credentialing process.
Provide a summary statement, limited to five (5) sentences, indicating whether each candidate was hired and the reasons behind the decision.

Alice Wilson, DNP, MSN, RN, NEA‐BC

2913 Kerry Forest Parkway, D4 Box 189 Tallahassee, Florida 32310

Cell 50.769.2268

FL License #9241700

EDUCATIONAL PREPARATION:

DNP, Doctor of Nursing Practice, University of North Florida, Tampa, FL December, 2011

MSN, Nursing Administration, Indiana University Purdue University, Indianapolis, IN 1996

BLS, Liberal Studies, Purdue University, W. Lafayette, IN, 1989

Diploma, Nursing, St. Bernard’s School of Nursing, New York, New York, 1971

PROFESSIONAL EXPERIENCE:

February, 2011‐February, 2017, Dean of Healthcare Professions, Gainesville Community College, Tallahassee, FL

June, 2008‐February, 2011 Director of Nursing, Tallahassee Community College, Tallahassee, FL

February, 2006‐June 2008 Director of Nursing, Florida Community College at Jacksonville (FCCJ) (now Florida State College at Jacksonville), Jacksonville, FL

July, 2003‐2006 Associate Dean, Natural Science and Health Division, Highland Community College, Rockford, IL

November, 1995‐June 30, 2003, Director of Nursing, Highland Community College, Freeport, IL

1988‐1994‐nursing faculty, Indiana Vocational Technical College, Gary, IN

1982‐1988‐Director of Nursing, Lakeside Health Center, Michigan City, IN 1981‐82‐staff nurse, scoliosis unit, Rush‐Presbyterian‐St.Luke’s Medical Center,Chicago, IL

1976‐81‐head nurse, Surgery and Addictions units, Memorial Hospital, Michigan City, IN 1974‐76‐staff nurse, Woodview Rehabilitation Center, Michigan City, IN 1972‐74‐school nurse, Gary Community Schools, Gary, IN

1971‐72‐staff nurse, Cardio Thoracic Surgery Unit, Cook County Hospital, Chicago, IL

COMMITTEES:

Academic Planning Committee, Tallahassee Community College, 2013‐present Administrative Effectiveness, Tallahassee Community College, 2013‐present Workforce Development, Tallahassee Community College, Tallahassee, FL, 2011‐13 Safety/Security, Tallahassee Community College, Tallahassee, FL, 2011‐2013 Employee Excellence, Tallahassee Community College, Tallahassee, FL, 2011‐present Academic Affairs Committee, Tallahassee Community College, Tallahassee, FL, 2008‐Present

SACS committee, Tallahassee Community College, Tallahassee, FL, 2010‐11 Community Partnership Council, Baptist Health, Jacksonville, FL 2006‐2008 First Coast Nursing Leaders Consortium, Jacksonville, FL 2006‐2008

AQIP category co‐chair, Highland Community College, 2005‐2006 College Cabinet, Highland Community College, 2003‐2006 Assessment Committee, Highland Community College, 2003‐2006

Curriculum & Instruction Committee, Highland Community College, 2003‐2006 Tax Referendum task force, Highland Community College, 2004

Wellness Committee, co‐chair, Highland Community College, 2003‐2006 Assessment Committee, Highland Community College, 2003‐2006 Strategic Planning, Chair of Leadership sub‐committee, Highland Community

College, 2002‐03

Enrollment Management, Highland Community College, 1997‐2003

Allied Health Advisory Committee/Nursing Advisory Committee, Highland Community College, 1994‐2006

Member of all nursing committees, 1994‐present

A variety of ad hoc committees; college space study, syllabus, faculty evaluation, all at Highland Community College, 1994‐2006

Low enrolled program task force, Chair and author of final report, Highland Community College, 2005

PROFESSIONAL ACTIVITIES:

Tallahassee‐Haiti Medical Team, Board of Trustees, Tallahassee, FL, 2011‐present Council of Advanced Practice Nurses, Tallahassee, FL, 2008‐2012

National Organization for Associate Degree Nursing (NOADN), member, 2001‐present National Organization for Associate Degree Nursing (NOADN), Treasurer, 2001‐2006 Illinois Organization for Associate Degree Nursing (IOADN), President, 2000‐03

Illinois Associate Degree Directors Council, President‐elect, 2004‐2006 Health Education Systems, Inc., Advisory Board member, 2002‐2006

National Organization for Associate Degree Nursing (NOADN), member 2001‐present Illinois Practical Nursing Directors Council, President, 2001‐2004

Illinois Associate Degree Directors Council, member, 1994‐2006

PRESENTATIONS:

19TH International Conference on College Teaching and Learning, Jacksonville, FL, “Create a Sensation with Raps and Songs”, April 15, 2008, collaboration with Susan Schultz, MS, RN, CCRN

COMMUNITY INVOLVEMENT:

Board Member, Capital Regional Medical Center, Key West, FL, 2012‐16

Tallahassee‐Haiti Project, Tallahassee, FL 2010‐present

Advisory Board, The Monroe Clinic, Monroe, WI, 1999‐2006

Advisory Committee, Rock Valley College Surgical Tech program, 1998‐2006 Advisory Committee, Rock Valley College Dental Hygiene program, 1998‐2006 Board of Directors, Provena‐St.Joseph’s Home Foundation, 1998‐2004 Board of Directors, Sojourn House, 1996‐2006

Resource Development Committee Chair, 1998‐2003

Board of Directors, Stephenson County Health Department, 2003‐2006 Personnel Committee

CERTIFICATIONS:

American Nurses Association, Certified in Nursing Administration, Advanced, (NEA‐BC)‐ 5/07‐5/17

Association of Nursing Executives, Certified in Strategic Leadership, 10/09

RESEARCH:

“New Nurse Residency‐An Evidence Based Approach”, 2009 “Predicting Success on the NCLEX‐PN”, 1995

AWARDS:

2016 Capital Regional Medical Center’s Nurse Excellence Award

2013 Capital Regional Medical Center’s Nurse Excellence Award 2003 Women of Excellence Award, YWCA

2002 Women of Excellence nominee

See below for additional information.

FSCJ – HSA4502 – Module 6 Nurse Resume 2

Hospital of Hope

Addendum to Resume Submission

Name: Alice Wilson

Address: 2913 Kerry Forest Pkwy D4 Box189 City: Tallahassee State: FL Zip: 32310

Phone: 850-766-2265

Enter the requested information:

DEA #: Current state license#: 9241700

Answer the following questions. If yes, provide reason/explanation:

· Have you at any time lost medical professional liability coverage? No__
X__ Yes____

If yes, explain:

· Loss of DEA number? No__
X__ Yes____

If yes, explain:

· Had privileges/suspended or revoked? No_
X___ Yes____

If yes, explain:

· Any claims filed against your liability coverage? No__
X__ Yes____

If yes, explain:

· Any prior professional disciplinary actions? No__
X__ Yes____

If yes, explain:

By initialing I hereby give my consent and agreement to the following actions:

_
AW____ I have received a written copy of the Hospital of Hope applicable rules and regulations.

__
AW___ I agree, in writing, to exhaust administrative internal remedies before litigating adverse credentialing decisions.

__
AW___ I hereby, release Hospital of Hope to conduct a background investigation.

Alice Wilson Alice Wilson

Printed Name Signature

Written Clinical Privilege Request

I hereby request clinical privileges at the Hospital of Hope. I am only requesting privileges for which I my education, training, current experience, and demonstrated performance I am qualified to perform.

Alice Wilson Alice Wilson

Printed Name Signature

CunninghamGroup

Medical Malpractice Insurance Specialists

Certificate Holder(s):
Insured:

Hospital of Hope Alice Wilson
One Hospital Road 2910 Kerry Forest Pkwy D4 Box 189
Jacksonville, FL 32256 Tallahassee, FL 32310

CunninghamGroup of Florida certified that professional liability insurance has been issued to the insured name below for the policy period indicated. The insurance afforded by the policy referenced below is not subject to any requirement or condition of any contract or other obligation.

This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the Policy referred to herein.

Insured: Alice Wilson

Policy Number: CG5678

Policy Period: 1/1/2016 to 12/31/2017

Retroactive Date: 1/1/2018

Limits of Insurance: Each Medical Incident $1,000,000 Aggregate – Policy Period $3,000,000

Policy Type: Permanent Protection Policy

Classification: Physician

·
Limits shown may have been reduced by paid claims

Mr. Big Wig
Mr. Big Wig

CEO CunninghanGroup Mr. Big Wig

Hospital of Hope

Credentialing Checklist
Board Members: (enter the team name and names of team members)

STANDARD TO BE MEASURED

ACTION TAKEN?

DATE

COMMENTS

A: APPLICATION

Name of Applicant:
Alice Wilson

Position Requested:

1. Applicant Identifying Information:

a. name and address

b. education and training

c. prior employment

d. board certifications

e. current state license and Drug Enforcement Administration (DEA) certification, if applicable

f. current competencies (i.e., skills and experience)

g. written statement seeking clinical privileges

h. personal and professional references (minimum of three)

2. Applicant Issues:

a. loss of medical professional liability coverage

b. loss of DEA number

c. suspension/revocation of privileges

d. past claims history

e. criminal charges

f. prior professional disciplinary actions

3. Release for background investigations:

a. Applicant executes a written consent and release from liability, to be attached to every reference inquiry.

b. Applicant is provided a copy of applicable rules and regulations.

c. Applicant agrees in writing to exhaust administrative internal remedies before litigating adverse credentialing decisions.

B: VERIFICATION AND REVIEW

1. Verify completion of education.

2. Ask the director or other authorized responsible party of the applicant’s residency or training program to complete a questionnaire regarding the applicant’s performance and capabilities.

3. Check dates of employment history and document any gaps in employment or appointment.

4. Obtain a copy of applicant’s DEA certificate and state medical license, if applicable.

5. Query the National Practitioner Data Bank and adhere to the requirements of the federal Health Care Quality Improvement Act of 1986.
https://www.npdb.hrsa.gov/index.jsp *

6. Verify the status of existing clinical privileges at other facilities.

7. Check with state and federal regulatory bodies for previous sanctions by Medicare and Medicaid programs.

8. Obtain a copy of applicant’s current medical professional liability insurance certificate, including verification of limits of coverage and claims experience.

9. Verify by telephone all information contained in written references.

C: DELINEATION OF CLINICAL PRIVILEGES

1. Applicant provides the clinical appointment committee with a written request for clinical privileges.

2. Committee processes the written request for clinical privileges based on established protocols and criteria.

3. Committee votes to approve or deny request.

4. Administrative leadership receives committee’s recommendation and makes final decision.

D: REAPPOINTMENT OF CLINICAL PRIVILEGES

1. Reappointment process occurs annually or, at minimum, every two years.

2. Committee verifies and documents the following information upon request for reappointment:

a. any changes in certification, appointment, education or professional accomplishments

b. verification of current license and DEA certification, if applicable

c. any professional disciplinary action taken against applicant

d. medical professional liability insurance coverage and claim experience

e. status with National Practitioner Data Bank, if applicable

E: PERFORMANCE APPRAISAL IS COMPLETED AND INCLUDES THE FOLLOWING INDICATORS:

1. Service usage

a. admissions data

b. drug utilization

c. utilization of lab and radiology services

2. Ratio of completed patient care records to delinquent patient care records

3. Results of member/patient satisfaction survey results

4. Results of quality improvement findings/outcomes for the provider

5. Result(s) of clinical peer-review findings

6. Clinical appointment committee reviews reappointment form and performance appraisal? (If yes when and indicate whether annual or special review)

7. Results of clinical appointment committee review: (Select either a or b below and include comment as to why

a) Reappointment is granted either without change to prior privileges, or with modified privileges? (State which)

b) Reappointment is denied, and applicant is notified via a letter, which also provides information about hearing procedures. (Explain why denied)

For the purpose of this team assignment, this form created and modified from Health Provider Services Organization Checklist.

The complete form can be found at:

Staff Credentialing Checklist Health Providers Service Organization (HPSO)

http://www.hpso.com/risk-education/individuals/articles/Staff-Credentialing-Checklist

Hospital of Hope

Credentialing Checklist
Board Members: (enter the team name and names of team members)

STANDARD TO BE MEASURED

ACTION TAKEN?

DATE

COMMENTS

A: APPLICATION

Name of Applicant:
John Hayden